Roles of Religious and Spiritual Advisors Among Adults in Singapore With Mental Illnesses
ABSTRACT OBJECTIVE Information is limited concerning the role of religious and spiritual advisors in providing help to people with mental illnesses in Singapore. This study examined that role, as well as the satisfaction with and the perceived effectiveness of the services provided, among people with mental health problems. METHODS Data were collected as part of a nationally representative household survey of residents 18 years and older in Singapore. The Composite International Diagnostic Interview, version 3.0, was used to diagnose mental illness as well as to collect information about the mental health services respondents had sought. RESULTS A total of 6,616 respondents completed the survey; in the overall sample, 1.5% reported seeking help from religious or spiritual advisors. This rate increased to 6.6% among those with at least one mental illness, with the prevalence being higher among respondents with lifetime dysthymia, generalized anxiety disorder, or bipolar disorder. Sociodemographic correlates associated with a lower likelihood of consultation with a religious or spiritual advisor included reporting "other" race-ethnicity as well as faith in Buddhism, Hinduism, or Islam. Most respondents who sought help from a religious or spiritual advisor in the last 12 months were satisfied with the help they received, and about half reported it to be very useful. CONCLUSIONS Religious and spiritual advisors are an important source of help for people with mental illness, and a majority of respondents with a mental illness were satisfied with the support they received from these sources.
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ABSTRACT: The Behavioral Model of Health Services Use was initially developed over 25 years ago. In the interim it has been subject to considerable application, reprobation, and alteration. I review its development and assess its continued relevance.Journal of Health and Social Behavior 04/1995; 36(1):1-10. DOI:10.2307/2137284 · 2.72 Impact Factor
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ABSTRACT: Adherence to antidepressant medication is a challenging clinical issue, which reduces treatment efficacy: 30-60% of all patients commencing treatment with antidepressants are estimated to stop taking the medication within the first 12 weeks. Patients' personal beliefs about depression and antidepressants are regarded as central influences on adherence. The aim was to gain detailed insight into patients' personal accounts of depression and use of antidepressant medication and to relate these accounts to the patients' self-reported level of adherence. In-depth, qualitative interviews of 16 depressed patients one, four, eight and twelve months after hospital discharge supplemented by diagnostic interviews and self-report measures. Kleinman's notion of "explanatory model" was used as the theoretical perspective on the patients' illness narratives. Interview transcripts were analysed thematically with "explanatory models" as the starting point. Patients had ambiguous experiences of depression and antidepressants. Patients explained their illness and the medical treatment in experience-near terms. Explanations of the reasons for depression were psychosocial and biology and medicine were not central. However, taking antidepressant medication was a meaningful part of being admitted to hospital, and the adoption of the rhetoric and practices of biomedicine strengthened patients' sense of control and hope for recovery. If medicine was ineffective, the explanatory models legitimised alternative strategies towards recovery, including non-adherence. The patients' reasons for adhering to antidepressants included a range of diverse psychosocial issues, and could be regarded as a central part of their common sense illness management.International journal of nursing studies 05/2012; 49(10):1220-9. DOI:10.1016/j.ijnurstu.2012.04.012 · 2.25 Impact Factor
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ABSTRACT: Although socio-cultural factors have been recognised as an important predictor in shaping help-seeking behaviour, few attempts have been made in this regard to specify the nature and impact of socio-cultural factors such as attitudes and belief systems prevalent in society. We investigated the lay public's attitudes toward help-seeking regarding psychiatric disorders, and their determinants, in a cross-sectional national survey in Germany (n = 1564), using structured interviews with vignettes depicting a person either suffering from depression or from schizophrenia. Two distinct methodological approaches (rating vs ranking) were applied. Public opinion considers mental health professionals helpful in treating schizophrenia but not in the treatment of depression. For depression, public opinion clearly favours the lay support system and believes in involving the family physician if the former resource is exhausted. Determinants of help-seeking recommendations were problem definition, perception of the cause of distress and anticipated prognosis, as well as resentment against mental health professionals. Our results suggest that attitudes and belief systems prevalent in society have a major impact on help-seeking behaviour, both through transmission to the person suffering from mental distress via his/her social network and through the person's own attitudes formed in the process of socialization. Implications are pointed out for the daily work of mental health care providers, health care planning and public discussion of mental health issues.Social Psychiatry and Psychiatric Epidemiology 05/1999; 34(4):202-10. DOI:10.1007/s001270050134 · 2.58 Impact Factor