[Show abstract][Hide abstract] ABSTRACT: Stigma and social exclusion related to mental health are of substantial public health importance for Europe. As part of ROAMER (ROAdmap for MEntal health Research in Europe), we used systematic mapping techniques to describe the current state of research on stigma and social exclusion across Europe. Findings demonstrate growing interest in this field between 2007 and 2012. Most studies were descriptive (60%), focused on adults of working age (60%) and were performed in Northwest Europe—primarily in the UK (32%), Finland (8%), Sweden (8%) and Germany (7%). In terms of mental health characteristics, the largest proportion of studies investigated general mental health (20%), common mental disorders (16%), schizophrenia (16%) or depression (14%). There is a paucity of research looking at mechanisms to reduce stigma and promote social inclusion, or at factors that might promote resilience or protect against stigma/social exclusion across the life course. Evidence is also limited in relation to evaluations of interventions. Increasing incentives for cross-country research collaborations, especially with new EU Member States and collaboration across European professional organizations and disciplines, could improve understanding of the range of underpinning social and cultural factors which promote inclusion or contribute toward lower levels of stigma, especially during times of hardship.
European Psychiatry 01/2014; in press. · 3.29 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study examined associations between problem gambling and type of gambling
engagement (online, land-based or both), psychological distress, alcohol-related
problems and demographics among male (n ¼ 1438) and female (n ¼ 1546) past-year
gamblers in Western Finland. In this sample, 7.6% of men and 3.1% of women were
screened as problem gamblers. Logistic regression analyses were used to study the
associations for men and women separately. Among men, engaging in both land-based
and online gambling or engaging in online gambling only and psychological distress
increased the risk of problem gambling. Among women, engaging in both land-based
and online gambling and alcohol-related problems were significantly associated with
problem gambling. The findings further highlight the need to consider sex differences
in preventive and treatment initiatives and policies targeting problem gambling. Online
gambling seems to have stronger links with problem gambling, which motivates further
research in the eventual harmfulness of this gambling form.
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to investigate the association between aspects of social capital and loneliness among the very old living at home and in institutional settings.
Half of those aged 85 years, and all 90- and 95-year-olds and older in urban and rural municipalities in northern Sweden and western Finland were invited to participate in a cross-sectional population-based study in 2005-2007. A sample of 483 participants who completed the study was included in the analyses.
Loneliness was experienced by 55% percent of those living in institutional settings often or sometimes and 45% of those living in their own homes. Loneliness was closely related to living alone, to depression, and to region (northern Sweden).
Social capital and loneliness are context dependent (i.e., geographical or living environment). Among the very old, the link between social capital resources and loneliness is also highly influenced by health status.
Journal of Aging and Health 08/2013; · 1.56 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Aim: To assess if older people with higher levels of social capital experience higher levels of sense of mastery than those with lower levels of social capital and to assess whether this association is stronger for retired older people than for older workers. Methods: The data originates from a general population mental health survey conducted among 2610 older people (50 years of age or older) in Finland in 2011. The response rate was 57.1%. The association between sense of mastery, measured by Pearlin's Sense of Mastery Scale, and social capital, measured by social networks, organisational activities, trust, and sense of belonging, were tested by logistic regression analyses. Results: The results showed that older workers experienced greater sense of mastery than retired older people. Trust and neighbourhood belonging were positively associated with sense of mastery. Conclusions: Inequalities in mental wellbeing between older people included in or excluded from the workforce are a public health challenge. Our findings imply that social capital needs to be prioritised as a means for enhancing mental health. More attention should be paid to promote mental wellbeing in retired older people.
Scandinavian Journal of Public Health 08/2013; · 1.97 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Previous research applying quantifiable measurements has established significant positive associations between social capital and mental health in older adults. This study aimed to obtain a deeper understanding of the causal mechanisms of social capital affecting mental wellbeing among older people. The study is based on two independent qualitative data materials collected through two focus group interviews and an open-ended question included in a Finnish population-based postal survey. The findings indicate that informal social contacts such as family members and life-long relationships between friends impact the experienced mental wellbeing among older adults due to shared life events, social support, mutual appreciation and trust, as well as a sense of belonging through common social activities. Hence, this study challenges Putnam's idea of social capital as a collective concept focusing on formal contacts and the benefits on a collective level. In addition, the findings highlight the obstacles specific to older adults in maintaining social networks and participation, which should be considered in order to promote mental health in later life.
Ageing and Society 07/2013; 33(05). · 1.16 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Social capital has previously been reviewed in relation to mental health. However, none have focused specifically on positive aspects of mental health such as mental well-being. This review aimed to explore the relationship between social capital and mental well-being in older people. Ten relevant databases were systematically searched using an extensive search strategy for studies, analyzing the link between social capital and mental well-being. Criteria for inclusion in the systematic review were: the study sample included older people (≥50 years); the study reported a mental well-being outcome; social capital was an exposure variable; and empirical research using quantitative methods and published in English, between January 1990 and September 2011. Eleven studies met the inclusion criteria. Each study was assessed against seven possible exposure measures (structural, cognitive; bonding, bridging, linking; individual, collective). The results showed that all included studies found positive associations between parts of social capital and aspects of mental well-being. Typically, the relationship between social capital and mental well-being differed within as well as between studies. Our results highlight that there is no 'gold standard' of how to measure social capital or mental well-being. Social capital is generated in the interaction between individual and collective life. A possibility for future research is therefore to follow Bronfenbrenner's classical division into macro, meso, and micro levels. We consider family and friends at the micro level to be the key factors in generating social capital and well-being in older people.
Aging and Mental Health 11/2012; · 1.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To study the association between structural and cognitive aspects of social capital and depression among older adults in two Nordic regions.
Data were retrieved from a postal survey targeting older adults aged 65, 70, 75 and 80 years (N=6 838, response rate=64%) residing in the Västerbotten region (Sweden), and the Österbotten region (Finland) in 2010. The associations between structural (measured by frequency of social contact with friends and neighbours) and cognitive (measured by experienced trust in friends and neighbours) aspects of social capital and depression (measured by Geriatric Depression Scale, GDS-4) were tested by logistic regression analyses.
Both low structural and cognitive social capital as defined in the study showed statistically significant associations with depression in older adults. Only experienced trust in neighbours failed to show significant association with depression. In addition, being single and being 80 years of age indicated a higher risk of depression as defined by GDS-4.
The findings underline the connection between adequate levels of both structural and cognitive individual social capital and mental health in later life. They also suggest that the connection differs depending on various network types; the cognitive aspect of relationships between friends was connected to depression, while the connection was not found for neighbours. Further, the oldest age group in the sample (80 years of age) is pointed out as a population especially vulnerable for depression that should not be overlooked in mental health promotion and depression prevention.
Aging and Mental Health 04/2012; 16(6):771-9. · 1.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This report aims to describe the regional population survey on mental health performed in 2008
and to introduce the questions and survey instruments included. The survey was a follow-up from
the population survey completed in 2005.
A large scale development project for the mental health and substance abuse services, the
Ostrobothnia Project, will be implemented in 2005–2014 by the hospital districts of the Vaasa,
South Ostrobothnia and Central Ostrobothnia regions. In addition, the regional depression project
‘Pohjalaiset masennustalkoot’, established by the Vaasa and South Ostrobothnia hospital districts,
acted in the area in 2004–2007. The projects were co-funded by the Finnish Ministry of Social Affairs
and Health. To lay the basis for an evaluation of the outcome and effectiveness of these projects,
a population survey was performed in the spring 2005 in the Ostrobothnia Project area aiming
to define the situation before the project interventions performed. A follow-up was conducted in
spring 2008. The random population sample constituted of 5,000 persons aged 15 to 80 from the
intervention area and another 5,000 persons of same age distribution from the Hospital District of
Southwest Finland, which was set as a control area. The number of inhabitants and the demography
of the Southwest Finland region can be considered similar to the intervention area.
The survey was set to collect information about mental health, attitudes towards mental
disorders and the use of mental health and substance abuse services. Age, sex, municipality, civil
status, basic education, the most advanced degree of education, current main activity, and activities
in associations and societies were set as background questions. Standardized survey instruments
were used in the questionnaire to define different indicators related to mental health. The Pearlin’s
Sense of Mastery scale was used as an indicator for the positive mental health and coping abilities.
The Oslo 3 instrument was used to define the social support. Three items from the RAND-36 health
survey were used to define limitations in psychological role functioning. Respondents’ mental health
was measured with the General Health Questionnaire (GHQ-12) scale and alcohol problems with
the CAGE test. Questions based on the Composite International Diagnostic Interview Short Form
(CIDI-SF) were used for assessing prevalence of major depressive disorder. Use of the social and
health care services for mental health or alcohol problems was studied with the same questions used
in the Finnish Health Examination Study Health 2000. One of the questions included in this survey
for measuring aspects of the social capital has also been used in the Health 2000 study. Respondents’
attitudes towards mental health disorders as well as their knowledge of mental health were examined
with questions that were partly constructed for this survey.
The survey response was 51.6 %. The highest response frequency was achieved in the Vaasa
Hospital District (55.9 %), followed by the other Ostrobothnian hospital districts with somewhat
lower response (ca 52.6 %). The lowest response could be noted in the Hospital District of Southwest
Finland (49.3 %). This could be explained by the fact that no reminder cards (due to financial reasons)
were sent in this hospital district and that the proportion of people with other mother tongue
languages than Finnish and Swedish is high in Southwest Finland, especially in Turku. Questionnaires
in Finnish were sent to these people. An obvious gender difference was noted regarding response
activity; 59.7 % of the women answered the survey, while the comparable number for the men
was only 43.3 %. Regarding the mother tongue of the respondents, the response per cent for the
Swedish-speaking was 61.2 %, while the Finnish-speaking respondents’ response rate was 50 %.
The age group 60-75 was the most active age group in responding. The response activity increased
with age, from 17 to 70 years of age, with a decrease among the respond
01/2012; National Institute for Health and Welfare.
[Show abstract][Hide abstract] ABSTRACT: The aim of this review was to assess the effectiveness of psychosocial interventions for the promotion of mental health and prevention of depression among older people. A systematic review of prospective controlled trials was conducted including 69 studies. The studies were divided into physical exercise, skill training, reminiscence, social activities, group support and multicomponent interventions. Data from 44 trials contributed to a meta-analysis of effectiveness. Overall, psychosocial interventions had a positive effect on quality of life and positive mental health. The pooled interventions also had a statistically significant effect on reduction in depressive symptoms. Social activities significantly improved positive mental health, life satisfaction and quality of life and reduced depressive symptoms. Based on the results of this study, duration of interventions is of importance, since interventions lasting for >3 months exhibited more positive effects compared with shorter interventions. Meaningful social activities, tailored to the older individual's abilities and preferences should be considered in aiming to improve mental health among older people.
Health Promotion International 12/2011; 26 Suppl 1:i85-107. · 1.94 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To determine the associations between the cognitive aspects of social capital and mental health status in older adults.
Data on older people (65 years of age or older, n = 1,102) were retrieved from a general population mental health survey conducted in Finland in 2008. The response rate was 61%. The associations between self-reported depression (measured by the Composite International Diagnostic Interview Short Form, CIDI-SF) or psychological distress (measured by the General Health Questionnaire, GHQ-12) and perceived social support, sense of belonging, and trust were tested by logistic regression analyses.
For the cognitive social capital indicators, difficult access to help from neighbours showed a significant association with depression. Furthermore, not having people to count on, experiencing a lack of concern from other people, and feeling mistrust towards other people were all significantly associated with psychological distress.
Links between mental health and cognitive social capital indicate that social support and trust may be important factors to consider when developing interventions to promote mental health and prevent mental disorders among older adults.
Scandinavian Journal of Public Health 09/2011; 39(7):757-65. · 1.97 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To assess the effectiveness of psychosocial interventions for the prevention of depression in older people.
Systematic review and meta-analysis of prospective controlled trials.
Thirty studies were included. Overall, psychosocial interventions had a small but statistically significant effect on depressive symptoms (17 trials, standardized mean difference = -0.17, 95% CI = -0.31 to -0.03). In comparison with no-intervention controls, social activities were effective in reducing depressive symptoms, but results should be interpreted with caution due to the small number of trials. No statistically significant effect on depressive symptoms was found for physical exercise, skill training, reminiscence, or for multicomponent interventions.
Psychosocial interventions have a small but statistically significant effect in reducing depressive symptoms among older adults. The current evidence base for psychosocial interventions for primary prevention of depression in older people is weak, and further trials warranted especially for the most promising type of interventions evaluated, that is, social activities.
Journal of Aging and Health 10/2010; 23(3):387-416. · 1.56 Impact Factor