Anna K. Forsman

Social capital as a resource for mental well-being in older people: A systematic review

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 Bronfenbrenners 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.

Psychosocial interventions for the prevention of depression in older adults: systematic review and meta-analysis

Objectives: To assess the effectiveness of psychosocial interventions for the prevention of depression in older people. Method: Systematic review and meta-analysis of prospective controlled trials. Results: 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. Discussion: 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.

The state of the art in European research on reducing social exclusion and stigma related to mental health: A systematic mapping of the literature

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.

ROAMER: roadmap for mental health research in Europe.

Despite the high impact of mental disorders in society, European mental health research is at a critical situation with a relatively low level of funding, and few advances been achieved during the last decade. The development of coordinated research policies and integrated research networks in mental health is lagging behind other disciplines in Europe, resulting in lower degree of cooperation and scientific impact.

Structural and cognitive social capital and depression among older adults in two Nordic regions

Objective: To study the association between structural and cognitive aspects of social capital and depression among older adults in two Nordic regions. Method: 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. Results: 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. Conclusion: 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.

Research priorities for public mental health in Europe: recommendations of the ROAMER project

BACKGROUND The ROAdmap for MEntal health Research in Europe project aimed to create an integrated European roadmap for mental health research. Leading mental health research experts across Europe have formulated consensus-based recommendations for future research within the public mental health field. METHODS Experts were invited to compile and discuss research priorities in a series of topic-based scientific workshops. In addition, a Delphi process was carried out to reach consensus on the list of research priorities and their rank order. Three web-based surveys were conducted. Nearly 60 experts were involved in the priority setting process. RESULTS Twenty priorities for public mental health research were identified through the consensus process. The research priorities were divided into summary principles-encompassing overall recommendations for future public mental health research in Europe-and thematic research priorities, including area-specific top priorities on research topics and methods. The priorities represent three overarching goals mirroring societal challenges, that is, to identify causes, risk and protective factors for mental health across the lifespan; to advance the implementation of effective public mental health interventions and to reduce disparities in mental health. CONCLUSIONS The importance of strengthening research on the implementation and dissemination of promotion, prevention and service delivery interventions in the mental health field needs to be emphasized. The complexity of mental health and its broader conceptualisation requires complementary research approaches and interdisciplinary collaboration to better serve the needs of the European population.

Cognitive components of social capital and mental health status among older adults: A population-based cross-sectional study:

Aims: To determine the associations between the cognitive aspects of social capital and mental health status in older adults. Methods: 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. Results: 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. Conclusions: 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.

Psychosocial Links Between Internet Use and Mental Health in Later Life: A Systematic Review of Quantitative and Qualitative Evidence:

Research on the role of information and communication technology (ICT) use for active aging is limited. The aim of this systematic review is to investigate the link between Internet use and mental health among older adults. The review was conducted based on searches in 9 electronic databases (2002-2014). A meta-synthesis approach was applied, examining quantitative (18) and qualitative (14) studies. The findings from the synthesis of quantitative statistical data indicate an overall positive association between Internet use and mental health and its psychosocial covariates in later life. The psychosocial links between Internet use and mental health identified from the qualitative data were (a) enhanced interpersonal interaction at individual level, (b) increased access to resources within the community, and (c) empowered social inclusion at society level. The results highlight the multi-level psychosocial links between Internet use and mental health, which may be applied in initiatives targeting healthy aging in various settings.

Public mental health research in Europe: A systematic mapping for the ROAMER project

BACKGROUND As part of the ROAMER (ROAdmap for MEntal health Research in Europe) project, aiming to create an integrated European roadmap for mental health research, we set out to map the hitherto unmapped territory of public mental health research in Europe. METHODS Five electronic databases (CINAHL, Health Management, Medline, PsycINFO, Social Services Abstracts) were used for identifying public mental health research articles published between January 2007 and April 2012. The number of publications for each European country in five research domains (i.e. mental health epidemiology, mental health promotion, mental disorder prevention, mental health policy and mental health services) was analysed by population size and gross domestic product (GDP), and mean impact factors were compared. RESULTS In all, 8143 unique publications were identified. Epidemiology research dominates public mental health research, while promotion, prevention and policy research are scarce. Mental health promotion is the fastest growing research area. Research targeting older adults is under-represented. Publications per capita were highest in northwestern Europe, and similar trends were found also when adjusting the number of publications by GDP per capita. The most widely cited research origins from Italy, Switzerland, the UK, the Nordic countries, the Netherlands, Greece and France. CONCLUSION In Europe, public mental health research is currently a matter of the affluent northern and western European countries, and major efforts will be needed to promote public mental health research in south and east Europe. In spite of a smaller public mental health research output, some Mediterranean countries produce highly cited public mental health research.

Social capital as a health resource in later life : the relevance of context

1. Healthy ageing: focus on social capital: Fredrica Nyqvist, Anna K. Forsman.- Part I Social capital and health as a resource for the individual: 2. Social network type and health among older Americans: Sharon Shiovitz-Ezra, Howard Litwin.- 3. Dynamic social capital and mental health in late life: Tal Spalter, Ariela Lowenstein, Noah Lewin-Epstein.- 4. The importance of social capital for health among older people: the Bourdieu perspective: Johanna Muckenhuber, Nathalie Burkert, Franziska Grossschadl, Rasky Eva.- 5. Social capital and neighbourhood in older peoples housing: Anne Gray.- Part II Social capital and health in the neighbourhood context: 6. Influence of living arrangements of community dwelling older adults on the association between social capital and health: Julie A. Norstrand, Allen Glicksman.- 7. Perceived social capital in self-defined urban neighbourhoods as a resource for healthy aging: Roman Kaspar, Frank Oswald, Jakob Hebsaker.- 8. Neighbourhood social capital and womens self-rated health - Is there an age pattern? A multi-level study from Northern Sweden: Malin Eriksson, Nawi Ng.- 9. Building social capital may protect loss of well-being among older people: Jane Murray Cramm, Anna Petra Nieboer.- Part III Social capital and health in various countries: 10. Social capital and self-rated health in older populations in lower- and upper-middle income countries in Africa and Asia: Nawi Ng, Malin Eriksson.- 11. Social participation and health: a cross-country investigation among older Europeans: Nicolas Sirven, Caroline Berchet, Howard Litwin.- 12. Social capital and self-rated health among ageing people in urban and rural locations in Finland and in Europe: Olli Nummela.- 13. The role of welfare states and social capital for self-rated health among older Europeans: Mikael Rostila, Mikael Nygard, Fredrica Nyqvist.- Part IV Implications and recommendations for research and practice: 14. How to manage with related concepts of research on wellbeing and health - a theoretical review with special reference to later life: Sakari Suominen.- 15. Social capital and mental health promotion among older adults: the psychosocial approach: Anna K. Forsman, Johanna Nordmyr.- 16. Concluding remarks: Anna K. Forsman, Fredrica Nyqvist.- Index.