Erminia Colucci

Focus groups can be fun: The use of activity-oriented questions in focus group discussions

Interest in focus group discussions has grown recently, and so has the recognition of them as a valuable method for qualitative data collection. Despite increasing popularity, they are not an easy option, and moderators must find appropriate ways to approach participants to achieve good-quality data. A path to reach this aim is the inclusion in the focus group agenda of some “exercises” (or activity-oriented questions) that are enjoyable and productive supplements to questions. Exercises provide a different way of gathering information and are beneficial, for instance, for more reflective participants. They can help focus the groups attention on the core study topic and also make subsequent comparative analysis more straightforward. They can also be helpful with young people and to discuss sensitive topics. The author describes and provides suggestions for use and examples of several exercises, illustrating their application in a research project investigating the cultural meaning of youth suicide in university students in Italy, India, and Australia.

Evaluation of Mental Health First Aid training with members of the Vietnamese community in Melbourne, Australia

BackgroundThe aim of this project was to investigate in members of the Vietnamese community in Melbourne the impact of Mental Health First Aid (MHFA) training on attitudes to people with mental illness and on knowledge about mental disorders. Our hypotheses were that at the end of the training participants would have increased knowledge of mental disorders and their treatments, and decreased negative attitudes towards people with mental disorders.MethodsRespondents were 114 participants in two-day MHFA training workshops for the Vietnamese community in Melbourne conducted by two qualified MHFA trainers. Participants completed the research questionnaire prior to the commencement of the training (pre-test) and at its completion (post-test). The questionnaires assessed negative attitudes towards people with mental illness (as described in four vignettes), ability to recognise the mental disorders described in the vignettes, and knowledge about how to assist someone with one of these disorders. Responses to open-ended questions were content analysed and coded. To evaluate the effect of the training, answers to the structured questions and to the coded open-ended questions given at pre- and post-test were compared using McNemar tests for dichotomous values and Wilcoxon tests for other scores.ResultsBetween pre- and post-test there was significant improvement in recognition of mental disorders; more targeted and appropriate mental health first aid responses, and reduction in inappropriate first aid responses; and negative attitudes to the people described in the vignettes declined significantly on many items of the stigma scale.ConclusionA two-day, MHFA training course for general members of the Vietnamese community in Melbourne demonstrated significant reductions in stigmatising attitudes, improved knowledge of mental disorders and improved knowledge about appropriate forms of assistance to give to people in the community with mental disorder. There is sufficient evidence to scale up to a population level program for the Vietnamese community, and a need for longitudinal evaluation of such a scaled up program.

The cultural facet of suicidal behaviour: Its importance and neglect

Abstract Culture is a central but debated concept in many disciplines and its complexity may become an even bigger source of argument in Suicidology. In spite of the intricacy of the study of this construct, the paper illustrates that various scholars have recognised the relevance of culture and ethnicity in the understanding of suicidal behaviour. The author provides evidence of the need to pay more attention to the meaning and interpretation of suicide in cross-cultural research and underlines the necessity to establish cultural-sensitive prevention strategies. The paper closes by providing methodological considerations and suggestions for future research on cultural aspects of suicidal behaviour.

In or out? Barriers and facilitators to refugee-background young people accessing mental health services

Refugee young people have been identified as a group with high risk for mental health problems, due to their experience of trauma, forced migration, and stressors associated with settlement. A high prevalence of mental health problems is reported in this group, however some research suggests refugee young people have low rates of mental health service access. There is little information available on barriers and facilitators to mental service delivery for this group. Using data from 15 focus groups and five key informant interviews with a total of 115 service providers from 12 agencies in Melbourne, Australia, this paper explores barriers and facilitators to engaging young people from refugee backgrounds with mental health services. Eight key themes emerged: cultural concepts of mental health, illness, and treatment; service accessibility; trust; working with interpreters; engaging family and community; the style and approach of mental health providers; advocacy; and continuity of care.

Mental Health First Aid guidelines for helping a suicidal person: a Delphi consensus study in Japan.

BackgroundThis study aimed to develop guidelines for how a member of the Japanese public should provide mental health first aid to a person who is suicidal.MethodsThe guidelines were produced by developing a questionnaire containing possible first aid actions and asking an expert panel of 32 Japanese mental health professionals to rate whether each action should be included in the guidelines. The content of the questionnaire was based on a systematic search of the relevant evidence and claims made by authors of consumer and carer guides and websites. The panel members were asked to complete the questionnaire by web survey. Three rounds of the rating were carried and, at the end of each round, items that reached the consensus criterion were selected for inclusion in the guidelines. During the first round, panel members were also asked to suggest any additional actions that were not covered in the original questionnaire (to include items that are relevant to local cultural circumstances, values, and social norms). Responses to these open-ended questions were used to generate new items.ResultsThe output from the Delphi process was a set of agreed upon action statements. The Delphi process started with 138 statements, 38 new items were written based on suggestions from panel members and, of these 176 items, 56 met the consensus criterion. These statements were used to develop the guidelines appended to this article.ConclusionsThere are a number of actions that are considered to be useful for members of the Japanese public when they encounter someone who is experiencing suicidal thoughts or engaging in suicidal behaviour. Although the guidelines are designed for members of the public, they may also be helpful to health professionals working in health and welfare settings who do not have clinical mental health training.

Suicide, Culture, and Society from a Cross-National Perspective

In this article, the authors explored the associations between suicide rates and a large number of sociocultural indexes, within the sociological framework provided by Durkheim and taking into account recent sociological theories. The analyses were performed on a sample of 87 nations and a subsample of posttraditional societies. The authors found strong positive (linear) correlations between suicide rates and measures of secularization, and curvilinear relationships between measures of individualization and suicide rates. Negative associations were found between suicide rates and measures of individualization in a subsample of posttraditional countries. Following the postmodernization and reflexive modernization theories, the authors argue that a new form of individualization is in place in secular–rational societies. This form of individualization exercises a negative effect on suicide rates through its positive influence on social integration and regulation.

Prevention of domestic violence against women and children in low-income and middle-income countries

Purpose of review Violence against women and children is increasingly recognized as an important and urgent public health, social and human rights issue cutting across geographical, socioeconomic and cultural boundaries. There is a large and growing body of literature that demonstrates the negative impact of such violence on the victims mental and physical health, as well as several other consequences on them, their families and communities. However, this literature for the most part comes from the so-called ‘developed countries’. This review, at the opposite, focused on current literature on prevention of domestic/family violence against children and women in low and middle income countries (LMICs). Recent findings Establishing effective prevention programmes for domestic violence against women and children in LMICs requires an understanding of the sociopolitical, economic and cultural settings and a multilevel collaboration among various stakeholders. Summary This review confirms the lack of research in the so-called ‘developing countries’ and provides suggestions for further research and prevention efforts in this setting.

On the Use of Focus Groups in Cross-Cultural Research

In spite of the diffusion of focus groups method across disciplines and in several areas of research, and although scholars have indicated the utility of this method in cross-cultural research and research with ethnic minority groups, focus groups have been used in this kind of study to a limited extent. One of the reasons for this might be due to the lack of confidence of the researcher in using this kind of method in culturally diverse populations. Being culturally sensitive and, at the same time, pursuing data comparability, makes doing cross-cultural focus groups research a difficult task that necessitates adequate planning and preparation. In this chapter, I present advantages and possible pitfalls of the use of focus groups in cross-cultural research, referring to my recent experience as moderator of focus group discussions in Italy, India and Australia. Suggestions and recommendations for the use of this method with culturally diverse groups are provided, looking at the three phases of the focus groups process: planning, conducting and analysing/reporting.

Mental Health First Aid guidelines for helping a suicidal person: a Delphi consensus study in the Philippines

BackgroundThis study aimed to develop guidelines for how a member of the Filipino public should provide mental health first aid to a person who is suicidal.MethodsThe guidelines were produced by developing a questionnaire containing possible first aid actions and asking an expert panel of 34 Filipino mental health clinicians to rate whether each action should be included in the guidelines. The content of the questionnaire was based on a systematic search of the relevant evidence and claims made by authors of consumer and carer guides and websites. The panel members were asked to complete the questionnaire by web survey. Three rounds of the rating were carried and, at the end of each round, items that reached the consensus criterion were selected for inclusion in the guidelines. During the first round, panel members were also asked to suggest any additional actions that were not covered in the original questionnaire (to include items that are relevant to local cultural circumstances, values, and social norms). Responses to these open-ended questions were used to generate new items.ResultsThe output from the Delphi process was a set of agreed upon action statements. The Delphi process started with 138 statements, 48 new items were written based on suggestions from panel members and, of these 186 items, 102 met the consensus criterion. These statements were used to develop the guidelines appended to this paper. The guidelines are currently being translated into local languages.ConclusionsThere are a number of actions that are considered to be useful for members of the public when they encounter someone who is experiencing suicidal thoughts or engaging in suicidal behaviour. Although the guidelines are designed for members of the public, they may also be helpful to non-mental health professionals working in health and welfare settings.

Indonesian experts' perspectives on a curriculum for psychologists working in primary health care in Indonesia

Mental health is a critical issue in Indonesia, since its population ranks among the top five in the world and the prevalence of common mental disorders is 11.6% of the adult population. However, the need to build an effective mental health-care system that is accessible to the whole population has only been recently addressed. The Aceh tsunami in 2004 brought to the forefront an unexpected window of opportunity to build a mental health-care system. Integration of mental health care into primary health care is a key strategy to close the treatment gap for people with mental disorders. Existing integration of psychologists into primary health care is a big step to meet the shortage of mental health-care specialists. As primary mental health care is an emerging field, the perspectives of Indonesian experts on Indonesian mental health care are needed to develop a curriculum for training psychologists to work in primary health care. In this study, data have been collected through semi-structured interviews with 24 Indonesian mental health experts, and three focus group discussions with 26 psychologists. Overall, experts agreed that to be able to work in primary health-care psychologists should have roles and training ranging from clinical to advocacy skills. Participants also agreed that psychologists should work in the community and contribute to primary health care as service providers and that strong collaborations between psychologists and other primary health-care providers are the key; these can be developed partly through referral and by respecting each others unique strengths.