Philip Baiden

An assessment of residents’ housing satisfaction and coping in Accra, Ghana

AimThe present paper is an original research that explores housing satisfaction and residents’ ability to cope with day-to-day demands, taking into account other dimensions of housing and sociodemographic factors.Subjects and methodsA cross-sectional survey (n = 562) was randomly administered to residents in three neighbourhoods (Labone, Asylum Down and Nima) in Accra, Ghana. The association between the outcome variables and housing attributes were analysed using logistic regression.ResultsThe findings indicate that housing satisfaction was significantly predicted by age, with older people more likely to be dissatisfied with their housing arrangement. Respondents were dissatisfied with housing arrangements if they lived in Nima [odds ratio (OR) = 2.75, p < .001], Asylum Down (OR = 1.72, p < .01), crowded households (OR = 1.158, p < .05) or in compound houses (OR = 2.50, p < .001). In the context of housing attribute variables, respondent’s ability to cope with day-to-day demands was significantly associated to their income level. Odour annoyance as an indicator of housing condition emerged as a strong predictor of respondent’s inability to cope with daily demands with OR ranging from 1.68 to 2.33. Those who were dissatisfied with the location of their home as a place to live also reported poor coping abilities (OR = 1.86, p < .01).Discussion and conclusionsFrom the findings, government policy on housing should encourage the construction of more affordable housing units to ease the crowding situation in Accra. There is also a need for the Accra City Council to provide clearer guidelines for both tenants and landlords in response to increasing tenancy disputes in context.

Housing and health in Ghana: the psychosocial impacts of renting a home.

This paper reports the findings of a qualitative study investigating the impacts of renting a home on the psychosocial health of tenants in the Accra Metropolitan Area (AMA) in Ghana. In-depth interviews (n = 33) were conducted with private renters in Adabraka, Accra. The findings show that private renters in the AMA face serious problems in finding appropriate and affordable rental units, as well as a persistent threat of eviction by homeowners. These challenges tend to predispose renters to psychosocial distress and diminishing ontological security. Findings are relevant to a range of pluralistic policy options that emphasize both formal and informal housing provision, together with the reorganization and decentralization of the Rent Control Board to the district level to facilitate easy access by the citizenry.

Prescription Medication Misuse Among Adolescents With Severe Mental Health Problems in Ontario, Canada

The purpose of this study was to examine the prevalence of prescription medication misuse among adolescents with severe mental health problems in Ontario, Canada, and to explore some of the factors that influence the misuse of prescription medication. Data were obtained from the Resident Assessment Instrument for Mental Health. A total of 2,677 adolescents between the ages of 12 and 18 years who were admitted into adult mental health beds were analyzed. Logistic regression was used in estimating the likelihood of misusing prescription medication. Overall, 17% of adolescent inpatients misused prescription medication. In the multivariate model, the following were found to be associated with misuse: being female, having multiple psychiatric admissions, education, threat or danger to self, problem with addiction, history of emotional abuse, use of alcohol, past year use of opiates and cannabis, as well as symptoms of depression. Misuse of prescription medication was less likely to occur among adolescents with a diagnosis of schizophrenia and adolescents who were admitted as a result of posing a threat or danger to others. Implications of the findings are discussed with suggestions for future research.

The enduring effects of early-childhood adversities and troubled sleep among Canadian adults: a population-based study

OBJECTIVE Although many studies have consistently found that early-childhood adversities are important risk factors for physical and mental health problems later in adulthood, few have examined the association between early-childhood adversities and troubled sleep. The objective of this study was to examine the association between early-childhood adversities and troubled sleep among adult Canadians. METHODS Data for this paper (N = 19,349) were obtained from Statistics Canadas 2012 Canadian Community Health Survey-Mental Health (CCHS-MH). Logistic regression analysis was conducted to examine the association between early childhood adversities and troubled sleep, while accounting for various sociodemographic, socioeconomic, health, and mental health factors. RESULTS Of the 19,349 respondents examined, 2748 representing 14.2% had troubled sleep. Controlling for sociodemographic, socioeconomic, health, and mental health factors, it was observed that for each additional childhood adversity experienced, the odds of having troubled sleep increased by 10% (odds ratio = 1.10, p <0.001, 95% confidence interval = 1.07-1.13). In addition, psychological distress, older age, being female, being unmarried, being white, a lower annual income, chronic pain, poor perceived health, and mental health difficulties were associated with troubled sleep. CONCLUSION The results of this paper provide population-based evidence for childhood adversities as a major predictor of troubled sleep in adulthood. The long-standing effects of these adversities on sleep highlight the importance of early detection, such as consistent assessment of sleep habits for children, adolescents, and adults, who have experienced childhood adversities, in health and mental health settings.

Examining non-suicidal self-injury among adolescents with mental health needs, in Ontario, Canada.

The objectives of this study were to examine the prevalence of non-suicidal self-injury (NSSI) among adolescents with mental health needs and specific factors associated with NSSI among adolescents aged 14 to 18 years who received mental health services in adult mental health facilities in Ontario, Canada. Data on 2,013 adolescents were obtained from the Ontario Mental Health Reporting System using the Resident Assessment Instrument—Mental Health (RAI-MH) and were analyzed using logistic regression. Approximately, 20.2% (407 adolescents) of the sample engaged in NSSI within the last 12 months. Results from multivariate logistic regression indicate that females were 2.19 times more likely to engage in NSSI than males. Intentional misuse of prescription medication emerged as the most important factor associated with NSSI. Other factors found to be associated with NSSI included multiple psychiatric admissions, sexual abuse, use of alcohol, mood disorders (e.g., depression), adjustment disorders, personality disorders and symptoms of depression. The article discusses the implications of the findings, with suggestions for future research.

An exploratory study of the factors associated with medication nonadherence among youth in adult mental health facilities in Ontario, Canada

Although the issue of medication nonadherence among children and youth appears to be high, there is a paucity of research examining associated factors related to medication nonadherence among youth with mental health difficulties. Using logistic regression, this exploratory study sought to examine specific factors associated with medication nonadherence among youth with mental health needs in Ontario, Canada. Data on 3681 youth between the ages of 12-18 years old were obtained from the Resident Assessment Instrument for Mental Health (RAI-MH). Medication nonadherence was observed among 24.6% of the study population. Multivariate results showed that youth who experienced side effects of psychotropic medication were more than 3 times more likely to have failed to adhere to their medication. Other significant factors contributing to medication nonadherence include age, having multiple psychiatric admissions, limited insight into mental health, and having a disturbed/dysfunctional relationship with immediate family members. Tobacco use, cannabis use, depressive symptoms, and positive symptoms were also associated with medication nonadherence. Our data highlights some of the factors associated with medication nonadherence among youth with mental health needs. Physicians, clinicians and mental health care providers need to consider these factors, particularly when planning for discharge.

Factors associated with the use of intrusive measures at a tertiary care facility for children and youth with mental health and developmental disabilities

This study seeks to identify some of the explanatory factors associated with the use of intrusive measures among children with mental health and developmental disabilities in psychiatric facilities. Intrusive intervention data were collected using an organizational database that was developed internally at a tertiary care facility. The sample was composed of 338 children/youth aged between 6 and 18 years (mean = 12.33, standard deviation = 2.70) admitted within a 2-year period. Logistic regression was used to examine the relationship between chemical restraint, physical restraint and secure isolation, and programme type after controlling for demographic and other relevant client characteristics. The study found that the number of chemical restraints and secure isolations was higher for clients with developmental disabilities than for clients with mental health, whereas the number of physical restraints was lower for clients with developmental disabilities than clients with mental health issues. Demographic variables also predicted specific types of intrusive measures. The results of this study outline the differential factors associated with specific types of intrusive measures to control aggressive and self-harm behaviours. The paper also outlines cultural change initiatives, organizational interventions, and policy implications for best practice services for children/youth in psychiatric facilities to further reduce intrusive measures.

The role of adverse childhood experiences as determinants of non-suicidal self-injury among children and adolescents referred to community and inpatient mental health settings

The objectives of this study were to examine the prevalence of, and determine the effect of adverse childhood experiences on non-suicidal self-injury among children and adolescents referred to community and inpatient mental health settings. Data for this study were obtained from the interRAI Child and Youth Mental Health dataset. A total of 2038 children and adolescents aged 8-18 years (M=12.49; SD=2.88, 61.1% males) were analyzed. Binary logistic regression was fitted to identify predictors of non-suicidal self-injury as a function of adverse childhood experiences, depression, and social support while simultaneously controlling for age, gender, type of patient, legal guardianship, marital status of parents/caregivers, history of foster family placement, and mental health diagnoses. Of the 2038 children and adolescents examined, 592 (29%) of this clinical sample engaged in non-suicidal self-injury. In the multivariate logistic regression model, children and adolescents who were physically abused had 49% higher odds of engaging in non-suicidal self-injury and children and adolescents who were sexually abused had 60% higher odds of engaging in non-suicidal self-injury, when compared to their non-abused counterparts. Other predictors of non-suicidal self-injury include: older age, female gender, inpatient status, depression, attention deficit-hyperactivity disorder, disruptive behavior disorder, and mood disorders. Children and adolescents who had some form of social support had a 26% decrease in the odds of engaging in non-suicidal self-injury. Assessment procedures for indicators of mental health, particularly among children and adolescents with a history of adverse childhood experiences, should also take into account non-suicidal self-injury. In addition to bolstering social support networks, addressing depression and related emotion regulation skills in childhood may help prevent future non-suicidal self-injury behaviors.

Childhood abuse and cannabis use among adolescents with mental health needs in Ontario, Canada

Objective: The purpose of this study was to examine the association between childhood abuse (emotional, physical and sexual abuse) and cannabis use among adolescents with mental health needs. Methods: Data on 3681 adolescent in-patients, 12–18 years old, were obtained from the Resident Assessment Instrument for Mental Health (RAI-MH). Using logistic regression, we estimated the odds of using cannabis by adolescents who experienced childhood abuse after controlling for age, gender, Aboriginal origin, problems with addiction, history of criminal justice involvement and symptoms of depression and mania. Results: There were 1844 adolescents, representing 50.1%, who reported using cannabis within the last 12 months. Controlling for demographic and patient characteristics, we found that cannabis use in the past year was strongly associated with childhood sexual and physical abuse. Compared to non-abused females, females who experienced sexual and physical abuse were more likely to have used cannabis. For males, the experience of physical abuse was marginally associated with cannabis use. Conclusion: The current data demonstrate the strong association between childhood sexual and physical abuse and cannabis use with a particularly strong association for females. Efforts aimed at treating cannabis use in adolescents who present with mental health needs should also consider their abuse histories.

The role of sense of community belonging on unmet health care needs in Ontario, Canada: findings from the 2012 Canadian community health survey

AimThis article examines the association between sense of community belonging and unmet health-care needs among individuals in Ontario, Canada, after adjusting for predisposing, enabling, and need factors associated with health-service use.Subjects and methodsThis study is based on data from Statistics Canada’s 2012 Canadian Community Health Survey. A sample of 21,257 individuals aged 12 and older was analyzed. Logistic regression was conducted to examine the association between sense of community belonging and unmet health-care needs.ResultsThe study found that one in ten individuals reported having unmet health-care needs. Sense of community belonging had a significant independent effect on unmet health-care needs. Respondents with a weak sense of community belonging were 1.27 times more likely to report having unmet health-care needs. Respondents who were younger, were females, had a higher education, or were without a regular doctor were more likely to have unmet health-care needs. Other factors associated with unmet health-care needs included poor physical health, poor mental health, difficulties in carrying out instrumental activities of daily living, and chronic conditions.ConclusionThe findings of this study emphasize the need to develop health-care policies and programs that appropriate and meet the needs of individuals with different health-related problems alongside the need to increase sense of community belonging.