Pub Date : 2025-10-02DOI: 10.1016/j.ssmmh.2025.100541
Rosario Yslado-Méndez , Stefan Escobar-Agreda , Ana L. Vilela-Estrada , David Villarreal-Zegarra , Junior Duberli Sánchez-Broncano , Jovanna Hasel Olivares Cordova , Wilfredo Manuel Trejo Flores , Claudia Alvarez-Yslado , Leonardo Rojas-Mezarina
Introduction
The design and implementation of digital mental health interventions (DMHI) requires understanding users' attitudes and perceptions to enhance acceptance in practice. In Peru's university settings, this remains underexplored.
Objective
To identify coping strategies, attitudes toward mental health, and perceptions of implementing DMHI among members of a public university in Peru.
Methods
A qualitative phenomenological study with purposive sampling was conducted with 34 participants: 10 students, 10 faculty members, 10 administrative staff, and 4 institutional policy decision-makers from a public university in Peru. Semi-structured interviews were used to collect data, and thematic and content analysis was performed to identify patterns and categories.
Results
Participants reported various coping strategies, most commonly seeking professional help and social interaction. Although most consider mental health essential, economic barriers and negative experiences hinder adherence to services. Virtual care during the pandemic was positively valued for continuity and convenience, although some expressed doubts about its effectiveness compared to in-person care.
Conclusions
In a public Andean university, there is openness to digital solutions for managing mental health, yet barriers persist related to cost, privacy, and connectivity. Universities should strengthen workforce training and advance context-tailored DMHI efforts within the campus setting.
{"title":"Perceptions, beliefs, and attitudes toward mental health and the implementation of digital mental health interventions in a university community in an Andean region: A qualitative study","authors":"Rosario Yslado-Méndez , Stefan Escobar-Agreda , Ana L. Vilela-Estrada , David Villarreal-Zegarra , Junior Duberli Sánchez-Broncano , Jovanna Hasel Olivares Cordova , Wilfredo Manuel Trejo Flores , Claudia Alvarez-Yslado , Leonardo Rojas-Mezarina","doi":"10.1016/j.ssmmh.2025.100541","DOIUrl":"10.1016/j.ssmmh.2025.100541","url":null,"abstract":"<div><h3>Introduction</h3><div>The design and implementation of digital mental health interventions (DMHI) requires understanding users' attitudes and perceptions to enhance acceptance in practice. In Peru's university settings, this remains underexplored.</div></div><div><h3>Objective</h3><div>To identify coping strategies, attitudes toward mental health, and perceptions of implementing DMHI among members of a public university in Peru.</div></div><div><h3>Methods</h3><div>A qualitative phenomenological study with purposive sampling was conducted with 34 participants: 10 students, 10 faculty members, 10 administrative staff, and 4 institutional policy decision-makers from a public university in Peru. Semi-structured interviews were used to collect data, and thematic and content analysis was performed to identify patterns and categories.</div></div><div><h3>Results</h3><div>Participants reported various coping strategies, most commonly seeking professional help and social interaction. Although most consider mental health essential, economic barriers and negative experiences hinder adherence to services. Virtual care during the pandemic was positively valued for continuity and convenience, although some expressed doubts about its effectiveness compared to in-person care.</div></div><div><h3>Conclusions</h3><div>In a public Andean university, there is openness to digital solutions for managing mental health, yet barriers persist related to cost, privacy, and connectivity. Universities should strengthen workforce training and advance context-tailored DMHI efforts within the campus setting.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"8 ","pages":"Article 100541"},"PeriodicalIF":2.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-29DOI: 10.1016/j.ssmmh.2025.100538
Kelly McDermott , Michaela F. George , David G. Blumenkrantz
Purpose
Mental health in young adults and widespread social disconnection are two intersecting crises seen in the U.S. We examine the impact of individualist cultural values in the U.S. on these crises and explore how traditional cultures have leveraged the sensitive period of adolescence to support mental health and social cohesion through coming-of-age rites of passage.
Methods
In this retrospective study, young adults were emailed a survey asking about their adolescent experiences of coming-of-age rites of passage and their current physical health, mental health and coping ability. We looked at associations between rites of passage experiences and outcomes in the n = 860 young adults who completed the survey.
Results
Having diverse rites of passage experiences was not associated with later outcomes, however, we did see associations between several individual experiences and outcomes. Having a connection with nature or the larger universe, giving something up from childhood and getting something symbolic of the transition were all significantly associated with outcomes.
Discussion
This paper explores how coming-of-age rites of passage can address the mental health and social disconnection crises in the U.S., setting the stage for more rigorous investigation of the topic. We recommend leveraging existing rites of passage programs and facilitators to help generate hypotheses, and to use more robust methods to identify mechanisms of action towards building multilevel rites of passage interventions to improve mental health and social connection.
{"title":"Remembering the way forward: How traditional and indigenous coming of age rites of passage can support mental health and social connection in the U.S","authors":"Kelly McDermott , Michaela F. George , David G. Blumenkrantz","doi":"10.1016/j.ssmmh.2025.100538","DOIUrl":"10.1016/j.ssmmh.2025.100538","url":null,"abstract":"<div><h3>Purpose</h3><div>Mental health in young adults and widespread social disconnection are two intersecting crises seen in the U.S. We examine the impact of individualist cultural values in the U.S. on these crises and explore how traditional cultures have leveraged the sensitive period of adolescence to support mental health and social cohesion through coming-of-age rites of passage.</div></div><div><h3>Methods</h3><div>In this retrospective study, young adults were emailed a survey asking about their adolescent experiences of coming-of-age rites of passage and their current physical health, mental health and coping ability. We looked at associations between rites of passage experiences and outcomes in the n = 860 young adults who completed the survey.</div></div><div><h3>Results</h3><div>Having diverse rites of passage experiences was not associated with later outcomes, however, we did see associations between several individual experiences and outcomes. Having a connection with nature or the larger universe, giving something up from childhood and getting something symbolic of the transition were all significantly associated with outcomes.</div></div><div><h3>Discussion</h3><div>This paper explores how coming-of-age rites of passage can address the mental health and social disconnection crises in the U.S., setting the stage for more rigorous investigation of the topic. We recommend leveraging existing rites of passage programs and facilitators to help generate hypotheses, and to use more robust methods to identify mechanisms of action towards building multilevel rites of passage interventions to improve mental health and social connection.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"8 ","pages":"Article 100538"},"PeriodicalIF":2.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-27DOI: 10.1016/j.ssmmh.2025.100518
Deborah J. Moon , Jeesoo Jeon , Amanda Cruce , Hyunjin Lee , Ruijie Ma , Brendan W. Case
Mental health field is shifting toward a greater focus on the presence of mental health beyond the assessment and treatment of mental illness. Flourishing is an emerging concept that captures the ultimate health and well-being in multiple dimensions. The knowledge of youth flourishing is crucial to promoting the mental health of all youths beyond those with mental illness. Despite the increased interest in youth flourishing, limited studies examined flourishing among disadvantaged youth. Moreover, a limited number of validated measures exist that can accurately measure flourishing for marginalized youth of different demographics. This paper presents the results from the Exploratory and Confirmatory Factor Analyses (FA) of the adolescent version of the Flourishing Index using the data collected from youth aging out of foster care (18–24 years old) who participated in the Flourishing After Foster Care study, a national survey of 379 transitional youth aging out of foster care. Additionally, we examined measurement invariance between the transitional youth of different sexes [male (n = 256) vs female (n = 89)], race [White (n = 272) vs youth of color (n = 83)], and sexual orientation [heterosexual (n = 282) vs sexual minority (n = 92)]. The results from the FAs supported a one-dimensional model with 10 items, which showed excellent fit (CFI = 0.985, TLI = 0.980, RMSEA = 0.054, SRMR = 0.021). Measurement invariance was supported based on sex and sexual orientation but not on race. Partial invariance was supported based on race with the exclusion of one item related to delayed gratification. Future research should build on these findings to further explore flourishing indicators for youths across different identities.
{"title":"Measuring flourishing for transitional youth aging out of foster care in the United States: Factor structure and invariance of the flourishing index","authors":"Deborah J. Moon , Jeesoo Jeon , Amanda Cruce , Hyunjin Lee , Ruijie Ma , Brendan W. Case","doi":"10.1016/j.ssmmh.2025.100518","DOIUrl":"10.1016/j.ssmmh.2025.100518","url":null,"abstract":"<div><div>Mental health field is shifting toward a greater focus on the presence of mental health beyond the assessment and treatment of mental illness. <em>Flourishing</em> is an emerging concept that captures the ultimate health and well-being in multiple dimensions. The knowledge of youth flourishing is crucial to promoting the mental health of all youths beyond those with mental illness. Despite the increased interest in youth flourishing, limited studies examined flourishing among disadvantaged youth. Moreover, a limited number of validated measures exist that can accurately measure flourishing for marginalized youth of different demographics. This paper presents the results from the Exploratory and Confirmatory Factor Analyses (FA) of the adolescent version of the Flourishing Index using the data collected from youth aging out of foster care (18–24 years old) who participated in the Flourishing After Foster Care study, a national survey of 379 transitional youth aging out of foster care. Additionally, we examined measurement invariance between the transitional youth of different sexes [male (n = 256) vs female (n = 89)], race [White (n = 272) vs youth of color (n = 83)], and sexual orientation [heterosexual (n = 282) vs sexual minority (n = 92)]. The results from the FAs supported a one-dimensional model with 10 items, which showed excellent fit (CFI = 0.985, TLI = 0.980, RMSEA = 0.054, SRMR = 0.021). Measurement invariance was supported based on sex and sexual orientation but not on race. Partial invariance was supported based on race with the exclusion of one item related to delayed gratification. Future research should build on these findings to further explore flourishing indicators for youths across different identities.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"8 ","pages":"Article 100518"},"PeriodicalIF":2.6,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-27DOI: 10.1016/j.ssmmh.2025.100536
Peter Collings , Elspeth Ready
This paper is an ethnographic description of cannabis use in a Canadian Inuit settlement. Cannabis is pervasive in Inuit communities, and both Inuit and public health authorities see it as a serious health and social problem. There is a general understanding that Inuit smoke cannabis to cope with stressors, but little investigation why Inuit choose cannabis instead of other options for managing stress. We describe how cannabis is a pathway through which cash and information circulate in communities, focusing on how smoking cannabis socially provides culturally appropriate forms of support for men experiencing stress. The interpersonal interactions occurring in the context of social cannabis use suggest persistence of traditional healing practices despite historical suppression, revealing how Inuit understandings of personhood and stress continue to shape how men offer support to one another. The positive social and psychological functions of cannabis, however, exist alongside the negative health effects and the economic and interpersonal consequences of excessive use.
{"title":"“I'd say, ‘smoke a little weed, you'll feel better:’” ethnographic observations of cannabis use in the Canadian Arctic","authors":"Peter Collings , Elspeth Ready","doi":"10.1016/j.ssmmh.2025.100536","DOIUrl":"10.1016/j.ssmmh.2025.100536","url":null,"abstract":"<div><div>This paper is an ethnographic description of cannabis use in a Canadian Inuit settlement. Cannabis is pervasive in Inuit communities, and both Inuit and public health authorities see it as a serious health and social problem. There is a general understanding that Inuit smoke cannabis to cope with stressors, but little investigation why Inuit choose cannabis instead of other options for managing stress. We describe how cannabis is a pathway through which cash and information circulate in communities, focusing on how smoking cannabis socially provides culturally appropriate forms of support for men experiencing stress. The interpersonal interactions occurring in the context of social cannabis use suggest persistence of traditional healing practices despite historical suppression, revealing how Inuit understandings of personhood and stress continue to shape how men offer support to one another. The positive social and psychological functions of cannabis, however, exist alongside the negative health effects and the economic and interpersonal consequences of excessive use.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"8 ","pages":"Article 100536"},"PeriodicalIF":2.6,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This paper presents results of the project “Towards an archive of the historical memory of the struggles and social demands of the Mad Movement”. This movement brings together organisations, associations, groups and activists, platforms of psychiatrised people, who connect through diverse strategies to advance struggles for social justice and recognition in the field of mental health. We understand this movement as an epistemic fraternity promoting a critical conscience in relation to the oppressions experienced by psychiatrised people. The Archive project is a tool available for resistance against epistemic violence. It rescues the oral memory and recovers the intangible heritage related to the social struggles, the associative dynamics and the trajectories of the Mad Movement in Catalonia. Thus, the project is based on a participatory action research approach, framed in Mad Studies, seeking to generate spaces for recognition and visibility in this area, based on the participation and reflection of its protagonists. Based on conversations with activists of movements in first person, it aims to build and activate a narrative that articulates a collective biography linked to the struggles to transform the hegemonic approaches in the field of mental health and denounce its excesses. From the activist narratives collected, we can get to know and recognise the impact and transformative capacity of the movement and how it undoes epistemic injustice through collective action and mutual aid that generate counter-hegemonic agency and epistemic fraternity.
{"title":"The Mad Movement in Catalonia. Epistemic resistance and counter-hegemony in mental health","authors":"Martín Correa-Urquiza , Araceli Muñoz , Elisa Alegre-Agís","doi":"10.1016/j.ssmmh.2025.100533","DOIUrl":"10.1016/j.ssmmh.2025.100533","url":null,"abstract":"<div><div>This paper presents results of the project “Towards an archive of the historical memory of the struggles and social demands of the Mad Movement”. This movement brings together organisations, associations, groups and activists, platforms of psychiatrised people, who connect through diverse strategies to advance struggles for social justice and recognition in the field of mental health. We understand this movement as an epistemic fraternity promoting a critical conscience in relation to the oppressions experienced by psychiatrised people. The Archive project is a tool available for resistance against epistemic violence. It rescues the oral memory and recovers the intangible heritage related to the social struggles, the associative dynamics and the trajectories of the Mad Movement in Catalonia. Thus, the project is based on a participatory action research approach, framed in Mad Studies, seeking to generate spaces for recognition and visibility in this area, based on the participation and reflection of its protagonists. Based on conversations with activists of movements in first person, it aims to build and activate a narrative that articulates a collective biography linked to the struggles to transform the hegemonic approaches in the field of mental health and denounce its excesses. From the activist narratives collected, we can get to know and recognise the impact and transformative capacity of the movement and how it undoes epistemic injustice through collective action and mutual aid that generate counter-hegemonic agency and epistemic fraternity.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"8 ","pages":"Article 100533"},"PeriodicalIF":2.6,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-23DOI: 10.1016/j.ssmmh.2025.100532
Francis Benedict , Christina V. Mramba , Sylvia Kaaya , Joseph Kimaro , Joy Noel Baumgartner , Max Bachmann
Background
Mental health services in sub-Saharan Africa, including Tanzania, are little studied and hence challenges and opportunities are not well known, leading to difficulties in improving access to, and quality of, services to those in need.
Objectives
1.
To conduct a situational analysis of mental health services in Dar es Salaam region,
2.
To consult with key stakeholders on mental health services delivery and planning, and
3.
To develop a regional mental health services plan.
Methods
This was a mixed-methods study, using the PRIME situational analysis tool, which provided a quantitative overview of mental health service needs, resources and activities. We conducted individual in-depth interviews (IDI, n = 5) with regional mental health service managers, and focus group discussions (FGD, n = 7) with 29 mental healthcare workers at primary healthcare facilities. We led a workshop with regional mental health service managers to discuss findings and to develop a regional mental healthcare services plan.
Results
The situational analysis identified a large burden of mental health care needs, but also a variety of health care services and providers in the region. The IDIs and FGDs found inadequate health facilities and staff providing mental health services, ineffective implementation of mental health policy regarding user fee exemptions and cost sharing, stigma in the community, and low community awareness. The financial burdens on patients were lower if patients were covered by health insurance, but health insurance has limitations regarding medication provision. The regional mental health plan proposes strengthening mental health services by integrating them into primary health care facilities, training health providers and other workers on mental health issues, strengthening referral systems, and increasing government and social insurance funding.
Conclusion
Despite barriers hindering mental health service provision in Dar es Salaam, there are positive factors that could potentially make mental health delivery more effective and sustainable. Financial and human resource constraints will limit such developments. Implementation of the regional plan will require ongoing engagement with stakeholders, but has the potential to enhance access to and improve quality of mental health care in the region.
背景：在撒哈拉以南非洲，包括坦桑尼亚，对精神卫生服务的研究很少，因此人们对挑战和机遇并不了解，导致在向有需要的人提供更好的服务和提高服务质量方面存在困难。2.对达累斯萨拉姆地区的精神卫生服务进行情景分析；2 .与主要利益攸关方就精神卫生服务的提供和规划进行磋商；制定区域精神卫生服务计划。方法采用综合方法，运用PRIME情景分析工具，对心理卫生服务需求、资源和活动进行定量分析。我们对地区精神卫生服务经理进行了个人深度访谈（IDI, n = 5），并对29名初级卫生保健机构的精神卫生工作者进行了焦点小组讨论（FGD, n = 7）。我们主持了一个区域精神卫生服务经理研讨会，讨论调查结果并制定区域精神卫生服务计划。结果通过情景分析，确定了该地区心理卫生保健负担较大，同时也存在多种卫生保健服务和提供者的需求。调查发现，提供精神卫生服务的卫生设施和工作人员不足，关于免除用户费用和分担费用的精神卫生政策执行不力，在社区中受到污名化，以及社区意识低下。如果病人有健康保险，病人的经济负担就会减轻，但健康保险在提供药物方面有限制。区域精神卫生计划建议通过将精神卫生服务纳入初级卫生保健设施、就精神卫生问题培训卫生提供者和其他工作人员、加强转诊系统以及增加政府和社会保险资金来加强精神卫生服务。结论尽管达累斯萨拉姆的精神卫生服务提供存在障碍，但仍有积极因素可能使精神卫生服务更加有效和可持续。财政和人力资源的限制将限制这种发展。该区域计划的实施将需要与利益攸关方的持续接触，但有可能增加本区域获得精神卫生保健的机会并提高其质量。
{"title":"Developing a regional mental health plan for Dar es Salaam, Tanzania: Results from a situational analysis, qualitative inquiry, and stakeholder engagement process","authors":"Francis Benedict , Christina V. Mramba , Sylvia Kaaya , Joseph Kimaro , Joy Noel Baumgartner , Max Bachmann","doi":"10.1016/j.ssmmh.2025.100532","DOIUrl":"10.1016/j.ssmmh.2025.100532","url":null,"abstract":"<div><h3>Background</h3><div>Mental health services in sub-Saharan Africa, including Tanzania, are little studied and hence challenges and opportunities are not well known, leading to difficulties in improving access to, and quality of, services to those in need.</div></div><div><h3>Objectives</h3><div><ul><li><span>1.</span><span><div>To conduct a situational analysis of mental health services in Dar es Salaam region,</div></span></li><li><span>2.</span><span><div>To consult with key stakeholders on mental health services delivery and planning, and</div></span></li><li><span>3.</span><span><div>To develop a regional mental health services plan.</div></span></li></ul></div></div><div><h3>Methods</h3><div>This was a mixed-methods study, using the PRIME situational analysis tool, which provided a quantitative overview of mental health service needs, resources and activities. We conducted individual in-depth interviews (IDI, n = 5) with regional mental health service managers, and focus group discussions (FGD, n = 7) with 29 mental healthcare workers at primary healthcare facilities. We led a workshop with regional mental health service managers to discuss findings and to develop a regional mental healthcare services plan.</div></div><div><h3>Results</h3><div>The situational analysis identified a large burden of mental health care needs, but also a variety of health care services and providers in the region. The IDIs and FGDs found inadequate health facilities and staff providing mental health services, ineffective implementation of mental health policy regarding user fee exemptions and cost sharing, stigma in the community, and low community awareness. The financial burdens on patients were lower if patients were covered by health insurance, but health insurance has limitations regarding medication provision. The regional mental health plan proposes strengthening mental health services by integrating them into primary health care facilities, training health providers and other workers on mental health issues, strengthening referral systems, and increasing government and social insurance funding.</div></div><div><h3>Conclusion</h3><div>Despite barriers hindering mental health service provision in Dar es Salaam, there are positive factors that could potentially make mental health delivery more effective and sustainable. Financial and human resource constraints will limit such developments. Implementation of the regional plan will require ongoing engagement with stakeholders, but has the potential to enhance access to and improve quality of mental health care in the region.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"8 ","pages":"Article 100532"},"PeriodicalIF":2.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-23DOI: 10.1016/j.ssmmh.2025.100531
Lisa Bormans, Baldwin Van Gorp
Background
In Western Europe, dementia is commonly portrayed in media as a societal burden, emphasizing economic costs and loss of personhood. The goal of this research is to nuance those representations by focusing on the personal experiences of people living with dementia (PLWD) and their interpretations of the condition.
Aims
This study examines which and how aspects of lived experiences inform meaning-making (RQ1) and how this meaning-making relates to cultural perspectives represented in media (RQ2).
Methods
Semi-structured in-depth interviews were conducted with 24 PLWD in Belgian care centers. Guided by interpretivism, reflexive thematic analysis was used, inductively for RQ1 and deductively for RQ2.
Results
The study identifies six interconnected factors in the participants’ lived experiences that shape their meaning-making: illness insight, self-concept, functional and physical changes, coping, social support, and prejudice and stigma. The personal meaning-making of PLWD reveals a nuanced mix of problematizing and de-problematizing perspectives, with the balance influenced by individual and social factors. This stands in stark contrast with the often one-sided media frames.
Conclusion
Meaning-making in dementia is not a passive reproduction of dominant cultural narratives, but an active process shaped by personal experiences, self-concept, and social context. The Meaning-Making of Dementia (MMoD) Model introduced in this study offers a framework to understand this process more fully. It may inform care practices by highlighting how different factors interact in shaping how dementia is understood. Supporting these elements could help foster more coherent and less distressing interpretations of the condition.
{"title":"The Meaning-Making of Dementia (MMoD) model: How people living with dementia navigate lived experience and cultural frames","authors":"Lisa Bormans, Baldwin Van Gorp","doi":"10.1016/j.ssmmh.2025.100531","DOIUrl":"10.1016/j.ssmmh.2025.100531","url":null,"abstract":"<div><h3>Background</h3><div>In Western Europe, dementia is commonly portrayed in media as a societal burden, emphasizing economic costs and loss of personhood. The goal of this research is to nuance those representations by focusing on the personal experiences of people living with dementia (PLWD) and their interpretations of the condition.</div></div><div><h3>Aims</h3><div>This study examines which and how aspects of lived experiences inform meaning-making (RQ1) and how this meaning-making relates to cultural perspectives represented in media (RQ2).</div></div><div><h3>Methods</h3><div>Semi-structured in-depth interviews were conducted with 24 PLWD in Belgian care centers. Guided by interpretivism, reflexive thematic analysis was used, inductively for RQ1 and deductively for RQ2.</div></div><div><h3>Results</h3><div>The study identifies six interconnected factors in the participants’ lived experiences that shape their meaning-making: illness insight, self-concept, functional and physical changes, coping, social support, and prejudice and stigma. The personal meaning-making of PLWD reveals a nuanced mix of problematizing and de-problematizing perspectives, with the balance influenced by individual and social factors. This stands in stark contrast with the often one-sided media frames.</div></div><div><h3>Conclusion</h3><div>Meaning-making in dementia is not a passive reproduction of dominant cultural narratives, but an active process shaped by personal experiences, self-concept, and social context. The <em>Meaning-Making of Dementia</em> (MMoD) <em>Model</em> introduced in this study offers a framework to understand this process more fully. It may inform care practices by highlighting how different factors interact in shaping how dementia is understood. Supporting these elements could help foster more coherent and less distressing interpretations of the condition.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"8 ","pages":"Article 100531"},"PeriodicalIF":2.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Interventions aimed at enhancing the reflective capacity of parents and carers (their ability to think about their own and their child's mental states, and how these underpin behaviour) aim to improve the quality of the carer-child relationship and child wellbeing. Evaluating how implementation of such interventions for foster carers interacts with the wider context of social care is vital for understanding how intervention mechanisms function. The Reflective Fostering Programme (RFP) is a mentalization-based, psycho-educational intervention delivered across 10 sessions to groups of 5–10 foster carers. Video-recordings of sessions were collected between April 2020 and December 2023 in three sites taking part in a randomised controlled trial in the United Kingdom. Group size in our sample ranged from 5 to 8 people (18 in total). Most participants were foster carers (n = 16), with the remaining (n = 2) kinship or connected carers. In close alignment with the demographic characteristics of carers in the UK, the majority (n = 15) were female, and White British (n = 17). Drawing on Goffman's concept of ‘face threat’, we used conversation analysis to examine the enactment of reflective fostering mechanisms within sessions to explore how the wider children's social care system shaped implementation and mechanisms of change. The development of supportive and trusting group dynamics was critical for facilitating engagement and participation with RFP. However, a supportive dynamic was contingent on carers navigating ‘interactional dilemmas’ to manage face-threatening risks to their personal and professional reputations. Active engagement with RFP relied on successful mitigation of these face-threats. In doing so, an interactional space was afforded for carers to practise and develop their reflective capacity. These findings highlight how implementation of RFP and other group-based foster care interventions need to carefully consider pre-existing relationships, the distribution of power, and strategies for creating a space for carers to overcome potential face-threatening risks and share difficult experiences. Social care services can facilitate implementation by creating a supportive environment which acknowledges and validates carer stress and vulnerability.
{"title":"Group dynamics in the delivery of the Reflective Fostering Programme: managing ‘face-threat’ risks in a mentalization-based intervention for foster carers","authors":"Po Ruby , Carys Seeley , Thando Katangwe-Chigamba , Adaku Anyiam-Osigwe , Caroline Cresswell , Karen Irvine , Nick Midgley , Jamie Murdoch","doi":"10.1016/j.ssmmh.2025.100523","DOIUrl":"10.1016/j.ssmmh.2025.100523","url":null,"abstract":"<div><div>Interventions aimed at enhancing the reflective capacity of parents and carers (their ability to think about their own and their child's mental states, and how these underpin behaviour) aim to improve the quality of the carer-child relationship and child wellbeing. Evaluating how implementation of such interventions for foster carers interacts with the wider context of social care is vital for understanding how intervention mechanisms function. The Reflective Fostering Programme (RFP) is a mentalization-based, psycho-educational intervention delivered across 10 sessions to groups of 5–10 foster carers. Video-recordings of sessions were collected between April 2020 and December 2023 in three sites taking part in a randomised controlled trial in the United Kingdom. Group size in our sample ranged from 5 to 8 people (18 in total). Most participants were foster carers (n = 16), with the remaining (n = 2) kinship or connected carers. In close alignment with the demographic characteristics of carers in the UK, the majority (n = 15) were female, and White British (n = 17). Drawing on Goffman's concept of ‘face threat’, we used conversation analysis to examine the enactment of reflective fostering mechanisms within sessions to explore how the wider children's social care system shaped implementation and mechanisms of change. The development of supportive and trusting group dynamics was critical for facilitating engagement and participation with RFP. However, a supportive dynamic was contingent on carers navigating ‘interactional dilemmas’ to manage face-threatening risks to their personal and professional reputations. Active engagement with RFP relied on successful mitigation of these face-threats. In doing so, an interactional space was afforded for carers to practise and develop their reflective capacity. These findings highlight how implementation of RFP and other group-based foster care interventions need to carefully consider pre-existing relationships, the distribution of power, and strategies for creating a space for carers to overcome potential face-threatening risks and share difficult experiences. Social care services can facilitate implementation by creating a supportive environment which acknowledges and validates carer stress and vulnerability.</div></div>","PeriodicalId":74861,"journal":{"name":"SSM. Mental health","volume":"8 ","pages":"Article 100523"},"PeriodicalIF":2.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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