List the parts of a comprehensive mental status examination (MSE) for mental health patients. Give examples of each and describe the significance to the advanced practice nurse.
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Incorporate a minimum of 5 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.
The Role of Mental Illness in Predicting Criminal Behavior Student’s Name: Institutional Affiliation: Course: Instructor: Date: The Role of Mental Illness in Predicting Criminal Behavior According to a study done by Perrotta (2020), a person’s propensity to do criminal acts increases with the severity of their mental condition. People with experience with the criminal justice system in the United States are more likely to develop mental illness than the general population (Perrotta, 2020). Individuals with a history of drug use are more prone to behavioral and cognitive problems and engage in criminal behavior. Research shows that, to a considerable extent, mental illness predicts violent crime, property crime, and violations of public order. Recidivism is also strongly predicted by mental illness. Those with mental illness are more prone than those who do not become victims of crime (Siennick et al., 2022). Furthermore, they are more likely to be arrested and imprisoned. Mental illness is a key predictor of victimization and criminal conduct. Mental illness is a significant public health issue. According to reports, one in every five persons in the United States has a mental illness. Mental illness is linked to a variety of negative effects, including a lower life expectancy, an increased chance of suicide, and an increased risk of victimization. Mental illness is also a significant burden on the economy, costing the United States billions of dollars each year in direct and indirect costs. Mental illness is a significant risk factor for criminal behavior. Early intervention and treatment of a mental illness are critical to preventing crime. Mental illness should be considered in all aspects of the criminal justice system, from policing and sentencing to treatment and rehabilitation. Several arguments posit that mental illness does not predict criminal behavior. These arguments typically focus on one or more of the following: 1. Mental illness is not a significant predictor of crime. 2. Mental illness is not a significant predictor of violent crime. 3. Mental illness is not a significant predictor of recidivism. 4. Victimization is not significantly predicted by mental illness. 5. The frequency of mental diseases is a minor public health problem. 6. Criminal behavior does not increase the likelihood of mental illness much. Typically, the first three reasons highlight the scarcity of evidence between mental illness and criminal behavior. After controlling for all other variables, these arguments highlight that mental illness does not significantly predict crime, violent crime, or recidivism. Argument 4 often emphasizes the shaky link between mental illness and victimization. This argument emphasizes that mental illness is not a reliable predictor of victimization or criminal behavior. Argument 5 emphasizes the paucity of evidence connecting mental illness to poor results. This argument emphasizes that a range of negative consequences, such as a reduced life expectancy, an increased chance of suicide, and an increased risk of victimization, are not always related to mental illness. Argument 6 often emphasizes the scarcity of evidence connecting mental illness to criminal conduct. This argument emphasizes that there is no true link between mental illness and criminal conduct. These are some arguments suggesting that mental illness does not predict criminal behavior. While there is some merit to these arguments, it is essential to remember that mental illness is a significant public health problem and that it is associated with a wide range of adverse outcomes (Siennick et al., 2022). Early intervention and treatment of a mental illness are critical to preventing crime. Mental illness should be considered in all aspects of the criminal justice system, from policing and sentencing to treatment and rehabilitation. Several strategies can be employed to help caregivers, patients, and families with mental illness to reduce instances of criminal arrests. 1. Early intervention and treatment of a mental illness are critical to preventing crime. Mental health interventions should be tailored to the specific needs of the individual. They should be delivered in a way that is culturally competent and responsive to the individual’s unique circumstances. 2. Mental illness should be considered in all aspects of the criminal justice system, from policing and sentencing to treatment and rehabilitation. 3. There should be increased investment in mental health services and supports, including crisis intervention services, to meet the needs of individuals with mental illness. 4. Families and caregivers should be educated about mental illness and its impact on criminal behavior. They should also be provided with support and resources to help them cope with the challenges of caring for someone with mental illness. 5. Individuals with mental illness should be treated with dignity and respect. Stigma and discrimination against mental illness must be addressed to ensure that individuals with it receive the care and treatment they need. These are just a few strategies that can be employed to help reduce the incidence of criminal arrests among individuals with mental illness. It is important to remember that each individual is unique and that not all strategies will work for everyone. It is crucial to tailor interventions and supports to the individual’s needs to be most effective. The working alliance has been shown to predict criminal behavior in those with mental illness significantly. In a study of 265 probationers with mental illness and substance abuse problems, the working alliance was found to moderate reductions in mental illness symptoms and criminal thinking (Scanlon et al., 2022). This suggests that the working alliance is an important factor to consider in treating mental illness and that it can significantly impact reducing criminal behavior. Other studies have also found a correlation between mental illness and criminal behavior. Girasek et al. (2022) found that psychiatric patients are more likely to be aggressors than the general population and that violence is more common in psychiatric settings than previously thought. This research suggests that mental illness can play a role in criminal behavior and that more attention should be paid to the mental health of those involved with the legal system. Overall, the research suggests that mental illness can be a significant factor in predicting criminal behavior. The working alliance appears to be a particularly important factor in treating mental illness and can significantly impact reducing criminal behavior. Often, a person’s mental state may be inferred from their outward actions and behavior. According to the study, a major contributor to the prevalence of mental illness in the corrections system is the erroneous diagnosis of offenders with psychiatric disorders (Lee, Yu, & Kim, 2020). The phrase “mood disorder” originates from psychodynamic theory. Many criminals have a mental condition that manifests in various ways, including sadness, social isolation, wrath, and narcissism. Conduct disorder is also common among juvenile detainees. Children with conduct disorder have trouble paying attention and following directions (Lee, Yu, & Kim, 2020). Many young individuals struggle with mental problems, and conduct disorder is one of the most prevalent. Some youngsters with mental disorders are stigmatized and shunned by their peers because of their behavior problems (Perrotta, 2020). Children may become withdrawn and aggressive as a result of the situation. Children diagnosed with this condition often have a history of exposure to trauma (McCart et al., 2020). Some of these kids may be the result of a failed marriage. Spreading awareness about providing support and shelter for those suffering from mental health issues is crucial if the United States is to prevail in the fight against these diseases. Because of their mental condition, they may be more likely to conduct a crime that causes harm to others. Media outlets should stop characterizing mentally ill persons as “crazy” when reporting on occurrences they create. The US case demonstrates how, if untreated, mental illness may be lethal. In addition, the government should conduct a thorough background check on all applicants for a firearms license to reduce the frequency and severity of mass shootings like those that have occurred in recent decades. Patients and the county would both suffer if they were treated like criminals. References Girasek, H., Nagy, V. A., Fekete, S., Ungvari, G. S., & Gazdag, G. (2022). Prevalence and correlates of aggressive behavior in psychiatric inpatient populations. World journal of psychiatry, 12(1), 1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8783168/ Lee, D., Yu, E. S., & Kim, N. H. (2020). Resilience as a mediator in the relationship between posttraumatic stress and posttraumatic growth among adult accident or crime victims: the moderated mediating effect of childhood trauma. European journal of psychotraumatology, 11(1), 1704563. Full article: Resilience as a mediator in the relationship between posttraumatic stress and posttraumatic growth among adult accident or crime victims: the moderated mediating effect of childhood trauma (tandfonline.com) McCart, M. R., Chapman, J. E., Zajac, K., & Rheingold, A. A. (2020). Community-based randomized controlled trial of psychological first aid with crime victims. Journal of consulting and clinical psychology, 88(8), 681. Community-based randomized controlled trial of psychological first aid with crime victims. – PsycNET (apa.org) Perrotta, G. (2020). Pedophilia: definition, classifications, criminological and neurobiological profiles, and clinical treatments. A complete review. Open Journal of Pediatrics and Child Health, 5(1), 019-026. Pedophilia: Definition, classifications, criminological and neurobiological profiles, and clinical treatments. A complete review (peertechzpublications.com) Scanlon, F., Hirsch, S., & Morgan, R. D. (2022). The relation between the working alliance on mental illness and criminal thinking among justice-involved people with co-occurring mental illness and substance use disorders. Journal of Consulting and Clinical Psychology, 90(3), 282. https://psycnet.apa.org/doi/10.1037/ccp0000719 Siennick, S. E., Picon, M., Brown, J. M., & Mears, D. P. (2022). Revisiting and unpacking the mental illness and solitary confinement relationship. Justice Quarterly, 39(4), 772-801. https://www.tandfonline.com/doi/abs/10.1080/07418825.2020.1871501
j ourna l homepage: www.e lsev ie r .com/ locate / jvb
Outcomes of work–life balance on job satisfaction, life satisfaction and mental health: A study across seven cultures
c
Jarrod M. Haar a,1, Marcello Russo b,⁎,1, Albert Suñe c, Ariane Ollier-Malaterre d
a School of Management, Massey University, Private Bag 102904, North Shore City, New Zealand b Department of Management, KEDGE Business School, 680 Cours de la Liberation, 33405 Talence cedex, Bordeaux, France Department of Management, Universitat Politècnica de Catalunya, Etseiat, C. Colom 11, 08222 Terrassa, Barcelona, Spain
d Organisation and Human Resources Department, École des Sciences de la Gestion, Université du Québec A Montréal, 315, rue Sainte-Catherine Est, local R-3490, Montréal, Québec H2X 3X2, Canada
a r t i c l e i n f o
⁎ Corresponding author. E-mail addresses: j.haar@massey.ac.nz (J.M. Haar), m
(A. Ollier-Malaterre). Denotes shared first authorship.
Article history: Received 22 May 2014 Available online 7 September 2014
This study investigates the effects of work–life balance (WLB) on several individual outcomes across cultures. Using a sample of 1416 employees from seven distinct populations – Malaysian, Chinese, New Zealand Maori, New Zealand European, Spanish, French, and Italian – SEM analysis showed that WLB was positively related to job and life satisfaction and negatively related to anx- iety and depression across the seven cultures. Individualism/collectivism and gender egalitarian- ism moderated these relationships. High levels of WLB were more positively associated with job and life satisfaction for individuals in individualistic cultures, compared with individuals in collec- tivistic cultures. High levels of WLB were more positively associated with job and life satisfaction and more negatively associated with anxiety for individuals in gender egalitarian cultures. Overall, we find strong support for WLB being beneficial for employees from various cultures and for cul- ture as a moderator of these relationships.
Work–life balance (WLB) is a central concern in everyday discourses (Greenhaus & Allen, 2011; Greenhaus, Collins, & Shaw, 2003; Guest, 2002; Kossek, Valcour, & Lirio, 2014; Maertz & Boyar, 2011). However, despite its popularity, WLB remains one of the least stud- ied concepts in work–life research (Greenhaus & Allen, 2011). Valcour (2007) noted that it is “a concept whose popular usage has outplaced its theoretical development” (p. 1513). A reason for this is the field’s struggle to agree on a common definition of WLB (Greenhaus & Allen, 2011). Another reason is that research on the positive individual outcomes of WLB has been relatively slow to accumulate (Greenhaus & Allen, 2011; Maertz & Boyar, 2011). In addition, most of the current studies focus on work–family balance, without considering individuals’ broader lives including community, leisure, church, sport and other activities (Hall, Kossek, Briscoe, Pichler, & Lee, 2013). In this study we work with a relatively consensual definition of WLB as being an individual’s assessment of how well her or his multiple life roles are balanced (e.g. Greenhaus & Allen, 2011; Haar, 2013; Kossek et al., 2014). We aim to contribute to WLB research at solidifying the concept of WLB by examining its relationship with four important individual outcomes: job satisfac- tion, life satisfaction, anxiety, and depression.
Furthermore, we know very little about the impact of cultures on the relationship between WLB and individual outcomes. A recent review of cross-national work–life research has identified only two cross-cultural studies focusing on WLB compared with 29 focusing
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on conflict and nine on enrichment; the only cultural dimension examined in these studies was gender egalitarianism (Ollier- Malaterre, 2014). This is a clear shortcoming of current research given that numerous calls have been issued to broaden the scope and ambition of work–life research by conducting cross-national studies that consider the impact of multiple cultural dimensions (Greenhaus & Allen, 2011; Kossek, Baltes, & Matthews, 2011; Ollier-Malaterre, Valcour, den Dulk, & Kossek, 2013; Poelmans, 2005). In this paper we address this gap by testing whether the relationships between WLB, job satisfaction, life satisfaction, anxiety, and de- pression are moderated by two important cultural dimensions: (1) individualism/collectivism (I/C) and (2) gender egalitarianism (GE). Based on a sample of 1416 employees from seven distinct cultures – Malaysian, Chinese, New Zealand Maori, New Zealand European, Spanish, French, and Italian, we find strong support for direct effects of WLB across all of the study’s samples. We also find moderating effects of I/C and GE on these relationships.
Our study makes three important contributions to the literature. First, we contribute to establish WLB as a solid construct that sheds light on major individual outcomes, thereby encouraging future research on WLB as a way to better understand a complex work–life interface, and encouraging practitioners to assess their employees’ WLB as part of their HR efforts. Second, our study is unique in the burgeoning body of cross-cultural research on the work–life interface (for a review, see Ollier-Malaterre, 2014) since it is the first, to our knowledge, to focus on WLB rather than work–family conflict or work–family enrichment and to have collected evidence that two dimensions of national culture, i.e. I/C and GE, moderate the relationships between WLB and individual outcomes. The finding that WLB has beneficial outcomes for individuals across seven distinct cultures lends further support to the construct of WLB. Third, our study provides evidence that work–life concepts that originated in Western cultures are generalizable beyond these cultures — we do so by including cultures of growing interest in the literature (e.g. Malaysia and China) as well as understudied cul- tures (e.g. New Zealand European and Maori).
2. Theoretical background and hypotheses
2.1. Work–life balance
Consistent with recent theoretical advancements (e.g. Frone, 2003; Greenhaus & Allen, 2011; Haar, 2013; Kossek et al., 2014), we conceptualize WLB as an individual’s perceptions of how well his or her life roles are balanced. This conceptualization of individuals subjectively gauging balance between the work and the rest of their life (Guest, 2002) is in contrast with prevailing views that considered balance to be equivalent to low role conflict (Duxbury & Higgins, 2001), to high role enrichment (Frone, 2003) or to an equal division of time and attention amongst the several roles that compose an individual’s life system (Marks & MacDermid, 1996). Our definition is grounded in the perception-centred approach that considers work–life balance to be a holistic concept, unique for each person and that depends upon his or her life values, priorities and goals (Kossek et al., 2014).
With a few exceptions (see Hill, Yang, Hawkins, & Ferris, 2004; Lyness & Judiesch, 2014), cross-national research has mostly neglected work–life balance. However, there is general consensus amongst scholars that work–life balance is highly valued by nearly all employees (Kossek et al., 2014) and it has important implications on people’s well-being and work productivity all over the world (Lyness & Judiesch, 2014). Interestingly, research conducted by IBM has shown that people’s nationality does not translate in differences in the expressed desire for work–life balance (Hill et al., 2004). Regarding the effects of WLB, extant research shows that people who perceive balance between their work and life roles tend to be more satisfied of their life and report better physical and mental health (Brough et al., 2014; Carlson, Grzywacz, & Zivnuska, 2009; Ferguson, Carlson, Zivnuska, & Whitten, 2012; Greenhaus et al., 2003; Haar, 2013; Lunau, Bambra, Eikemo, Van der Wel, & Dragano, 2014). Building on these premises, in this article we hypothesize, for two reasons, that WLB will be positively related to job and life satisfaction and negatively related to mental health universally for all employees.
First, we believe that individuals who experience WLB may be more satisfied of their job and life “because they are participating in role activities that are salient to them” (Greenhaus et al., 2003; p. 515). Second, we believe that balanced individuals may be mentally healthier because they experience a sense of harmony in life and optimal psychophysiological conditions which enable them to meet the long-term demands of work and nonwork roles (Greenhaus et al., 2003). This may lead them to be less apprehensive about their abilities to conciliate work and nonwork commitments and also less prone to develop ruminating thoughts about the lack of balance in life that can deplete their physical and mental resources (Rothbard, 2001). Accordingly, we hypothesize that the benefits of WLB will be universal across all country cultures.
H1. WLB will be positively related to job satisfaction across cultures.
H2. WLB will be positively related to life satisfaction across cultures.
H3. WLB will be negatively related to anxiety across cultures.
H4. WLB will be negatively related to depression across cultures.
2.2. Moderating effects of individualism/collectivism
I/C is the cultural dimension that has received the “lion’s share of attention as a predictor of cultural variation” (Brewer & Chen, 2007, p. 133). This dimension is also a powerful moderator of employee cross-cultural studies (Ramamoorthy & Flood, 2002), including work– family studies (Hill et al., 2004; Spector et al., 2004, 2007). I/C reflects whether people view themselves as independent (individualists)
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or are tightly linked to others as part of groups (collectivists) (Triandis, 1995). We follow House, Hanges, Javidan, Dorfman, and Gupta (2004), where in-group collectivism is defined as “the degree to which individuals express pride, loyalty, and cohesiveness in their or- ganizations or families” (p. 30). In essence, in individualistic cultures people tend to prioritize personal interests over common goals, whereas in collectivistic cultures people tend to prioritize common goals, including family ones, over personal needs.
A recent review of cross-cultural work–life research found no studies linking I/C and WLB (Ollier-Malaterre, 2014). However, there is considerable research showing that work–family conflict is less detrimental to individuals in collectivistic than in individualistic cul- tures (Lu, Gilmour, Kao, & Huang, 2006; Lu et al., 2010; Spector et al., 2004, 2007; Yang, Chen, Choi, & Zou, 2000). This can be explained by the presence of different appraisal mechanisms in different cultures (Aycan, 2008). In collectivistic cultures, work is viewed as a way of supporting a family (Redding, 1993; Redding & Wong, 1986) such that people tend to deem work–family conflict as an inev- itable life experience to promote wealth and financial stability for the family (Aryee, Luk, Leung, & Lo, 1999; Spector et al., 2007). In- stead, in individualistic cultures work is generally viewed as an individual achievement that contributes to self-actualization and that is incompatible with family roles (Spector et al., 2004, 2007); therefore people deem work–family conflict to be problematic and a threat to personal health and well-being (Aycan, 2008). Drawing on these assumptions, we expect WLB to be less strongly related to positive outcomes in collectivistic than in individualistic cultures. We reason that achieving balance should be more pivotal for peo- ple in individualistic cultures, as it is considered more essential in individualistic societies to live one’s life to the fullest and to recover from the stress and strains associated with work roles (Spector et al., 2004, 2007). Instead, people in collectivistic cultures tend to per- ceive role imbalance in a less problematic way as they view it as an inevitable cost in promoting family well-being (Aryee et al., 1999). From this we can infer that individuals in individualistic cultures will benefit more from experiencing greater WLB as achieving WLB is more of a focus in their cultures and thus will weigh more towards their satisfaction and mental health. Accordingly,
H5. Individualism/collectivism will moderate the relationship between WLB and individual outcomes, such that:
H5. The positive relationship between WLB and (a) job satisfaction and (b) life satisfaction will be stronger in countries higher in
individualism. H5. The negative relationship between WLB and (c) anxiety and (d) depression will be stronger in countries higher in individualism.
2.3. Moderating effects of gender egalitarianism
GE reflects the presence of “beliefs [in the society] about whether members’ biological sex should determine the roles that they play in their homes, business organizations, and communities” (House et al., 2004, p. 347). Low GE cultures are characterized by be- liefs in the traditional gendered division of labour, which depict men as breadwinners and women as caregivers and homemakers (Wood & Eagly, 2002). Notably, extant research has shown that in high GE cultures there is less adhesion to traditional gender pat- terns and it is considered personally and socially acceptable that both women and men pursue their own life goals and struggle to guarantee the desired level of involvement in both work and non-work roles (Lyness & Judiesch, 2014).
Research on the influence of GE on the work–life interface is still at a very early stage and cross-national research in particular is very scarce (Lyness & Judiesch, 2014; Lyness & Kropf, 2005). Lyness and Judiesch (2008) found a GE moderated relationship, with managers’ self-rating of WLB more positively related to peer’s and supervisor’s advancement potential rating for female managers in high gender egalitarian cultures and for men managers in low gender egalitarian cultures. In this paper, we hypothesize that WLB will be associated with higher job and life satisfaction and lower anxiety and depression for individuals living in high GE cultures than for those living in low GE cultures. We contend that living in cultures where both men’s and women’s work and non-work role involvement is encouraged and considered socially acceptable can amplify the beneficial effects of WLB (Corrigall & Konrad, 2006). Conversely, in low GE cultures we believe that achieving WLB may be less beneficial as traditional gender role prescriptions are pre- vailing and may instil in the population the expectations that men should prioritize work over the family and women should do the opposite. Thus, experiencing WLB might not be perceived as beneficial as it might be in high GE cultures because it is inconsistent with societal expectations about gender division of labour. Accordingly,
H6. Gender egalitarianism will moderate the relationship between WLB and individual outcomes, such that:
H6. The positive relationship between WLB and (a) job satisfaction and (b) life satisfaction will be stronger in countries higher in
GE. H6. The negative relationship between WLB and (c) anxiety and (d) depression will be stronger in countries higher in GE.
Fig. 1 illustrates our general structural model.
3. Method
3.1. Samples and procedures
Data were collected from six countries (New Zealand, Spain, France, Italy, Malaysia and China) and included seven samples. Two separate samples were collected from New Zealand: Maori (indigenous people of New Zealand) and New Zealand European, the
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Fig. 1. General study model: Outcomes of WLB across cultures.
largest population group (equivalent to Caucasians in the US). Table 1 illustrates the descriptive data of the seven samples as well as of the combined sample. The authors personally collected data from four countries including both samples from New Zealand, while two research assistants native of China and Malaysia collected data from these countries. We used our networks to generate the largest number of employees from a broad range of organizations. Then, following basic principles of snowball sampling (Biernacki & Waldford, 1981), we asked recruited participants to recommend participation in the research to their contacts. The necessary require- ment to be included in the sample was being engaged in a full-time job. All surveys where English is not the first language were trans- lated into the native language (e.g., French, Italian, Mandarin) and then back-translated to minimize translation error (Brislin, 1980).
Overall, the combined sample includes 1416 employees of whom 546 come from collectivistic cultures (Maori, Malaysia and China). The average age was 37.6 years, gender was fairly evenly split (55% female) and the majority were married (70%) and parents (61%).
Table 1 Overall study demographics.
Country Demographics Sector
N Age (years) Gender (female) Married Parent Private Public Not-for-profit
New Zealand New Zealand Maori France Italy Spain Malaysia China
366 335 139 238 127 110 101
34.3 38.9 39.2 44.0 39.7 32.1 31.4
55% 63% 62% 43% 50% 48% 63%
70% 67% 80% 69% 78% 75% 47%
51% 69% 74% 60% 66% 63% 43%
56% 22% 74% 63% 62% 4%
45%
40% 70% 22% 35% 36% 96% 38%
4% 8% 4% 2% 2% 0%
17%
Total sample Collectivistic: Average age Gender Married Parents Industry:
1416 Maori, Malaysia and China (n = 546) 37.6 years (SD = 11.5 years) 55% female 70% 61% 46.8% Private 48.5% Public 4.6% Not-for-profit
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3.2. Measures
All samples used the same items, and except where noted, all items were rated on a 5-point scale (1 = strongly disagree to 5 = strongly agree). Items were averaged to produce composite indicators, with higher scores indicating higher values of the given mea- sure. All measures achieved adequate reliability within each country sample (all α N .70). We thus combined the seven samples to test our hypotheses (with alphas reported in Table 3).
3.2.1. WLB WLB was measured using a 3-item measure by Haar (2013). A sample item is “I manage to balance the demands of my work and
personal/family life well”. As this measure is still new, we conducted factor analysis (principal components, varimax rotation) for each distinct population and on the combined sample. The three items loaded onto a single factor universally across all seven samples with eigenvalues greater than 1; accounting for sizeable amounts of the variance and achieving adequate reliability in all samples as shown in Table 2.
3.2.2. Job satisfaction Job satisfaction was measured using 3-items by Judge, Bono, Erez, and Locke (2005). A sample question is “Most days I am enthu-
siastic about my work”.
3.2.3. Life satisfaction Life satisfaction was measured using the 5-item scale by Diener, Emmons, Larsen, and Griffin (1985). A sample question is “In most
ways my life is close to ideal”.
3.2.4. Anxiety and depression Anxiety and depression were assessed using 6-items by Axtell et al. (2002). This measure has been shown to have good psychomet-
ric properties (Haar, 2013; Spell & Arnold, 2007). The items were rated on a 5-point scale (1 = never to 5 = all the time). Presented with three adjectives for each measure, respondents were asked to indicate how often each adjective applied to them while they were at work.
3.2.5. Collectivism Collectivism was assessed by coding cultures using GLOBE scores for in-group collectivism (House et al., 2004). This approach is
superior to the typical dichotomous approach often used in the work–family literature (e.g. Spector et al., 2004), as it offers a range of scores that better reflect cultural variations across countries. New Zealand (European) was rated the most individualistic (3.67), and China the most collectivistic (5.8). One issue we came across was that the GLOBE study does not list New Zealand Maori as a sep- arate culture than the rest of the New Zealand population. Indeed, while making up 14% of the population, it is grouped into New Zealand culture as a whole. Since Maori have been found to have a strong collectivistic culture (Brougham & Haar, 2013; Haar, Roche, & Taylor, 2012) and prior research has widely documented that is distinct from the individualistic New Zealand European (Haar & Brougham, 2011; Podsiadlowski & Fox, 2011), we decided to use for this particular ethnic group the same score as in China (5.8). This score aligns with the GLOBE collectivism score for the Southern Asia cluster (Gupta, Surie, Javidan, & Chhokar, 2002), which provides an overall score for the six countries that make up the cluster. As such, we suggest that this provides a useful proxy for a collectivistic culture that aligns well with Maori (Brougham & Haar, 2013). Furthermore, we tested our model without in- cluding the Maori sample and we found no noticeable differences in our results. Therefore, we suggest that including the Maori sam- ple does not distort our overall findings and provides an additional rich new population to explore.
3.2.6. Gender egalitarianism Gender egalitarianism was assessed by coding cultures using the GLOBE scores (House et al., 2004). China was rated the least gen-
der egalitarian (3.68) with Italy the highest (4.88). As with collectivism, this approach is superior to the dichotomous approach but
Table 2 Results of exploratory factor analysis for WLB.
Responses were coded 1 = strongly disagree, 5 = strongly agree Factor loadings for each country
NZ NZ Maori France Italy Spain Malaysia China Combined
1. I am satisfied with my WLB, enjoying both roles .847 .906 .875 .873 .801 .912 .907 .874 2. Nowadays, I seem to enjoy every part of my life equally well .866 .904 .842 .870 .841 .882 .809 .875 3. I manage to balance the demands of my work and .821 .883 .910 .800 .886 .916 .867 .860
personal/family life well
Number of items in measure All analyses confirmed a one factor 3-item measure Eigenvalues 2.141 2.471 2.304 2.159 2.134 2.450 2.230 2.267 Percentage variance 71.4% 80.6% 76.8% 72.0% 71.1% 81.7% 74.3% 75.6% Cronbach’s alpha .80 .88 .85 .80 .80 .89 .83 .84
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similarly, does not have a score for Maori. We followed the same logic outlined above for collectivism and used the same score as in China.
3.2.7. Control variables In line with prior research (Carlson et al., 2009), we included gender (coded as 1 = female and 0 = male) and work–family conflict
as covariates in our analyses. We used 6-items from the scale by Carlson, Kacmar, and Williams (2000) to measure work-to-family conflict (WFC) and family-to-work conflict (FWC). A sample item for WFC is “I have to miss family activities due to the amount of time I must spend on work responsibilities” and a sample item for FWC is “The time I spend on family responsibilities often interfere with my work responsibilities”.
3.3. Measurement models
To confirm the separate dimensions of the various study’s measures in the combined sample, a CFA was run in SEM using AMOS 20.0. We followed Williams, Vandenberg, and Edwards (2009) recommendations regarding the goodness-of-fit measures: (1) the comparative fit index (CFI ≥ .95), (2) the root-mean-square error of approximation (RMSEA ≤ .08), and (3) the standardized root mean residual (SRMR ≤ .10). The hypothesized measurement model included seven distinct factors: WLB, WFC, FWC, job satisfaction, life satisfaction, anxiety and depression, and resulted in a good fit to the data, meeting all minimum requirements: χ2 (209) = 771.0 (p = .000), CFI = .97, RMSEA = 0.05 and SRMR = 0.04. The goodness of the hypothesized model was also confirmed by testing al- ternative models as advocated by Hair, Black, Babin, and Anderson (2010). Overall, the hypothesized measurement model did fit the data better than all the alternative models (results available from authors), which resulted in all alternative models being a significant- ly poorer fit (p b .001). This confirmed WLB to be a distinct construct from WFC and FWC.
Multi-group analysis CFA was conducted to establish measurement invariance between the seven samples (Bou & Satorra, 2010). While SEM model comparisons typically test chi-squared differences, this heavy reliance has been criticized (Schmitt & Kuljanin, 2008). This is because large samples and complex models are highly susceptible to significant changes in the chi-squared value. Cheung and Rensvold (2000) offered a number of alternative goodness-of-fit measures and we focus on the RMSEA because Meade and Kroustalis (2006) show that this measure is not affected by model complexity. Our model showed measurement equivalence as the difference in RMSEA between the seven samples; constrained and unconstrained models were very small at .002 (0.022 versus 0.024), which is below the critical value established by Cheung and Rensvold (2000). As such, this gives us confidence that the com- bined sample has metric invariance and can be analysed as a combined sample.
3.4. Analysis
Hypotheses were tested using SEM in AMOS v.20 to assess the direct (Hypotheses 1–4) and potential moderating effects of I/C (Hypotheses 5) and GE (Hypotheses 6), due to SEM being found to be superior to regression analysis (Cheng, 2001; Iacobucci, Saldanha, & Deng, 2007). Aligned with recommendations by Aiken and West (1991), the interaction terms were z-scored. Because the size of the structural models became overly complex when we included both moderators in the models, we ran two sets of mod- eration models for I/C and GE, respectively. For moderation analyses in SEM, all three z-scored WLB items were multiplied by the sin- gle GLOBE variable (I/C or GE score) to create a new variable in each model: (1) the interaction of WLB × I/C, and (2) the interaction of WLB × GE.
4. Results
4.1. Correlations
Descriptive statistics and intercorrelations for the study variables in the combined sample are shown in Table 3. The four outcome variables were all significantly correlated to each other (all p b .01) in the expected directions. WLB, WFC and
FWC were also correlated (all p b .01). In addition, I/C was significantly correlated to WLB (r = .08, p b .01), anxiety and depression (both r = − .14, p b .01), while GE was significantly correlated to WLB (r = − .09, p b .01), job satisfaction (r = .18, p b .01), anxiety (r = .34, p b .01) and depression (r = .15, p b .01). Furthermore, I/C and GE were significantly correlated to each other (r = − .38, p b .01).
4.2. Structural models
The two moderated SEM models included an additional interaction term to the measurement model: (1) WLB × I/C, and (2) WLB × GE. Consequently, both models were larger than the original measurement model. Despite this, the moderated structural models still resulted in a good fit to the data, meeting all minimum requirements for I/C (model 1): χ2 (307) = 970.4 (p = .000), CFI = 0.96, RMSEA = 0.04 and SRMR = 0.03, and for GE (model 2): χ2 (307) = 1145.1 (p = .000), CFI = 0.96, RMSEA = 0.04 and SRMR = 0.04. Table 4 highlights the significant direct and moderation effects from both models.
Aligned with the recommendations of Grace and Bollen (2005), unstandardized regression coefficients are presented in our tables. Table 4 shows that WLB was significantly related to job satisfaction (path coefficient = .50, p b .001) and life satisfaction (path coefficient = .52, p b .001), supporting Hypotheses 1 and 2. WLB was also significantly linked with anxiety (path coefficient = − .37,
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Table 3 Means, standard deviations and correlations of model variables.
N = 1416 (Cronbach’s alpha is reported on diagonal line in italics). ⁎ p b .05. ⁎⁎ p b .01.
p b .001), and depression (path coefficient = − .38, p b .001), supporting Hypotheses 3 and 4. Furthermore, we re-analysed the data separately for all seven samples and these confirmed the effects held in all country samples (see Table 5). Importantly, these effects were found after controlling for WFC and FWC.
Model 1 explored I/C as a moderator, and it was directly and significantly related to both anxiety and depression (both path coef- ficients = − .10, p b .001). Significant interaction effects were found between WLB and I/C towards job satisfaction (path coeffi- cient = − .12, p b .01) and life satisfaction (path coefficient = − .11, p b .01). Model 2 explored GE as a moderator, and it was directly and significantly related to job satisfaction (path coefficient = .08, p b .001), anxiety (path coefficient = .29, p b .001), and depression (path coefficient = .10, p b .001). Significant interaction effects were found between WLB and GE towards job satisfaction (path coefficient = .05, p b .05), life satisfaction (path coefficient = .10, p b .001), and anxiety (path coefficient = − .09, p b .01).
4.3. Interaction plots
To provide a better understanding of the interaction effects, plots are presented in Figs. 2 to 4. The interactions for I/C on job and life satisfaction (Fig. 2) are almost identical and are thus reported together. They show that there
are significant differences between respondent groups, with respondents living in individualistic cultures reporting higher levels of satisfaction (both job and life) at low levels of WLB compared to respondents living in collectivistic cultures. At high levels of WLB, respondents living in individualistic cultures reported stable levels of job and life satisfaction, while respondents living in collectivistic cultures reported significantly less job and life satisfaction, in line with our expectations. Overall, employees living in individualistic cultures reported significantly higher job and life satisfaction as expected, supporting Hypotheses 5a and 5b. Results provided no sup- port for Hypotheses 5c and 5d.
The interactions for GE on job and life satisfaction (Fig. 3) are almost identical and again, we represent them together. They show that there are significant differences between respondent groups, with respondents living in high gender egalitarian cultures reporting higher levels of job and life satisfaction at low levels of WLB compared to respondents living in less GE cultures. At high levels of WLB, all respondents reported higher levels of job and life satisfaction, but respondents in high GE cultures reported signif- icantly higher levels of job satisfaction and life satisfaction than those living in less GE cultures. Overall, employees living in GE cultures reported significantly higher levels of job satisfaction and life satisfaction. Fig. 4 shows there are no significant differences towards anxiety at low levels of WLB between respondent groups at low or high GE. At high levels of WLB, all respondents report lower anxiety
Table 4 Final structural model results (combined data).
Outcomes
Job satisfaction Life satisfaction Anxiety Depression
Model 1: Work–life balance .50⁎⁎⁎ .52⁎⁎⁎ − .37⁎⁎⁎ − .38⁎⁎⁎
Unstandardized regression weights, only main effects are shown. We controlled for gender, work–family conflict and family–work conflict directly on the DVs, and these three control variables covary on WLB. Similarly, all four DVs covary.
⁎ p b 0.05. ⁎⁎ p b .01. ⁎⁎⁎ p b .001.
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Table 5 Direct effects structural model results (individual samples).
Outcomes
New Zealand Maori: New Zealand European France Italy Spain Malaysia China
Job satisfaction Work–life balance Total R2
.26⁎⁎⁎
.13 .67⁎⁎⁎
.42 .58⁎⁎⁎
.22 .57⁎⁎⁎
.72 .48⁎⁎⁎
.15 .55⁎⁎⁎
.41 .59⁎⁎⁎
.40
Life satisfaction Work–life balance Total R2
.21⁎⁎⁎
.12 .66⁎⁎⁎
.39 .65⁎⁎⁎
.58 .73⁎⁎⁎
.40 .49⁎⁎⁎
.36 .34⁎⁎⁎
.32 .66⁎⁎⁎
.47
Anxiety Work–life balance Total R2
− .17⁎⁎⁎
.09 − .40⁎⁎⁎
.26 − .26⁎
.16 − .39⁎⁎⁎
.19 − .34⁎⁎⁎
.24 − .42⁎⁎
.26 − .19†
.12
Depression Work–life balance Total R2
− .25⁎⁎⁎
.11 − .46⁎⁎⁎
.23 − .39⁎⁎
.10 − .37⁎⁎⁎
.21 − .32⁎⁎
.12 − .64⁎⁎
.33 − .34⁎⁎
.15
Unstandardized regression weights, only main effects are shown. We controlled for gender, work–family conflict and family–work conflict directly on the DVs, and these three control variables covary on WLB. Similarly, all four DVs covary.
† p b 0.1. ⁎ p b 0.05. ⁎⁎ p b .01. ⁎⁎⁎ p b .001.
although those respondents in high GE cultures reported a steeper decrease compared to respondents in low GE cultures. These find- ings support Hypotheses 6a, 6b, and 6c.
Overall, the structural model accounted for moderate amounts of variance for all outcomes, and these were identical between the two moderation models for most outcomes: job satisfaction (R2 = .25), life satisfaction (R2 = .33), and depression (R2 = .18). Only towards anxiety were there major differences in variance, with the GE model accounting for far greater variance (R2 = .28) than the I/ C model (R2 = .18).
4.4. Supplementary analyses
Finally, an ANOVA test was conducted to examine the reported levels of WLB between the seven samples. Although the ANOVA test is important to know that at least two groups differ, it does not identify the groups that actually differ. Therefore, we run a mul- tigroup mean comparison between all distinct populations to identify the pattern of differences in our results by using the Fisher’s Least Significant Difference (LSD) and Student–Newman–Keuls tests as post-hoc analyses. The LSD test indicates which group config- urations significantly differ from one another, whereas the Student–Newman–Keuls is a sequential test designed to indicate which groups are significantly different from all the others. It orders mean scores from the lowest to the highest and compares pairs of groups for significant differences. Overall, the F-tests (results available from authors) revealed the presence of a significant difference for WLB across sample between at least two distinct populations. The Student–Newman–Keuls test revealed that the only significant difference existed between the Spanish and Italian samples, with Spanish respondents reported significantly higher levels of WLB (M = 3.47, s.d. = 0.76) than the Italian respondents (M = 3.24, s.d. = 0.79). Notably, the Maori sample (M = 3.56,
4
3.5
3
2.5
2
1.5
Jo b
an d
Li fe
S at
is fa
ct io
n
Individualism
Collectivism
Low Work-Life Balance High Work-Life Balance
Fig. 2. Interaction between WLB and I/C on Job and Life satisfaction.
369 J.M. Haar et al. / Journal of Vocational Behavior 85 (2014) 361–373
5
4.5
Low Work-Life Balance High Work-Life Balance
Low Gender
Egalitarianism
High Gender
Egalitarianism
Jo b
an d
L ife
S at
is fa
ct io
n 4
3.5
3
Fig. 3. Interaction between WLB and Gender egalitarianism on Job and Life satisfaction.
s.d. = 0.94) reported significantly higher levels of WLB than the samples from Italy (p b .000), New Zealand (p b .000), France (p b .01), Malaysia (p b .05), but not China (p = .052).
5. Discussion and conclusions
The present study investigated the outcomes of WLB on job satisfaction, life satisfaction, anxiety and depression across seven distinct cultures. More specifically, we explored whether individualism/collectivism (I/C) and gender egalitarianism (GE) moderated the relationship between WLB and these four outcomes. We found strong and consistent support across all cultures for WLB to be as- sociated with outcomes in the expected directions, albeit with some differences related to variations in national culture. Regarding I/C, as expected, we found that high levels of WLB were more positively associated with job and life satisfaction for individuals in individ- ualistic cultures, compared with those in collectivistic cultures. As such, we provide the first or one of the first empirical evidence that the outcomes of WLB can be better understood by including I/C in the analysis. A possible explanation for this result is linked to the importance that WLB has in individualistic cultures where it is a critical component influencing individuals’ subjective assessment of the overall quality of their work and life experiences (Spector et al., 2004, 2007). Furthermore, in individualistic cultures individuals generally have full responsibility for achieving WLB. Therefore, it is possible that, once achieved, WLB may lead to higher feelings of satisfaction in life due to contentment linked to this achievement. Notably, I/C did not significantly moderate the relation- ship between WLB and anxiety or depression. This is an interesting finding that can be understood in light of the broader network and greater level of social/family support usually experienced by individuals in collectivistic cultures that may help them to cope better with life adversities (Powell, Francesco, & Ling, 2009).
Regarding GE, we found that the beneficial effects of WLB on job and life satisfaction were most salient for individuals living in highly gender egalitarian cultures. This suggests that people in high GE cultures tend to be more satisfied with their job and life when experiencing high WLB than people in low GE cultures. This result is remarkable as this is the first study that documents the presence of differentiated outcomes of WLB across cultures that vary in their levels of GE. A possible explanation for this result is that in high GE cultures there is less adhesion to traditional gender role beliefs and therefore both women and men can perceive equal opportunities to pursue personal and professional life goals (House et al., 2004). Importantly, in such cultures there is higher
3
2.5 Low Gender
Egalitarianism
High Gender
Egalitarianism
Low Work-Life Balance High Work-Life Balance
A nx
ie ty
2
1.5
1
Fig. 4. Interaction between WLB and Gender egalitarianism on Anxiety.
370 J.M. Haar et al. / Journal of Vocational Behavior 85 (2014) 361–373
social approval and more tolerance towards the individual’s desire to balance work and non-work roles according to personal life preferences and values without having to sacrifice one domain over the others (Corrigall & Konrad, 2006; Lyness & Kropf, 2005). As a result, individuals may feel more satisfied when experiencing WLB as it is consistent with both personal and societal values and beliefs.
GE also moderated the relationship between WLB and anxiety. The negative relationship between WLB and anxiety was stronger for those living in high GE cultures. This implies that achieving WLB in high GE cultures is likely to enhance the beneficial effects of role balance on mental health. In line with our knowledge that individuals tend to internalize societal gender norms of the country they live in (Eagly & Wood, 2012), this finding indicates that there may be less mental pressure and anxiety for those achieving greater WLB in high GE cultures, indicating the presence of higher acknowledgement of benefits associated with greater role balance. It is also important to note that the low levels of anxiety for people living in high GE cultures may depend on the fact that in such cultures, people are more likely to engage in activities that are functional to experience detachment from work and replenish mental and phys- ical energies (Larson, Verma, & Dworkin, 2001).
5.1. Theoretical contributions
The present study contributes to the emerging WLB literature in several ways. The present study makes significant contributions to the work–life literature. First, we strengthen research on WLB by establishing its relationship with positive outcomes for individuals, which holds after controlling for work–family conflict. This supports the insightfulness of the perception-centred approach character- izing WLB research. It extends prior work conceptualizing WLB as a holistic construct (Greenhaus & Allen, 2011; Kossek et al., 2014) being different than work–family conflict and enrichment (Carlson et al., 2009; Greenhaus & Allen, 2011; Valcour, 2007). We believe that this will help to encourage future research on WLB, and this is important because WLB, as a concept distinct from work–life con- flict and work–life enrichment (Valcour, 2007), has the potential to shed light on the complexity of the work–life interface. Our study also emphasizes the importance to focus on work–life balance rather than on work–family balance, as the former term reflects more truthfully the myriads of personal life situations and role involvement decisions that nowadays characterize the contemporary society (Hall et al., 2013). This is consistent with major trends in work–life research emphasizing WLB to be a broad issue relevant for all working people (Haar, 2013; Kossek et al., 2014).
Second, this is one of the first studies that explores the outcomes of WLB across several countries and considers the influence of two distinct cultural dimensions, namely individualism/collectivism and gender egalitarianism. This is important as we compare countries that present noticeable differences with regard to their values, assumptions, norms, and belief systems about the gender roles. Thus, our paper enriches comparative work–life research at the individual level and contributes to bridge the macro–micro gap between country-level contexts and individual-level variables (Bamberger, 2008; Ollier-Malaterre et al., 2013). Moreover, while a couple of studies have explored the relationship between WLB and GE (e.g., Lyness & Judiesch, 2014), this is the first study, to our knowledge, that considers the moderating role of I/C on the positive effects generated by WLB. This is noteworthy given that I/C represents one of the most studied dimension in cross-cultural research (Brewer & Chen, 2007) and is an important boundary con- dition of our model explaining why people living in different countries perceive the benefits of WLB to greater or lesser extent. Fol- lowing recent recommendations in cross-cultural research (e.g., Taras, Rowney, & Steel, 2009), we used GLOBE scores for I/C and GE as these are reliable and objective instruments for quantifying cultural differences (House et al., 2004).
Third, we tested WLB effects in some settings of growing interest in the literature (e.g. Malaysia and China) and in some understudied settings (e.g. New Zealand European and Maori). Thus, this article contributes to establish the generalizability of work–life concepts and measures developed in Western countries to other regions of the world (Kossek & Ollier-Malaterre, 2013; Ollier-Malaterre et al., 2013; Powell et al., 2009). This is important given that WLB has considerable implications for people all around the world (Hill et al., 2004; Lyness & Judiesch, 2014). Our finding that the direct effects of WLB hold across all of the study’s samples aligns with research pointing out the universal benefit of the work–life interface (Hill et al., 2004; Poelmans et al., 2003; Shaffer, Joplin, & Hsu, 2011; Spector et al., 2004, 2007). However, our finding that two dimensions of national culture (I/C and GE) moderate the re- lationships between WLB and individual outcomes highlights the need to include cultural dimensions in research designs.
5.2. Practical implications
Our findings imply that achieving WLB may hold the key to greater job and life satisfaction, and diminished mental health issues, and this may hold in many countries. This has important implications for organizations that should make sure to assess their employees’ WLB in addition to measuring their work–life conflict. Organizations should invest in promoting WLB by implementing work–life policies, such as flexible working hours, and by embracing a supportive work culture that encourages em- ployees to use the work–life policies that are available in the organization (Allen, 2001; Eaton, 2003; Hammer, Kossek, Anger, Bodner, & Zimmerman, 2011). In addition, encouraging employees to recognize and celebrate their success in balancing roles (when achieved) and to elongate the time frame upon which they to gauge their work–life balance (Marsh, 2010) is also critical to foster greater benefits through understanding the potential changing nature of WLB. This may be particularly important in individu- alistic cultures and in high gender egalitarian cultures where work–life balance seems to be especially beneficial. Moreover, this can also prevent – especially in individualistic cultures – employees become frustrated when experiencing temporary situations of role imbalance.
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5.3. Limitations, future research and conclusions
While the present study encompasses seven distinct samples across six countries, a limitation is the cross-sectional, self-report na- ture of the data, although this approach is common in other work–family cross-cultural studies (Greenhaus & Allen, 2011; Spector et al., 2007). To alleviate this limitation we conducted higher order statistical approaches (i.e., CFA) using SEM to confirm the distinct nature of our measures. Furthermore, Kenny (2008) suggests that SEM does somewhat mitigate the potential bias related to the presence of common method variance. Similarly, testing for moderation effects also reduces the chances for common method variance (Evans, 1985). In addition, as advocated by Haar (2013), a self-report approach is needed to accurately tap the perception-centred na- ture of WLB. While additional secondary source data (e.g., supervisor, partner) would be preferable, it was prohibitively difficult to gain such data across a wide range of countries and individuals. As such, the data collected here are similar to that undertaken in other cross-cultural studies, but the CFA and structural analysis run in our study provide some unique statistical contributions, and the moderation analyses also help offset such limitations.
The present study has implications for future studies, especially cross-cultural studies in the work–life research areas. We hope that it will encourage research based on the concept of WLB, which is an important concept shedding light in job and life satisfaction as well as mental health, and which is more generalizable across cultures than what its Western origin presumed. While our study used robust scores for I/C and GE, it has been noted that individual-level allocentrism and idiocentrism may make some individuals more sensitive to cultural contexts than others (Triandis, Leung, Villareal, & Clack, 1985; Wang, Lawler, Walumbwa, & Shi, 2004). Therefore future studies should strive to measure both culture-level and individual-level of I/C and GE. Furthermore, there is to date no research investigating the role that other cultural dimensions may play in the relationship between WLB and outcomes. In particular, we encourage researchers to include in future studies the four other dimensions identified in a recent review as extensively impacting work–life conflict, enrichment and balance (Ollier-Malaterre, 2014): i.e. power distance, uncertainty avoidance, humane orientation (House et al., 2004) and specificity/diffusion (Trompenaars & Hampden-Turner, 1998). This area of research is almost void and opens avenues for many fruitful studies.
In conclusion, the present study emphasizes the crucial role that WLB plays in promoting greater job and life satisfaction and better mental health across employees in different cultures. It also points out that culture, in this study I/C and GE, moderates these relation- ships. Taken together, the findings of this study offer a fresh and nuanced picture on similarities and differences across cultures, which we hope will encourage future studies in the growing field of comparative work–life research.
Acknowledgments
We thank Tammy Allen and other conference attendees for their helpful feedback on an earlier version of this paper presented at the International Center for Work and Family 2013 conference. We are also grateful to the anonymous reviewers who gave us insight- ful suggestions.
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Aim of the Assessment Students will have the opportunity to develop their creativity and written skills as they create a mental health educational poster that can be used by consumers their carers / family and significant others. The poster will provide educational information that is easy to understand by non- professionals. With the use of non-jargonistic language and some visual information, you will be able to communicate your knowledge and provide education to help promote mental health and recovery of consumers and their carers/family/significant others. You will need the scenario called Mike’s story for both Assessments 2 and 3. Task You are to create and submit a 400-word A4 poster via Turnitin with a reference list in a separate Word document. • Using the scenario Mike’s story, you will choose a topic to create a poster that will help Mike and his carers/family and significant others to have a better understanding of Mike’s mental ill-health or illness and help the consumer move closer to their recovery. • This poster should be educational, help promote good mental health and easily understood by non-health professionals. • HINT: To help you, think of some topics that you would like to provide Mike and his carers/family/significant others from the scenario (Mike’s story), that would help promote positive mental health and recovery. Think of information that could help with early intervention to prevent mental ill-health or mental illness for Mike. The poster should effectively communicate the key message in an engaging and succinct manner. • Use evidence-based information with a minimum of 5 relevant, current, peer-reviewed academic resources. Here are some ideas and topics that you many find helpful and would like to use: • What is anxiety? • Antidepressants – information for consumers’ carers/family/significant others • Mental Health Recovery • Preventing Stigma in mental health • Importance/role of carer/family / significant other in mental health recovery. What to include in my poster? At a minimum students should include: 1. Student name and student ID 2. A title that clearly indicates your topic (you can make it catchy) 3. Significance of topic – You can start by explaining why your topic is important. 4. Statement about the incidences of the mental health issue/s in Australia. 5. Explain how your topic can facilitate recovery and promote wellbeing. 6. Future directions (consider what needs to be done to sustainably support recovery and wellbeing of mental health consumers).Tips • A poster is a visual representation of your chosen topic. • Use graphs, tables, diagrams, and images where appropriate. Use colour to attract attention and give your work some impact. • Ensure that all graphics and visual images are relevant to your topic. • Keep it simple, clear, and concise. Use language that is academic, professional and recovery orientated. Avoid jargon, acronyms, and stigmatising. • The poster needs to be eye-catching, attractive, and engaging but avoids overcrowding of information. • The poster needs to be an A4 page. • What software to use: You may use PowerPoint, Word, Adobe Illustrator, Photoshop, Canva to name a few. Mike’s story Mike is a 21-year-old male who presented in Emergency Department (ED) with thoughts of self-harm, agitation and insomnia. He was brought in by his flatmate who is a student nurse, who had noticed the changes in his mental health. He has not been sleeping well and gained weight over the last two years. Mike has moved from Melbourne to Sydney to study engineering at university. After two years of working part time in a construction firm, he was given the opportunity to supervise some of his co-workers. This is a new role and Mike found this to be very challenging, particularly as he is required to supervise a crew. He wants to show his supervisors that he can do the job. When he arrived in ED, he was agitated, had minimal eye contact, difficult to engage and would only engage with a handful of the nurses. Lately, he has been having trouble sleeping. A GP from a medical centre prescribed Temazepam 20mg nocte. He also started taking Phenergan 10mg to help him sleep. He has previously taken Phenergan for his allergies which he can buy from the chemist without a prescription. He thought this might help with his sleepless nights. He has been watching shows in his iPad in bed at night, in the hope that it would help him go to sleep. The medications did not help and instead, he stated that it kept him more awake at night. He started smoking marijuana to help manage his insomnia with very little effect. He stated that he has intermittent sleep and has not slept properly for 6 days. He has been supported by his GP and a private psychologist since he was 19 years old, when he was first diagnosed with anxiety. However, since he moved to Sydney, he has not found a GP in Sydney that he can trust. He continues to be on Fluoxetine 20mg daily but feels that he needs it reviewed because of his low mood. He voiced that his long-term goal is to cease the medication and ‘this would what make me feel like I have recovered’. He expressed that he is not ready to stop his medications. Mike admitted that he previously had thoughts of harming himself by crashing his car. This was the reason his GP commenced him on Fluoxetine and Mike started seeing a psychologist who helped him with his self-harm thoughts which helped him. However, these self-harm thoughts and feelings are starting to return, and he does not want these thoughts to consume his life again.He does not have any family in Sydney. He is reluctant to tell his family in Melbourne about the changes in his mental health. They do not know that he is on medications for his anxiety. He stated that although his family are very supportive, he did not want to burden them with his problems. He knows that his mother would want him to go back home to Melbourne. He said that going back home would make him feel like he failed. ‘I am an adult and not a child anymore’. Mike started to feel inadequate, constantly second guessing himself and was irritable at work. He also started to gain weight since he started on Fluoxetine two years ago. He does not have the time nor the energy to exercise due to work and study. He really wants to lose weight and go back to his ideal weight to play football again. But he feels unmotivated at the moment due to his mood. He is too scared to go to Employee Assistance Program (EAP) at work and does not want to let his supervisors know. He does not want to be seen as incompetent at his new role as supervisor
Applied Human Behavior in the Social Environment text to read the following:
Chapter 20, “Mental Health and Mental Illness as Influences on Human Behavior.”
This chapter focuses on concept of mental health versus mental illness; proposes positive psychology and resilience as effective interventions with a focus on strengths and resources; and addresses causes of suicide and controversies surrounding suicide.
After completing the unit readings, address the following:
What are your thoughts about the way society treats individuals and families who have mental illness?
What are your thoughts about society’s perspective on mental health care?
Once you develop your ideas, discuss, from this perspective, the implications for social work practice.
Be sure to cite support for your specific points as well as using examples for emphasis
Contract Scenario: Calvin had been an avid coin collector for many years, and the most valuable coin in his collection was an uncirculated, mint condition, 1943 Lincoln penny made of copper (most pennies made during World War II were made of zinc because copper was needed in the war effort). That penny had a value of between $60,000 and $95,000.In August of 2017, Calvin had a serious stroke that left him unable to speak or walk, but his doctor assured his family that Calvin would recover over time with intensive therapy. Calvin was a widower and did not have any children, but he had several nephews who visited him from time to time as he recovered. None of the nephews had any real interest in Calvin’s coin collection. One of Calvin’s nephews, Billy, who visited Calvin more often than the other nephews, sometimes listened to Calvin talk (talking was a part of Calvin’s therapy) about his mounting medical bills and his coin collection, but Billy never showed much interest in the medical bills or the coin collection. In October, as Calvin’s recovery progressed slowly, Billy visited Calvin and told Calvin that he had been reading about coin collecting, and he realized that Calvin’s collection, especially the 1943 Lincoln copper penny, was valuable, and Billy suggested that Calvin should consider selling the 1943 Lincoln copper penny and use the proceeds to pay his medical bills. Calvin resisted the idea at first, but Billy continued to urge Calvin to sell the penny so that he would not have to worry about the medical bills. Finally, when Billy told Calvin that he would arrange the sale of the penny for a commission of just 5% of the sale price of the penny, Calvin began to think that selling the coin might be a good idea. He was still a little confused about how the sale would work and what Billy would do to make sure that the penny would be sold for the best price. Calvin told Billy that he thought that the penny was worth almost $100,000, but Billy assured Calvin that the market had changed recently, and that the penny was now worth $40,000 to $45,000. Eventually, Calvin allowed Billy to sell the penny for the best price he could get and to take a 5% commission for arranging the sale of the penny. Billy then sold the penny to a friend for $40,000, took his 5% commission, and paid the remainder of the sale price to Calvin. A few months later, as Calvin continued to recover, he read a story in a coin collecting magazine about how an uncirculated, mint condition, 1943 Lincoln penny made of copper had just sold at auction for more than $100,000, and Calvin began to wonder if Billy had taken advantage of him. Calvin consulted a lawyer and asked the two questions below.
Did he (Calvin) have the mental capacity to enter into the contract when he agreed to let Billy sell the penny? What would he (Calvin) have to prove to show a court that he did not have the necessary mental capacity when he authorized Billy to sell the penny?
Did Billy exert undue influence over Calvin to cause Calvin to enter into the contract that allowed Billy to sell the penny?
What do you think? Does Calvin have a case to set aside the contract with Billy on either of these theories?Your case study should be at least two pages in length and include at least two outside sources. Be sure to use APA formatting for all citations and references
Contract Scenario: Calvin had been an avid coin collector for many years, and the most valuable coin in his collection was an uncirculated, mint condition, 1943 Lincoln penny made of copper (most pennies made during World War II were made of zinc because copper was needed in the war effort). That penny had a value of between $60,000 and $95,000.In August of 2017, Calvin had a serious stroke that left him unable to speak or walk, but his doctor assured his family that Calvin would recover over time with intensive therapy. Calvin was a widower and did not have any children, but he had several nephews who visited him from time to time as he recovered. None of the nephews had any real interest in Calvin’s coin collection. One of Calvin’s nephews, Billy, who visited Calvin more often than the other nephews, sometimes listened to Calvin talk (talking was a part of Calvin’s therapy) about his mounting medical bills and his coin collection, but Billy never showed much interest in the medical bills or the coin collection. In October, as Calvin’s recovery progressed slowly, Billy visited Calvin and told Calvin that he had been reading about coin collecting, and he realized that Calvin’s collection, especially the 1943 Lincoln copper penny, was valuable, and Billy suggested that Calvin should consider selling the 1943 Lincoln copper penny and use the proceeds to pay his medical bills. Calvin resisted the idea at first, but Billy continued to urge Calvin to sell the penny so that he would not have to worry about the medical bills. Finally, when Billy told Calvin that he would arrange the sale of the penny for a commission of just 5% of the sale price of the penny, Calvin began to think that selling the coin might be a good idea. He was still a little confused about how the sale would work and what Billy would do to make sure that the penny would be sold for the best price. Calvin told Billy that he thought that the penny was worth almost $100,000, but Billy assured Calvin that the market had changed recently, and that the penny was now worth $40,000 to $45,000. Eventually, Calvin allowed Billy to sell the penny for the best price he could get and to take a 5% commission for arranging the sale of the penny. Billy then sold the penny to a friend for $40,000, took his 5% commission, and paid the remainder of the sale price to Calvin. A few months later, as Calvin continued to recover, he read a story in a coin collecting magazine about how an uncirculated, mint condition, 1943 Lincoln penny made of copper had just sold at auction for more than $100,000, and Calvin began to wonder if Billy had taken advantage of him. Calvin consulted a lawyer and asked the two questions below.
Did he (Calvin) have the mental capacity to enter into the contract when he agreed to let Billy sell the penny? What would he (Calvin) have to prove to show a court that he did not have the necessary mental capacity when he authorized Billy to sell the penny?
Did Billy exert undue influence over Calvin to cause Calvin to enter into the contract that allowed Billy to sell the penny?
What do you think? Does Calvin have a case to set aside the contract with Billy on either of these theories?Your case study should be at least two pages in length and include at least two outside sources. Be sure to use APA formatting for all citations and references
This week, you learned about the following three commonly confused mental health disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition: major depressive disorder, bipolar (I and II) disorder, and borderline personality disorder.
In two-pages, describe the differences between major depressive disorder and bipolar disorder. Then, differentiate bipolar disorder from borderline personality disorder. Why do you think these disorders are commonly confused?
Find three peer-reviewed articles on treating these conditions (one for each disorder). Describe reasons why correctly identifying these disorders is important for treatment.
Parameters: APA format; Times New Roman, 12-pt. font; one-inch margins; double-spaced; subheads; two-pages, in addition to a cover page and a reference page; support with academic references
Mental health problems among the veterans pose major policy problems. Every year, tens of thousands of American soldiers leave the military to join their civilian life. However, there is growing global recognition that veterans often face post-conflict dysfunctions that affect their mental and physical wellbeing. For instance, the ongoing conflict in Iraq and Afghanistan has heightened interests in the welfare and health of regular and reserve combatants on their returns from duty and their eventual transition to civilian life (Mitchell et al. 2020). The US literature that explores individuals returning from the 1991 Gulf War suggest that these people who had survived wars and joined the civilian life are more likely to be unemployed or lose their jobs. Such people also end up joining the prison system or rely on alcohol to escape their mental agony. Additionally, some soldiers often leave service prematurely, experience lost working days, and end up socially excluded.
The most commonly mentioned mental health problems that affect veterans include adjustment disorders, alcohol and substance use disorders, depressive symptoms, personality disorders, posttraumatic stress disorder, and drug misuse. In the United States, the experiences of service individuals returning unwell from the Vietnam War have often influenced the traumatology discipline for the past four decades (Iverson & Greenberg, 2009). These incidences resulted in the ultimate incorporation of the term posttraumatic stress disorder into the Diagnostic and Statistical Manual of Medical Disorders in 1980s (Vance et al., 2020). Despite historians recognizing the Vietnam War as low-intensity one for the US armed forces, the most popular congressionally mandated outcome study, the National Vietnam Veterans Readjustment Study showed that there is a lifetime prevalence of 30.9 percent and an existing 15.2% for PTSD.
Mental health professionals have for a long time reported numerous cases of psychiatric casualties among service personnel. Physicians have, for instance, identified battle hypnosis after military actions among servicemen in 1914. The large battle artilleries filled many health care institutions with many unscathed soldiers who presented with mental disturbances. Thereafter, this number increased phenomenally at a rapid pace. Thus, the concept of shell shock emerged in Europe as a metaphor to describe incurable wounds of war suffered both by populations and countries during and after WWI. British physician Myers first crafted the phrase ‘shell shock’ to provide a medical definition of a specific form of injury that was plaguing the British expeditionary forces (Vance et al., 2020). After associating the concept after what he perceived to be injury’s cause, he explained that the effects of an exploding shell might impair the senses, which include hearing, sight, smell, and taste. Along with other physicians, Myers started to acknowledge the misleading nature of the term. This shift in their view of the disease was driven by the idea that many of such cases occurred among individuals who had never been near shell explosions. As a matter of fact health professionals found that emotional disturbances alone were sufficient to cause the symptoms attributed to shell shock (Jones, 2012). Thus, its perceived symptoms became highly varied to the extent that they could incorporate almost any malady other than physical wound. The diagnosis and assessment of mental health problems among veterans has evolved significantly from the shell shock to modern evidence-based methods of treating them.
Shell Shock and Mental Health Problems among Veterans
Shell shock is a term that emerged to describe the traumatic experiences and symptoms that were observed among soldiers and veterans following World War I. The term was crafted by soldiers themselves and its symptoms took the form of fatigue, confusion, nightmares, and impaired sight and hearing. It was often diagnoses by assessing a service person’s inability to function without an obvious cause to be identified (Jones, 2012). Since many of the symptoms were largely physical, it had minimal overt semblance with the contemporary diagnostic procedures of posttraumatic stress disorder. During the WWI, a group of service men viewed the shell shock as cowardice or a form of malingering but Myers convinced the British military to take it seriously and design appropriate techniques that continue to guide contemporary treatment models. The earliest cases of the disease that Myers evaluated exhibited a wide range of perceptual abnormalities, which included loss or impaired hearing, sight, sensation, alongside other common physical symptoms, including tremor, loss of balance, headache, and fatigue (Stagner, 2014). He inferred that such problems were largely psychological rather than physical casualties, and held the view that these symptoms were overt illustrations of repressed trauma.
Like Myers, William McDougall asserted that shell shock could be treated using psychological interventions such as cognitive and affective reintegration. The shell-shocked military personnel, for instance, attempted to manage their traumatic experiences by repressing or splitting off any memory of a traumatic experience (Stagner, 2014). The symptoms are characterized by tremor or contractures, which are the outcomes of unconscious processes that are designed to maintain the dissociation. These scholars believed that patients might be treated if their memories were assessed and integrated within their consciousness, a procedure that may need many sessions.
In light of the above, Myers, together with a team of physicians began to realize that the term shell shock was misguiding health professionals who were keen on addressing the problem. This is because many cases of the disease had been identified among people who had never been to a shell explosion, In fact, physicians found that emotional disturbances alone were sufficient to cause the symptoms attributed to shell shock and that it became so varied that it could nearly take the form of any malady other than physical wounds. From paralysis to insomnia, blindness to poor appetite and agitation, the shell shock emerged to become the blanket diagnosis and explanation for any number of abnormalities (Stagner, 2014). By 1918, the American Expeditionary Force’s Surgeon General reached a conclusion that the shell shock was no longer a useful diagnosis. As a consequence, the government ordered American doctors to cease using the term since it had become of minimal importance and used as a military slang.
The ambiguity that surrounded the meaning of shell shock went beyond the medical profession to the military world. This is especially the case for American service men that were operating on the West Front and writers, film producers, as well as medical professionals on the American home front. The flexibility that was inherent in the term’s definition enabled it to take a wholly new, and often even contradictory meaning. For instance, one of the special editions of the Journal of Contemporary History on shell shock in 2000 featured Jay Winter, who argued that the disease often seemed to be a quicksilver and shifting character. It thus became part of a language that, as Winter describes, one that reveals the vastness of varying national traditions and perceptions within the overall cultural history of the Great War. Assessing how Americans molded the disorder to fit their cultural environment exposes this vastness, thereby paving the way for the First World War US military culture. The continued discussions about war recovery efforts, and symbolisms regarding the country’s foreign policies at the end of the war and during the interwar era called for more assessment into the causes, diagnosis, and treatment modalities of the disease.
While the country did not enter WWI until 1917, the American press had closely monitored and assessed the global medical discussions regarding shell shock since it final official use in 1915. By the time the United States had ventured into the war, Americans had already designed their own conceptualization of this seemingly new consequence of war. While the British talks often emphasized on the disease’s origins and depicted it as a form of hysteria or malingering, the American depictions focused on validating the shell shock as an injury of war. The country’s psychiatrists, the American Expeditionary Force (AEF), as well as images in popular culture, represented the disease within the progressive, empirical language of healing and recovery. By 1916, empirical, reports from popular American psychiatrists and British soldiers on the front started to alter American media talks relating to the disease. Many scholars, for instance, held that soldiers’ witnessing of horrors of industrial warfare caused shell shock, a form of psychological trauma. By September 1916, a British soldier revealed to American readers how the war caused trench nerves among his colleagues. Thus, American psychiatrists who reported back to the United States from the European front also tabled a study regarding the shell shock within the context of mental trauma. To him, the war caused emotional strain on both the mentally stable and unstable service personnel.
Policymakers in America’s health care sector set the foundation for an expansive medical treatment program to respond to high cases of shell shock. While occasionally discussed, policymakers saw few links between the traumas of civil war and the war taking place in the European continent. Only a few scholarly publications existed on Civil War soldiers with mental and nervous injuries (Stagner, 2014). The official medical and surgical history of the War devoted their efforts merely on a few pages to treatment, and WWI era psychiatrists asserted that the number of service personnel were too small and neuropsychiatry too undeveloped to offer useful guidance for their own tasks. Additionally, American physicians, like their European peers, were inclined to believe that shell shock was not like traumas developed by previous wars. Countless shell bombardments, coupled with the slaughter of machine guns, and unannounced mine explosions resulted in the creation of a stress-intensive environment in which the soldiers’ bravery and skill no longer ensured their survival. These injuries of contemporary warfare needed modern insights into the treatment modalities, which were separate from the experiences of the past.
Soldiers who participated in World War 1 underwent many traumatic experiences, and worked and lived in inhumane conditions. shell shock was common among, European, Asian, and American soldiers alike. For instance, European soldiers underwent fatigue, strain, and hunger (Mcleod, 2019). Although soldiers are trained to be resilient, prolonged periods of starvation coupled with poor working conditions and war are overwhelming even for the most resilient of soldiers (Mcleod, 2019). While the soldiers were working in duress, the expectations on them was high not only from their seniors but also governments that expected them to be victorious regardless of the working conditions or their traumatic experiences (Mcleod, 2019). Therefore, the working conditions and hardships experienced by the soldiers significantly contributed to shell shock. While it was clear that the poor working conditions could cause PTSD, the supervisors and commanders did not believe so. Instead, they thought that the soldiers experiencing shell shock were weak in spirit (Mcleod, 2019). However, this appears not to be the case because the condition it was common among different groups of soldiers in different places.
Rather than merely assessing the past American experiences, the US preparation highly depended upon assessment of soldiers who suffered in the European continent. Observers began assessing psychiatrists, such as Thomas Salmon’s visits to the European Front in early 1917. Their evaluations were to make suggestions to the American military that would aid in the prevention of shell shock from disabling as many troops as it had affected the British. After Salmon’s report, the AEF launched a mental health assessment programs for all recruits. Moreover, the US Army Surgeon General developed a neuropsychiatric division for establishing specific treatment centers for patients’ shock cases in Europe. Its policies on shell shock represented the country’s military’s greater understanding of the injuries. Screening exercises indicated that the development of shell shock might have been strongly linked to hereditary insanity or mental instabilities. These reports implied that the conditions of war merely aroused shell shock in those already predisposed to psychosocial illnesses. However, these decisions to develop the neuropsychiatric division and design treatment facilities recognized that genetics alone could not explain or deter shell shock. More specifically, the AEF observed that after a soldier’s exposure to the problem in the trench warfare, unlike those with hereditary insanity, those with shell shock could be treated.
From Shell Shock to PTSD
Over time the shell shock phrase was replaced with post-combat disorder or post-war disorder, which was used to describe the clusters of medically unexplained symptoms that were observed among servicemen after exposure to warring environments. These presentations were also referred to as ‘war syndromes’ (Young, 2020). However, the term was later viewed as misleading in one respect as the same symptom clusters that were observed in solders that break down during training or service in the United Kingdom and have not yet been exposed to the stress of battle (Pagel, 2021). Additionally, post-combat disorders were not the same as combat stress responses since they are characterized by somatic and neurological symptoms of chronic characteristics.
The concept of post-war disorder would later evolve into the posttraumatic stress disorder. This occurred after researchers examined the subjective responses of sufferers and defined it. To them, a condition is regarded as PTSD after a person’s response to the event involves intensive fear, helplessness, and horror. Moreover, the diagnostic criteria for PTSD requires physicians to assess whether the person has experienced an event that is outside the confines of usual human experience and that would be markedly distressing or almost everyone (Pagel, 2021). These include serious threats to life or physical integrity, serious threats or harm to children, spouses, or other close relatives and friends. Other traumatic experiences may include sudden destruction of home or community or seeing others being seriously injured or killed as a result of an accident or physical violence (Young, 2020). The DSM criteria also suggest that such a traumatic event should be persistently re-experienced in at least one of the following ways. First, there must be recurrent and intrusive distressing recollections of the event, especially among young children, repetitive plays in which themes or elements of the trauma are expressed. When it comes to veterans, patients may experience recurring distressing dreams of the events, as well as sudden acting or feelings that point to traumatic events, which continue to recur after living service. Finally, the soldiers may have frequent hallucinations, illnesses, or dissociative behaviors.
Conclusion
Soldiers who participated in the First World War, in 1914, experienced health abnormalities that they named the shell shock. The major symptoms of the disorder included impaired auditory and optic capacities, anxiety, nightmares, parasomnia, and tremors (Stone, 2018). At the time, physicians were not aware of the causes and what the disorder was. The disorder impacted their mental and emotional wellbeing. However, unlike other known conditions including anxiety, the disorder was manifested physically in that the affected soldiers could not operate with the usual competency (Stone, 2018). Initially, it was thought that the shell shock resulted from a severe concussion that significantly affected the nervous system. In the forces, it was believed that the symptoms resulted from fear. To that effect, it was believed that soldiers who were not courageous enough experienced the illness rather than their more courageous colleagues.
Understanding shell shock was not easy when it was first noticed among the soldiers who participated in World War 1. While the symptoms of Shell Shock including anxiety and tremors were initially detected among soldiers who had directly participated in battle, they were later detected in soldiers who had not been near exploding weapons including bombs (Stone, 2018). At first, the condition suffered by the second group of soldiers was thought to be neurasthenia. Neurasthenia is a condition signified by severe nervous breakdown as a result of participation in war, but was also encompassed by shell shock (Stone, 2018). Before World War 1, similar disorders were observed among German and French soldiers in the 18th Century (Macleod, 2019). The term neurasthenia was used to describe the disorder that was symptomized by low-grade nervousness (Stone, 2018). The greatest symptom of the disorder was believed to be exhaustion because soldiers who suffered from Shell Shock were generally exhausted.
Unlike in the World War 1 where the symptoms of Shell Shock were speculated to be fear of war, there were no suspected cause of the disorder in the 19th Century. However, the main symptoms of the disorder then were singled out to be extreme fatigue, insomnia, nightmares, anorexia related depicted by physical and mental tiredness, and sensory sensitization (Stone, 2018). At the time, Shell Shock was believed to be caused by an undetectable change to the chemical structure of the nervous system. In the US, the disorder was thought to be a disease associated with the modern American lifestyle (Macleod, 2019). In particular, neurasthenia, which was held as a component of Shell Shock, was believed to be perpetrated by the fast-paced lifestyle, increased workload, and emotional repression associated with the modernity paradigm.
The pre-war diagnosis of Post-Traumatic Stress Disorder (PTSD) was arguably messy, controversial, and confusing. For instance, it was thought that the illness was connected to other underlying disorders including epilepsy rather than traumatic experiences. Among the soldiers who suffered from PTSD, then known as shell shock, laboratory tests revealed that hysteria caused by psychical abnormality was common (Macleod, 2019). According to the restricted field consciousness theory, the mind assembles information and ideas according to the specific experiences that the body is exposed to (Gyatso, 2020). In this regard, exposure to specific disturbing experiences were likely to elicit responses that were products of extreme changes that corresponded to the nature of the stimuli (Trivedi, et al. 2020). Although shell shock was associated with traumatic experiences by soldiers, it was wrongly diagnosed as fear of war, and feebleness (Stone, 2018). However, in reality, a significant number of brave soldiers suffered from shell shock. Consequently, soldiers’ health significantly deteriorated because they did not receive the right emotional and psychiatric interventions that would improve their emotional and mental wellbeing.
In 1914, a British doctor Albert Wilson, asserted that soldiers who suffered from Shell Shock would not be tended to by psychiatrists. His rationale was that the soldier patients who were crying like children and mentally disturbed would recover after receiving treatment for their physical injuries (Macleod, 2019). Moreover, the doctor argued that their brave colleagues would increase their motivation and give them courage to overcome the spirit of fear that affected their metal wellbeing. However, it became apparent that mental intervention was necessary since the symptoms shown by the soldiers did not change even after being discharged from the hospital (Macleod, 2019). Since even unwounded soldiers experienced severe hysteria, it became apparent that shell shock was caused by their experiences of seeing their colleagues hurt and killed apart from their physical injuries.
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Analyzing Social Problems and Social Policy: Mental illnesses
Description and causes
Within modern society, mental health illness is one of the most effective problems experienced by most people. Mental health refers to behavioral, cognitive, and emotional well-being. Mental illness thus refers to a condition that affects an individual’s feelings, mood, thinking, and behaviors. Some of the most common mental illnesses include anxiety, major bipolar disorder, depression, psychosis, schizophrenia, and trauma.
Several factors usually bring about mental health challenges. One of the main factors leading to mental health challenges is substance abuse. According to a study by Smith et al. (2017), there is a high correlation between substance use and mental health challenges. Thus, substance use could be used as a predictor of mental illnesses. Additionally, early adverse life experiences, for example, exposure to violence and sexual assault, could lead to mental illnesses. Duin et al. (2018) support this view, who conducted empirical research on the role of adverse childhood experiences on mental health and found a positive relationship between the two variables.
Mental illnesses in society
According to the CDC (2021), 1 in 25 American citizens live with serious mental challenges including bipolar disorder, schizophrenia, or a major depression. Additionally,1in every 5 American adults are diagnosed with at least one mental illness in any given year. The statistics indicate the high prevalence of mental health issues within modern society, hence why it is one of the main focus areas of social workers.
Risk Population
The issue of mental illness is typically experienced across the demographic scope affecting people of all ages and races. However, mental health issues are highly diverse along racial lines whereby adults exhibiting two or more races experience 31.7% prevalence compared to white adults with 22.2% (National Institute of Mental Health (NIH), 2019). This statistic indicates the prevalence of risk factors within the minority communities compared to the white ethnic groups. Some of the risk factors include disparities that come with racism, including poor access to quality mental health care and other social-economic constraints (McKnight, 2021).
Theories of Mental health
Some of the most effective theories used in explaining mental health issues include behaviorism, biological, cognitive, humanistic, and psychodynamic theories. Behaviorism theorists believe that life experiences manifest behaviors; for example, Freud’s theory suggests that the body undergoes several psychosexual stages. On the other hand, psychodynamic theories focus on the driving forces within individuals that motivate their behavior. An example is Erik Erikson’s theory which analyzes an individual’s growth through eight stages in exploring deficiencies in their behavior. On the other hand, cognitive theories emphasize that behaviors are shaped by attitudes, behaviors, and beliefs of individuals. An example of a cognitive theory includes Piaget’s developmental theory and social-cultural cognitive theory.
The most common method applied by scholars in assessing and treating mental health issues involves therapy, whereby a counselor tries to evaluate the origin of the problem and its prevalence within society. One of the approaches undertaken by the government consists of the development of policies under the Affordable Care Policy (ACA) to promote accessibility and health-seeking behavior of people experiencing mental health issues. An example of such a policy is the accessibility of healthcare to as long as somebody has insurance coverage. According to Thomas et al. (2017), there have been positive results in the mental well-being of U.S citizens ever since the introduction of the policy. The improvement in mental well-being reflects the significance of accessibility as an approach towards solving mental health issues.
McKnight-Eily, L. R., Okoro, C. A., Strine, T. W., Verlenden, J., Hollis, N. D., Njai, R., Mitchell, E. W., Board, A., Puddy, R., & Thomas, C. (2021). Racial and ethnic disparities in the prevalence of stress and worry, mental health conditions, and increased substance use among adults during the COVID-19 pandemic — United States, April and May 2020. MMWR. Morbidity and Mortality Weekly Report, 70(5), 162-166. https://doi.org/10.15585/mmwr.mm7005a3
Smith, L. L., Yan, F., Charles, M., Mohiuddin, K., Tyus, D., Adekeye, O., & Holden, K. B. (2017). Exploring the link between substance use and mental health status: What can we learn from the self-medication theory? Journal of Health Care for the Poor and Underserved, 28(2S), 113-131. https://doi.org/10.1353/hpu.2017.0056
Thomas, K. C., Shartzer, A., Kurth, N. K., & Hall, J. P. (2017). Impact of ACA health reforms for people with mental health conditions. Psychiatric Services, 69(2), 231-234. https://doi.org/10.1176/appi.ps.201700044
Van Duin, L., Bevaart, F., Zijlmans, J., Luijks, M. A., Doreleijers, T. A., Wierdsma, A. I., Oldehinkel, A. J., Marhe, R., & Popma, A. (2018). The role of adverse childhood experiences and mental health care use in psychological dysfunction of male multi-problem young adults. European Child & Adolescent Psychiatry, 28(8), 1065-1078. https://doi.org/10.1007/s00787-018-1263-4
