Greetings and welcome to joining our movement in mental health promotion and collective empowerme... more Greetings and welcome to joining our movement in mental health promotion and collective empowerment! Mental health is a vital aspect of wellbeing in each and everyone of us. The term itself, however, is sometimes associated with negative stigmatizing connotations. There is work to be done to eliminate mental stigma and all other kinds of stigma in society and within ourselves. What are stigmatizing thoughts but stories and beliefs that diminish, divide, and disempower us? The remedy, as well as the path of healing and empowerment, lies in strengthening our wellbeing at the core, touching the heart of each of us individually and linking our hearts with each other collectively. This manual is lovingly crafted with this purpose in mind and heart. Our manual will help you as trained facilitators to deliver group sessions to promote mental wellbeing, increase resilience, decrease mental health stigma, and increase activism and advocacy to promote mental health using our intervention model, Acceptance and Commitment to Empowerment (ACE), rooted in Acceptance and Commitment Therapy (ACT) and Group Empowerment Psychoeducation (GEP). This is in the context of our research project that aims to promote youth mental health in China through our ACE-Linking Youth and 'Xin' (hearts) (ACE-LYNX) intervention. The manual includes detailed instructions, debriefing guidelines, and practical tips on engaging participants in ACE-LYNX experiential group exercises. The intervention can be useful in promoting mental health of all ages from all corners of the world, transcending the literal limits of language and culture, if the facilitator can embody the ACE model, outreach from the heart first and foremost, and engage participants in a dynamic participatory process. This manual builds on the insights and lessons learned from numerous completed intervention research and programs over a decade. We would like to express our heartfelt gratitude to all those who have contributed to the development and refinement of the ACE-LYNX learning activities and production of this manual, including: • Participants and team members of two projects -Community Champions HIV/AIDS Advocates Mobilization Project (funded by Canadian Institute of Health Research, 2011-2014); and Strength In Unity: Reducing Mental Illness Stigma Among Men in Asian Communities in Canada (funded by Movember Canada, 2014-2017). Their valuable feedback and insights have been instrumental in shaping this manual and ensuring that it meets the needs of facilitators and participants alike. • Dr. Mateusz Zurowski, who contributed to the Acceptance and Commitment Training modules in the CHAMP study. • Ms. Sunny Li, who translated this training manual from English into Chinese. • Linking Hearts team members in Jinan, especially Professor Cheng Shengli and Professor Yu Miao, who led the Chinese team consultation and cultural interpretation of this training manual to ensure accuracy and relevance to the local context of Jinan, Shandong, China, as well as the leadership and support of Professors Jia Cun-Xian and Gao Jianguo.
P sychotherapy is one of the major interventions in psychia- try's therapeutic armamentarium. Eve... more P sychotherapy is one of the major interventions in psychia- try's therapeutic armamentarium. Even interventions such as pharmacotherapy have a psychotherapeutic element, although they are not usually considered within the realm of psychotherapy. However, psychotherapy as developed in the West may not be directly applicable in other cultural settings. As North America rapidly becomes more culturally diverse, there is increasing demand for culturally appropriate mental health services. Clinical cultural competence, including the modification of psychotherapy practice to serve the culturally different, is imperative (1,2). A growing body of literature comments on various cultural aspects of psychotherapy (3).
Taking Action on Racism and Structural Violence in Psychiatric Training and Clinical Practice
The Canadian Journal of Psychiatry
A position paper developed by the Canadian Psychiatric Association's (CPA) Transcultural ... more A position paper developed by the Canadian Psychiatric Association's (CPA) Transcultural Psychiatry Section and the Education Committee and approved by the CPA Board of Directors on May 19, 2022.
International Journal of Environmental Research and Public Health
The purpose of this study was to verify the mediating role of depressive symptoms between excessi... more The purpose of this study was to verify the mediating role of depressive symptoms between excessive daytime sleepiness and suicidal ideation in college students. Of the 6944 participants, 2609 (37.6%) were male and 4335 (62.4%) were female. College students with excessive daytime sleepiness (p < 0.001) and those with depressive symptoms (p < 0.001) were more likely to have suicidal ideation. Moreover, both excessive daytime sleepiness (β = 0.14, 95% CI: 1.01–1.32) and depressive symptoms (β = 1.47, 95% CI: 3.80–5.00) were associated with suicidal ideation. The effect size of the mediating role of depressive symptoms in excessive daytime sleepiness to suicidal ideation was 50.41% for the entire sample, 58.33% for males, and 42.98% for females. Depressive symptoms partially mediated the relationship between excessive daytime sleepiness and suicidal ideation. The timely assessment of depressive symptoms in college students with excessive daytime sleepiness, and intervention, may ...
International Journal of Environmental Research and Public Health
Psychological distress and mental illness have become increasingly pervasive among Chinese univer... more Psychological distress and mental illness have become increasingly pervasive among Chinese university students. However, many university students who need mental health treatment or psychological support do not actively seek help from professional counselors or service providers, which could lead to poor mental health outcomes. To promote help-seeking, we undertook a qualitative study to understand Chinese university students’ perspectives on help-seeking and mental health counseling. We conducted 13 focus group interviews with students in six universities in Jinan, China, and altogether 91 (62%) female students, and 56 (38%) male students participated in the study. Our results indicate that students’ misconception and distrust of on-campus counseling, stigma of mental illness, low mental health literacy, and hard-to-access mental health services are the major barriers that impede students help-seeking behaviors. Internal struggles and systematic and organizational barriers are iden...
BACKGROUND Since the pandemic, more Canadians have reported poorer mental health. A vital group e... more BACKGROUND Since the pandemic, more Canadians have reported poorer mental health. A vital group experiencing high level of stressors are health care providers (HCPs) caring for COVID-19 patients, carrying out public health responses, or working with vulnerable populations. The mental health of HCPs are negatively affected by the pandemic, not only at work but also at home and in the community. Intersecting stressors at multiple levels contribute to HCPs’ experiences of fatigue, insomnia, anxiety, depression, and post-traumatic stress symptoms. OBJECTIVE The aim of this study is to explore the pandemic stressors experienced by HCPs at work, at home and in the community before participating in the Pandemic Acceptance and Commitment to Empowerment Response (PACER) online intervention. METHODS Informed by a social ecological approach, we use a qualitative reflective approach to engage 74 HCPs in diverse roles. Data were collected during the first two waves of the COVID-19 pandemic (June...
Throughout its history the strategy and tactics of contextual behavioral science (CBS) research h... more Throughout its history the strategy and tactics of contextual behavioral science (CBS) research have had distinctive features as compared to traditional behavioral science approaches. Continued progress in CBS research can be facilitated by greater clarity about how its strategy and tactics can be brought to bear on current challenges. The present white paper is the result of a 2 1/2-year long process designed to foster consensus among representative producers and consumers of CBS research about the best strategic pathway forward. The Task Force agreed that CBS research should be multilevel, process-based, multidimensional, prosocial, and pragmatic, and provided 33 recommendations to the CBS community arranged across these characteristics. In effect, this report provides a detailed research agenda designed to maximize the impact of CBS as a field. Scientists and practitioners are encouraged to mount this ambitious agenda. The Association for Contextual Behavioral Science (ACBS) Task Force on the Strategies and Tactics of Contextual Behavioral Science Research was created by the ACBS Board in Fall 2018. The Board took this action at the recommendation of the ACBS Publications Committee, which believed that the association, the field, and potential authors of the Journal of Contextual Behavioral Science (JCBS) could benefit from a
BACKGROUND Chinese students are extremely vulnerable to developing mental illness. The stigma ass... more BACKGROUND Chinese students are extremely vulnerable to developing mental illness. The stigma associated with mental illness presents a barrier to seeking help for their mental health. OBJECTIVE The Linking Hearts—Linking Youth and ‘Xin’ (hearts) project is an implementation science project that seeks to reduce mental illness stigma and promote the mental health of university students in Jinan, China. The Linking Hearts project consists of 3 components. In this paper, we outline the protocol for the first component, that is, the contextual assessment and analysis of the mental health needs of university students as the first step to inform the adaptation of an evidence-based intervention to be implemented in Jinan, China. METHODS Six local universities will participate in the Linking Hearts project. A total of 100 students from each university (n=600) will engage in the contextual assessment through self-report surveys on depression, anxiety, stress, mental health knowledge, and men...
Integrating neuroscience in psychiatry: a cultural–ecosocial systemic approach
The Lancet Psychiatry, Apr 1, 2023
Psychiatry has increasingly adopted explanations for psychopathology that are based on neurobiolo... more Psychiatry has increasingly adopted explanations for psychopathology that are based on neurobiological reductionism. With the recognition of health disparities and the realisation that someone&#39;s postcode can be a better predictor of health outcomes than their genetic code, there are increasing efforts to ensure cultural and social–structural competence in psychiatric practice. Although neuroscientific and social–cultural approaches in psychiatry remain largely separate, they can be brought together in a multilevel explanatory framework to advance psychiatric theory, research, and practice. In this Personal View, we outline how a cultural–ecosocial systems approach to integrating neuroscience in psychiatry can promote social–contextual and systemic thinking for more clinically useful formulations and person-centred care.
Providing mediator training using a telecommunication format increases access to training by redu... more Providing mediator training using a telecommunication format increases access to training by reducing geographical and financial barriers, while maintaining or increasing efficiency. Limited research has implemented this format to train facilitators in acceptance and commitment training (ACT), an empirically supported intervention. The aim of this research was to examine the efficacy of behavioural skills training via telecommunication for training novice facilitators to provide ACT to caregivers of individuals with neurodevelopmental disabilities. This two-part study involved concurrent multiple-baseline designs, each across 4 participants. Quantitative data on fidelity and confidence were collected at baseline, post-training, and at 1-month follow-up. The results from this study provide preliminary support for the use of behavioural skills training via telecommunication to train ACT facilitators. Increasing the number of competently trained facilitators will help build capacity to increase access to ACT across geographical regions. Keywords Behavior skills training. Telecommunication. Acceptance and commitment training Mediator training is essential within the field of behavior analysis to increase consumers' access to services (Parsons et al., 2012). Behavioral skills training (BST) is an empirically supported, performance and competency-based training that This research was completed as part of the first author's master's thesis at Brock University, supervised by the second author. We thank the participants and the Centre for Addiction and Mental Health.
International Journal of Environmental Research and Public Health
From existing empirical research, we identified that Chinese college students commonly experience... more From existing empirical research, we identified that Chinese college students commonly experience stigma surrounding mental illness and found some factors that support them in resisting the stigma and achieving psychological health. However, less research provides qualitative data involving individual experiences and insights on mental illness within this group of college students. This study, based on Linking Hearts (an internationally cooperative research-sharing project between China and Canada), was conducted in Shandong, Jinan, and aims to promote the mental health of college students by empowering interdisciplinary professionals and students. Through the research project, this study analyzed the materials from 24 focus groups, explored the understanding of mental illness and prevalence of mental illness stigma in Chinese colleges at the present time, administered a background questionnaire, and provided statistical support for some revealed themes. The final themes are as foll...
International Journal of Environmental Research and Public Health, 2021
This study aimed to explore the association between mental health knowledge level and the prevale... more This study aimed to explore the association between mental health knowledge level and the prevalence of depressive symptoms among Chinese college students. A cross-sectional study was conducted in six universities in Jinan, Shandong Province, China, and a total of 600 college students were recruited to self-complete a series of questionnaires. The Mental Health Knowledge Questionnaire (MHKQ) was used to investigate the level of mental health knowledge. Depressive symptoms were investigated with the depression subscale of the Depression Anxiety Stress Scale (DASS-21). The prevalence rate of depressive symptoms among college students was 31.2%. Compared with MHKQ scoring in the 1st quartile, college students with MHKQ scoring in the 3rd quartile and in the 4th quartile reported lower levels of depressive symptoms after adjusting for potential confounding factors. Since mental health knowledge level was related to depressive symptoms among college students, increased efforts to promote...
Background: Rapid urbanization, academic pressures, and developmental life transition stressors c... more Background: Rapid urbanization, academic pressures, and developmental life transition stressors contribute to mental health stress for postsecondary students in China. Effective prevention, early identification, and timely intervention are challenged by stigma, a lack of mental health literacy, and inadequate mental health resources. Objective: Our implementation science (IS) research project is aimed at evaluating the use of an evidence-informed mental health promotion intervention named Acceptance and Commitment to Empowerment -Linking Youth and 'Xin' (hearts) (ACE-LYNX) to promote university student mental health in Jinan, China. We will engage and collaborate with Shandong Mental Health Center, the provincial mental health center, and six local universities in different regions of Jinan. The ACE-LYNX intervention aims to reduce social stigma against mental illness, enhance mental health literacy, and improve access to quality mental health care by increasing interdisciplinary collaboration and forming a mental health network. It is based on two evidence-based approaches, Acceptance and Commitment Therapy (ACT) and Group Empowerment Psychoeducation (GEP), and it will be delivered through online learning and in-person group training. The project will train 90 interdisciplinary professionals using the model. They will in turn train 15 professionals and 20 students at each university. The project will adopt the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework, which provides a structure to examine the process and outcomes of implementation using mixed methods comprising quantitative and qualitative approaches along five dimensions: reach, efficacy, adoption, implementation, and maintenance. Results: Over the course of the project, 720 champions will be directly trained. They will contribute to developing a formal and informal mental health network, strengthened by student-led mental health initiatives and professional-led initiatives to promote collaborative care and facilitated care pathways. We anticipate that our project will reach out to 11,000 to 18,000 students. This IS protocol will outline our unique intervention model and key steps to contextualize, implement, and evaluate community-based mental health intervention.
OBJECTIVE To examine whether family medicine residents and faculty members appreciate the full sp... more OBJECTIVE To examine whether family medicine residents and faculty members appreciate the full spectrum of health advocacy as described in articles published in Canadian Family Physician in 2016 and to identify the perceived challenges and enablers of advocating across the entire spectrum. DESIGN Analysis of a subset of data from a qualitative study using semistructured interviews and focus groups. SETTING University of Toronto in Ontario. PARTICIPANTS A total of 9 family medicine faculty members and 6 family medicine residents. METHODS A subset of transcripts from a 2015 qualitative study that explored family medicine and psychiatry residents' and faculty members' understanding of the CanMEDS-Family Medicine health advocate role were reviewed, guided by interpretive descriptive methodology. MAIN FINDINGS Results indicated that family medicine physicians and residents were able to identify the full spectrum of advocacy described in the Canadian Family Physician articles and ...
BACKGROUND Psychological distress, isolation, feelings of powerlessness, and limited social suppo... more BACKGROUND Psychological distress, isolation, feelings of powerlessness, and limited social support are realities faced by temporary migrant live-in caregivers in Canada. Furthermore, they experience multiple barriers in accessing mental health services due to their long work hours, limited knowledge of health resources, precarious employment, and immigration status. OBJECTIVE The Women Empowerment - Caregiver Acceptance & Resilience E-Learning (WE2CARE) project is a pilot intervention research project that aims to promote the mental well-being and resiliency of migrant live-in caregivers. The objectives include exploring the effectiveness of this program in achieving the following: (1) reducing psychological distress (depression, anxiety, and stress); (2) promoting committed actions of self-care; and (3) building mutual support social networks. Further, participants’ satisfaction with the intervention and their perceived barriers to and facilitators of practicing the self-care stra...
International Health Trends and Perspectives, 2021
Background: The Canadian Caregiver program, initiated in 1992, functions to conceal the inadequat... more Background: The Canadian Caregiver program, initiated in 1992, functions to conceal the inadequate public policy and programs on child and elder care in Canada. Consequently, migrant caregivers have become an invisible diaspora filling a domestic labour gap with few protections. Aim and Methods: This scoping review aims to identify the systemic barriers that undermine social integration of migrant caregivers. We searched ten publication index databases from 2001-2020. We retrieved 1,624 articles, after accounting for exclusion criteria, 22 peer-reviewed articles were selected for this review representing migrant women across Canada who are and/or were part of the program. Results: Four key barriers were identified: economic exploitation, deskilling and downward occupational mobility, asymmetrical accountability, and social isolation. Conclusion: Discriminatory policies and hidden exploitative employment practices of the Canadian Caregiver program perpetuate a cycle of marginalizatio...
Greetings and welcome to joining our movement in mental health promotion and collective empowerme... more Greetings and welcome to joining our movement in mental health promotion and collective empowerment! Mental health is a vital aspect of wellbeing in each and everyone of us. The term itself, however, is sometimes associated with negative stigmatizing connotations. There is work to be done to eliminate mental stigma and all other kinds of stigma in society and within ourselves. What are stigmatizing thoughts but stories and beliefs that diminish, divide, and disempower us? The remedy, as well as the path of healing and empowerment, lies in strengthening our wellbeing at the core, touching the heart of each of us individually and linking our hearts with each other collectively. This manual is lovingly crafted with this purpose in mind and heart. Our manual will help you as trained facilitators to deliver group sessions to promote mental wellbeing, increase resilience, decrease mental health stigma, and increase activism and advocacy to promote mental health using our intervention model, Acceptance and Commitment to Empowerment (ACE), rooted in Acceptance and Commitment Therapy (ACT) and Group Empowerment Psychoeducation (GEP). This is in the context of our research project that aims to promote youth mental health in China through our ACE-Linking Youth and 'Xin' (hearts) (ACE-LYNX) intervention. The manual includes detailed instructions, debriefing guidelines, and practical tips on engaging participants in ACE-LYNX experiential group exercises. The intervention can be useful in promoting mental health of all ages from all corners of the world, transcending the literal limits of language and culture, if the facilitator can embody the ACE model, outreach from the heart first and foremost, and engage participants in a dynamic participatory process. This manual builds on the insights and lessons learned from numerous completed intervention research and programs over a decade. We would like to express our heartfelt gratitude to all those who have contributed to the development and refinement of the ACE-LYNX learning activities and production of this manual, including: • Participants and team members of two projects -Community Champions HIV/AIDS Advocates Mobilization Project (funded by Canadian Institute of Health Research, 2011-2014); and Strength In Unity: Reducing Mental Illness Stigma Among Men in Asian Communities in Canada (funded by Movember Canada, 2014-2017). Their valuable feedback and insights have been instrumental in shaping this manual and ensuring that it meets the needs of facilitators and participants alike. • Dr. Mateusz Zurowski, who contributed to the Acceptance and Commitment Training modules in the CHAMP study. • Ms. Sunny Li, who translated this training manual from English into Chinese. • Linking Hearts team members in Jinan, especially Professor Cheng Shengli and Professor Yu Miao, who led the Chinese team consultation and cultural interpretation of this training manual to ensure accuracy and relevance to the local context of Jinan, Shandong, China, as well as the leadership and support of Professors Jia Cun-Xian and Gao Jianguo.
P sychotherapy is one of the major interventions in psychia- try's therapeutic armamentarium. Eve... more P sychotherapy is one of the major interventions in psychia- try's therapeutic armamentarium. Even interventions such as pharmacotherapy have a psychotherapeutic element, although they are not usually considered within the realm of psychotherapy. However, psychotherapy as developed in the West may not be directly applicable in other cultural settings. As North America rapidly becomes more culturally diverse, there is increasing demand for culturally appropriate mental health services. Clinical cultural competence, including the modification of psychotherapy practice to serve the culturally different, is imperative (1,2). A growing body of literature comments on various cultural aspects of psychotherapy (3).
Taking Action on Racism and Structural Violence in Psychiatric Training and Clinical Practice
The Canadian Journal of Psychiatry
A position paper developed by the Canadian Psychiatric Association&#39;s (CPA) Transcultural ... more A position paper developed by the Canadian Psychiatric Association&#39;s (CPA) Transcultural Psychiatry Section and the Education Committee and approved by the CPA Board of Directors on May 19, 2022.
International Journal of Environmental Research and Public Health
The purpose of this study was to verify the mediating role of depressive symptoms between excessi... more The purpose of this study was to verify the mediating role of depressive symptoms between excessive daytime sleepiness and suicidal ideation in college students. Of the 6944 participants, 2609 (37.6%) were male and 4335 (62.4%) were female. College students with excessive daytime sleepiness (p < 0.001) and those with depressive symptoms (p < 0.001) were more likely to have suicidal ideation. Moreover, both excessive daytime sleepiness (β = 0.14, 95% CI: 1.01–1.32) and depressive symptoms (β = 1.47, 95% CI: 3.80–5.00) were associated with suicidal ideation. The effect size of the mediating role of depressive symptoms in excessive daytime sleepiness to suicidal ideation was 50.41% for the entire sample, 58.33% for males, and 42.98% for females. Depressive symptoms partially mediated the relationship between excessive daytime sleepiness and suicidal ideation. The timely assessment of depressive symptoms in college students with excessive daytime sleepiness, and intervention, may ...
International Journal of Environmental Research and Public Health
Psychological distress and mental illness have become increasingly pervasive among Chinese univer... more Psychological distress and mental illness have become increasingly pervasive among Chinese university students. However, many university students who need mental health treatment or psychological support do not actively seek help from professional counselors or service providers, which could lead to poor mental health outcomes. To promote help-seeking, we undertook a qualitative study to understand Chinese university students’ perspectives on help-seeking and mental health counseling. We conducted 13 focus group interviews with students in six universities in Jinan, China, and altogether 91 (62%) female students, and 56 (38%) male students participated in the study. Our results indicate that students’ misconception and distrust of on-campus counseling, stigma of mental illness, low mental health literacy, and hard-to-access mental health services are the major barriers that impede students help-seeking behaviors. Internal struggles and systematic and organizational barriers are iden...
BACKGROUND Since the pandemic, more Canadians have reported poorer mental health. A vital group e... more BACKGROUND Since the pandemic, more Canadians have reported poorer mental health. A vital group experiencing high level of stressors are health care providers (HCPs) caring for COVID-19 patients, carrying out public health responses, or working with vulnerable populations. The mental health of HCPs are negatively affected by the pandemic, not only at work but also at home and in the community. Intersecting stressors at multiple levels contribute to HCPs’ experiences of fatigue, insomnia, anxiety, depression, and post-traumatic stress symptoms. OBJECTIVE The aim of this study is to explore the pandemic stressors experienced by HCPs at work, at home and in the community before participating in the Pandemic Acceptance and Commitment to Empowerment Response (PACER) online intervention. METHODS Informed by a social ecological approach, we use a qualitative reflective approach to engage 74 HCPs in diverse roles. Data were collected during the first two waves of the COVID-19 pandemic (June...
Throughout its history the strategy and tactics of contextual behavioral science (CBS) research h... more Throughout its history the strategy and tactics of contextual behavioral science (CBS) research have had distinctive features as compared to traditional behavioral science approaches. Continued progress in CBS research can be facilitated by greater clarity about how its strategy and tactics can be brought to bear on current challenges. The present white paper is the result of a 2 1/2-year long process designed to foster consensus among representative producers and consumers of CBS research about the best strategic pathway forward. The Task Force agreed that CBS research should be multilevel, process-based, multidimensional, prosocial, and pragmatic, and provided 33 recommendations to the CBS community arranged across these characteristics. In effect, this report provides a detailed research agenda designed to maximize the impact of CBS as a field. Scientists and practitioners are encouraged to mount this ambitious agenda. The Association for Contextual Behavioral Science (ACBS) Task Force on the Strategies and Tactics of Contextual Behavioral Science Research was created by the ACBS Board in Fall 2018. The Board took this action at the recommendation of the ACBS Publications Committee, which believed that the association, the field, and potential authors of the Journal of Contextual Behavioral Science (JCBS) could benefit from a
BACKGROUND Chinese students are extremely vulnerable to developing mental illness. The stigma ass... more BACKGROUND Chinese students are extremely vulnerable to developing mental illness. The stigma associated with mental illness presents a barrier to seeking help for their mental health. OBJECTIVE The Linking Hearts—Linking Youth and ‘Xin’ (hearts) project is an implementation science project that seeks to reduce mental illness stigma and promote the mental health of university students in Jinan, China. The Linking Hearts project consists of 3 components. In this paper, we outline the protocol for the first component, that is, the contextual assessment and analysis of the mental health needs of university students as the first step to inform the adaptation of an evidence-based intervention to be implemented in Jinan, China. METHODS Six local universities will participate in the Linking Hearts project. A total of 100 students from each university (n=600) will engage in the contextual assessment through self-report surveys on depression, anxiety, stress, mental health knowledge, and men...
Integrating neuroscience in psychiatry: a cultural–ecosocial systemic approach
The Lancet Psychiatry, Apr 1, 2023
Psychiatry has increasingly adopted explanations for psychopathology that are based on neurobiolo... more Psychiatry has increasingly adopted explanations for psychopathology that are based on neurobiological reductionism. With the recognition of health disparities and the realisation that someone&#39;s postcode can be a better predictor of health outcomes than their genetic code, there are increasing efforts to ensure cultural and social–structural competence in psychiatric practice. Although neuroscientific and social–cultural approaches in psychiatry remain largely separate, they can be brought together in a multilevel explanatory framework to advance psychiatric theory, research, and practice. In this Personal View, we outline how a cultural–ecosocial systems approach to integrating neuroscience in psychiatry can promote social–contextual and systemic thinking for more clinically useful formulations and person-centred care.
Providing mediator training using a telecommunication format increases access to training by redu... more Providing mediator training using a telecommunication format increases access to training by reducing geographical and financial barriers, while maintaining or increasing efficiency. Limited research has implemented this format to train facilitators in acceptance and commitment training (ACT), an empirically supported intervention. The aim of this research was to examine the efficacy of behavioural skills training via telecommunication for training novice facilitators to provide ACT to caregivers of individuals with neurodevelopmental disabilities. This two-part study involved concurrent multiple-baseline designs, each across 4 participants. Quantitative data on fidelity and confidence were collected at baseline, post-training, and at 1-month follow-up. The results from this study provide preliminary support for the use of behavioural skills training via telecommunication to train ACT facilitators. Increasing the number of competently trained facilitators will help build capacity to increase access to ACT across geographical regions. Keywords Behavior skills training. Telecommunication. Acceptance and commitment training Mediator training is essential within the field of behavior analysis to increase consumers' access to services (Parsons et al., 2012). Behavioral skills training (BST) is an empirically supported, performance and competency-based training that This research was completed as part of the first author's master's thesis at Brock University, supervised by the second author. We thank the participants and the Centre for Addiction and Mental Health.
International Journal of Environmental Research and Public Health
From existing empirical research, we identified that Chinese college students commonly experience... more From existing empirical research, we identified that Chinese college students commonly experience stigma surrounding mental illness and found some factors that support them in resisting the stigma and achieving psychological health. However, less research provides qualitative data involving individual experiences and insights on mental illness within this group of college students. This study, based on Linking Hearts (an internationally cooperative research-sharing project between China and Canada), was conducted in Shandong, Jinan, and aims to promote the mental health of college students by empowering interdisciplinary professionals and students. Through the research project, this study analyzed the materials from 24 focus groups, explored the understanding of mental illness and prevalence of mental illness stigma in Chinese colleges at the present time, administered a background questionnaire, and provided statistical support for some revealed themes. The final themes are as foll...
International Journal of Environmental Research and Public Health, 2021
This study aimed to explore the association between mental health knowledge level and the prevale... more This study aimed to explore the association between mental health knowledge level and the prevalence of depressive symptoms among Chinese college students. A cross-sectional study was conducted in six universities in Jinan, Shandong Province, China, and a total of 600 college students were recruited to self-complete a series of questionnaires. The Mental Health Knowledge Questionnaire (MHKQ) was used to investigate the level of mental health knowledge. Depressive symptoms were investigated with the depression subscale of the Depression Anxiety Stress Scale (DASS-21). The prevalence rate of depressive symptoms among college students was 31.2%. Compared with MHKQ scoring in the 1st quartile, college students with MHKQ scoring in the 3rd quartile and in the 4th quartile reported lower levels of depressive symptoms after adjusting for potential confounding factors. Since mental health knowledge level was related to depressive symptoms among college students, increased efforts to promote...
Background: Rapid urbanization, academic pressures, and developmental life transition stressors c... more Background: Rapid urbanization, academic pressures, and developmental life transition stressors contribute to mental health stress for postsecondary students in China. Effective prevention, early identification, and timely intervention are challenged by stigma, a lack of mental health literacy, and inadequate mental health resources. Objective: Our implementation science (IS) research project is aimed at evaluating the use of an evidence-informed mental health promotion intervention named Acceptance and Commitment to Empowerment -Linking Youth and 'Xin' (hearts) (ACE-LYNX) to promote university student mental health in Jinan, China. We will engage and collaborate with Shandong Mental Health Center, the provincial mental health center, and six local universities in different regions of Jinan. The ACE-LYNX intervention aims to reduce social stigma against mental illness, enhance mental health literacy, and improve access to quality mental health care by increasing interdisciplinary collaboration and forming a mental health network. It is based on two evidence-based approaches, Acceptance and Commitment Therapy (ACT) and Group Empowerment Psychoeducation (GEP), and it will be delivered through online learning and in-person group training. The project will train 90 interdisciplinary professionals using the model. They will in turn train 15 professionals and 20 students at each university. The project will adopt the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework, which provides a structure to examine the process and outcomes of implementation using mixed methods comprising quantitative and qualitative approaches along five dimensions: reach, efficacy, adoption, implementation, and maintenance. Results: Over the course of the project, 720 champions will be directly trained. They will contribute to developing a formal and informal mental health network, strengthened by student-led mental health initiatives and professional-led initiatives to promote collaborative care and facilitated care pathways. We anticipate that our project will reach out to 11,000 to 18,000 students. This IS protocol will outline our unique intervention model and key steps to contextualize, implement, and evaluate community-based mental health intervention.
OBJECTIVE To examine whether family medicine residents and faculty members appreciate the full sp... more OBJECTIVE To examine whether family medicine residents and faculty members appreciate the full spectrum of health advocacy as described in articles published in Canadian Family Physician in 2016 and to identify the perceived challenges and enablers of advocating across the entire spectrum. DESIGN Analysis of a subset of data from a qualitative study using semistructured interviews and focus groups. SETTING University of Toronto in Ontario. PARTICIPANTS A total of 9 family medicine faculty members and 6 family medicine residents. METHODS A subset of transcripts from a 2015 qualitative study that explored family medicine and psychiatry residents' and faculty members' understanding of the CanMEDS-Family Medicine health advocate role were reviewed, guided by interpretive descriptive methodology. MAIN FINDINGS Results indicated that family medicine physicians and residents were able to identify the full spectrum of advocacy described in the Canadian Family Physician articles and ...
BACKGROUND Psychological distress, isolation, feelings of powerlessness, and limited social suppo... more BACKGROUND Psychological distress, isolation, feelings of powerlessness, and limited social support are realities faced by temporary migrant live-in caregivers in Canada. Furthermore, they experience multiple barriers in accessing mental health services due to their long work hours, limited knowledge of health resources, precarious employment, and immigration status. OBJECTIVE The Women Empowerment - Caregiver Acceptance & Resilience E-Learning (WE2CARE) project is a pilot intervention research project that aims to promote the mental well-being and resiliency of migrant live-in caregivers. The objectives include exploring the effectiveness of this program in achieving the following: (1) reducing psychological distress (depression, anxiety, and stress); (2) promoting committed actions of self-care; and (3) building mutual support social networks. Further, participants’ satisfaction with the intervention and their perceived barriers to and facilitators of practicing the self-care stra...
International Health Trends and Perspectives, 2021
Background: The Canadian Caregiver program, initiated in 1992, functions to conceal the inadequat... more Background: The Canadian Caregiver program, initiated in 1992, functions to conceal the inadequate public policy and programs on child and elder care in Canada. Consequently, migrant caregivers have become an invisible diaspora filling a domestic labour gap with few protections. Aim and Methods: This scoping review aims to identify the systemic barriers that undermine social integration of migrant caregivers. We searched ten publication index databases from 2001-2020. We retrieved 1,624 articles, after accounting for exclusion criteria, 22 peer-reviewed articles were selected for this review representing migrant women across Canada who are and/or were part of the program. Results: Four key barriers were identified: economic exploitation, deskilling and downward occupational mobility, asymmetrical accountability, and social isolation. Conclusion: Discriminatory policies and hidden exploitative employment practices of the Canadian Caregiver program perpetuate a cycle of marginalizatio...
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Papers by Kenneth Fung