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This chapter’s purpose is to summarize and analyze current states of the rights of persons with disabilities and the nexus of these rights with mental health and psychosocial well-being, particularly focusing on the Convention on the Rights of Persons with Disabilities (CRPD) and the Sustainable Development Goals (SDGs). It describes the key rights in CRPD and analyzes the interrelationship between CRPD and SDGs. The chapter also presents the history of global efforts to protect and promote the rights of persons with disabilities as well as recent and current developments. Persons with disabilities, including persons with mental health conditions and psychosocial disabilities, have faced numerous barriers and violations of human rights for a long time. The adoption of CRPD, coupled with SDGs and other key global agreements, provides great momentum for realizing their rights. The chapter concludes that respecting diversity, eliminating social barriers (including attitudinal ones), being attentive to the silent majority and minorities and reaching out to unheard voices, enabling supportive environment where individuals support each other based on needs instead of their attributes, and establishing and incorporating indicators pertaining to mental health and well-being into the monitoring efforts of sustainable development, peace and security, and overall human rights together with mental health perspectives are critical.
Children with congenital heart disease and their families are at risk of psychosocial problems. Emotional and behavioural problems, impaired school functioning, and reduced exercise capacity often occur. To prevent and decrease these problems, we modified and extended the previously established Congenital Heart Disease Intervention Program (CHIP)–School, thereby creating CHIP-Family. CHIP-Family is the first psychosocial intervention with a module for children with congenital heart disease. Through a randomised controlled trial, we examined the effectiveness of CHIP-Family.
Methods:
Ninety-three children with congenital heart disease (age M = 5.34 years, SD = 1.27) were randomised to CHIP-Family (n = 49) or care as usual (no psychosocial care; n = 44). CHIP-Family consisted of a 1-day group workshop for parents, children, and siblings and an individual follow-up session for parents. CHIP-Family was delivered by psychologists, paediatric cardiologists, and physiotherapists. At baseline and 6-month follow-up, mothers, fathers, teachers, and the child completed questionnaires to assess psychosocial problems, school functioning, and sports enjoyment. Moreover, at 6-month follow-up, parents completed program satisfaction assessments.
Results:
Although small improvements in child outcomes were observed in the CHIP-Family group, no statistically significant differences were found between outcomes of the CHIP-Family and care-as-usual group. Mean parent satisfaction ratings ranged from 7.4 to 8.1 (range 0–10).
Conclusions:
CHIP-Family yielded high program acceptability ratings. However, compared to care as usual, CHIP-Family did not find the same extent of statistically significant outcomes as CHIP-School. Replication of promising psychological interventions, and examination of when different outcomes are found, is recommended for refining interventions in the future.
The present study examined longitudinal associations between four family meal patterns (i.e. never had regular family meals, started having regular family meals, stopped having regular family meals, maintained having regular family meals) and young adult parents’ dietary intake, weight-related behaviours and psychosocial well-being. In addition, family meal patterns of parents were compared with those of non-parents.
Design
Analysis of data from the longitudinal Project EAT (Eating and Activity in Adolescents and Young Adults) study. Linear and logistic regressions were used to examine the associations between family meal patterns and parents’ dietary intake, weight-related behaviours and psychosocial well-being.
Setting
School and in-home settings.
Subjects
At baseline (1998; EAT-I), adolescents (n 4746) from socio-economically and racially/ethnically diverse households completed a survey and anthropometric measurements at school. At follow-up (2015; EAT-IV), participants who were parents (n 726) and who were non-parents with significant others (n 618) completed an online survey.
Results
Young adult parents who reported having regular family meals as an adolescent and as a parent (‘maintainers’), or who started having regular family meals with their own families (‘starters’), reported more healthful dietary, weight-related and psychosocial outcomes compared with young adults who never reported having regular family meals (‘nevers’; P<0·05). In addition, parents were more likely to be family meal starters than non-parents.
Conclusions
Results suggest that mental and physical health benefits of having regular family meals may be realized as a parent whether the routine of regular family meals is carried forward from adolescence into parenthood, or if the routine is started in parenthood.
Post-traumatic symptomatology is one of the signature effects of the pernicious exposures endured by responders to the World Trade Center (WTC) disaster of 11 September 2001 (9/11), but the long-term extent of diagnosed Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) post-traumatic stress disorder (PTSD) and its impact on quality of life are unknown. This study examines the extent of DSM-IV PTSD 11–13 years after the disaster in WTC responders, its symptom profiles and trajectories, and associations of active, remitted and partial PTSD with exposures, physical health and psychosocial well-being.
Method
Master's-level psychologists administered sections of the Structured Clinical Interview for DSM-IV and the Range of Impaired Functioning Tool to 3231 responders monitored at the Stony Brook University World Trade Center Health Program. The PTSD Checklist (PCL) and current medical symptoms were obtained at each visit.
Results
In all, 9.7% had current, 7.9% remitted, and 5.9% partial WTC-PTSD. Among those with active PTSD, avoidance and hyperarousal symptoms were most commonly, and flashbacks least commonly, reported. Trajectories of symptom severity across monitoring visits showed a modestly increasing slope for active and decelerating slope for remitted PTSD. WTC exposures, especially death and human remains, were strongly associated with PTSD. After adjusting for exposure and critical risk factors, including hazardous drinking and co-morbid depression, PTSD was strongly associated with health and well-being, especially dissatisfaction with life.
Conclusions
This is the first study to demonstrate the extent and correlates of long-term DSM-IV PTSD among responders. Although most proved resilient, there remains a sizable subgroup in need of continued treatment in the second decade after 9/11.
This chapter focuses on the United Nations (UN), and its work related to mental health and psychological well-being, so that the mental health community can strengthen partnership with the UN as a key stakeholder in global mental health. In 2006, the UN General Assembly adopted the Convention on the Rights of Persons with Disabilities (CRPD) by consensus. The Convention on the Rights of the Child (CRC) recognizes the rights of children with regard to mental health. The convention states that child must have a standard of living adequate for the child's physical, mental, spiritual, moral, and social development. The Platform for Action (PFA) reaffirms that women have the right to enjoy the highest attainable standard of physical and mental health. An interagency mechanism on mental health and psychosocial well-being should be established to support integration of mental health into existing and emerging priorities of the UN policies and programs.
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