Assessing support for mental health policies among policy influencers and the general public in Alberta and Manitoba, Canada.

BACKGROUND: There is a need to improve mental health policy in Canada to address the growing population burden of mental illness. Understanding support for policy options is critical for advocacy efforts to improve mental health policy. Our purpose was to describe support for population-level healthy public policies to improve mental health among policy influencers and the general public in Alberta and Manitoba; and, identify associations between levels of support and sociodemographic variables and relative to the Nuffield Bioethics Intervention Ladder framework. METHODS: We used data from the 2019 Chronic Disease Prevention Survey, which recruited a representative sample of the general public in Alberta (n = 1792) and Manitoba (n = 1909) and policy influencers in each province (Alberta n = 291, Manitoba n = 129). Level of support was described for 16 policy options using a Likert-style scale for mental health policy options by province, sample type, and sociodemographic variables using ordinal regression modelling. Policy options were coded using the Nuffield Council on Bioethics Intervention Ladder to classify support for policy options by level of intrusiveness. RESULTS: Policy options were categorized as 'Provide Information' and 'Enable Choice' according to the Nuffield Intervention Ladder. There was high support for all policy options, and few differences between samples or provinces. Strong support was more common among women and among those who were more politically left (versus center). Immigrants were more likely to strongly support most of the policies. Those who were politically right leaning (versus center) were less likely to support any of the mental health policies. Mental health status, education, and Indigenous identity were also associated with support for some policy options. CONCLUSIONS: There is strong support for mental health policy in Western Canada. Results demonstrate a gap between support and implementation of mental health policy and provide evidence for advocates and policy makers looking to improve the policy landscape in Canada.

A comprehensive, open-source data model for wastewater-based epidemiology.

The recent SARS-COV-2 pandemic has sparked the adoption of wastewater-based epidemiology (WBE) as a low-cost way to monitor the health of populations. In parallel, the pandemic has encouraged researchers to openly share their data to serve the public better and accelerate science. However, environmental surveillance data are highly dependent on context and are difficult to interpret meaningfully across sites. This paper presents the second iteration of the Public Health Environmental Surveillance Open Data Model (PHES-ODM), an open-source dictionary and set of data tools to enhance the interoperability of environmental surveillance data and enable the storage of contextual (meta)data. The data model describes how to store environmental surveillance program data, metadata about measurements taken on various specimens (water, air, surfaces, sites, populations) and data about measurement protocols. The model provides software tools that support the collection and use of PHES-ODM formatted data, including performing PCR calculations and data validation, recording data into input templates, generating wide tables for analysis, and producing SQL database definitions. Fully open-source and already adopted by institutions in Canada, the European Union, and other countries, the PHES-ODM provides a path forward for creating robust, interoperable, open datasets for environmental public health surveillance for SARS-CoV-2 and beyond.

Composing Well-being: Mental Health and the Mass Observation Project in Twentieth-Century Britain.

This article argues that the Mass Observation Project (MOP) at the University of Sussex offers a unique window onto the history of mental health and the voices of those who have lived with mental health conditions during the late-twentieth century. This article analyses how a sample of MOP participants use their writing to reflect on their experiences, and compose narratives about, mental illness over time. More specifically, we suggest that MOP's capacity for the longitudinal study of individual respondents (underutilised by historians of mental health) offers exciting historiographical and methodological possibilities, not just in the history of mental health but for historians of medicine more generally. We conclude by considering how, for a handful of the participants in the project, mental health is entwined with MOP, as project participants deploy the archive to write about their experiences and even find something akin to therapy in the narrative act.

The Community Health and Social Medicine Incubator: a service-learning framework for medical student-led projects.

The Community Health and Social Medicine (CHASM) Incubator is a social impact venture that gives medical and other health care students the opportunity to develop initiatives that sustainably promote health equity for, and in partnership with, community partners and historically marginalized communities. Students learn how to develop projects with project management curricula, are paired with community health mentors, and are given seed micro-financing. As the first community health incubator driven by medical students, CHASM provides a framework for students interested in implementing sustainable solutions to local health disparities which extends the service-learning opportunities offered in existing curricula.

L'incubateur CHASM (Community Health and Social Medicine) est une initiative visant à créer un impact social en donnant aux étudiants en médecine et des autres sciences de la santé la possibilité de développer des initiatives durables en collaboration avec des partenaires communautaires et des communautés historiquement marginalisées. CHASM met en valeur l'équité en matière de santé. Les étudiants apprennent à élaborer des projets via un cursus de gestion de projet, sont jumelés à des mentors en santé communautaire et bénéficient de micro-financement de départ. Ce premier incubateur de santé communautaire mené par des étudiants en médecine fournit un cadre aux étudiants qui souhaitent mettre en œuvre des solutions durables aux inégalités en matière de santé. Il élargit également les possibilités d'apprentissage par le service offertes dans les cursus existants.

Who or what is to blame? Examining sociodemographic relationships to beliefs about causes, control, and responsibility for cancer and chronic disease prevention in Alberta, Canada.

BACKGROUND: Beliefs about causes and responsibility for chronic diseases can affect personal behaviour and support for healthy policies. In this research we examined relationships between socio-demographics (sex, age, education, employment, political alignment, perceived health, household income, household size) and perceptions of causes and responsibility for health behaviour, chronic disease correlates, and attitudes about cancer prevention and causes. METHODS: Using data from the 2016 Chronic Disease Prevention survey in which participants (N = 1200) from Alberta, Canada responded to items regarding how much they believed personal health behaviours, prevention beliefs, and environmental factors (i.e., healthy eating, physical activity, alcohol, smoking, and where a person lives or works) are linked to getting cancer. Participants also responded to questions about causes and responsibility for obesity, alcohol, and tobacco (i.e., individual or societal). Relationships were examined using multinomial logistic regression on socio-demographics and survey items of interest. RESULTS: Men (compared to women) were less likely to link regular exercise, or drinking excessive alcohol, to reducing or increasing cancer risk. Similarly, men were less likely to link environmental factors to cancer risk, and more likely to agree that cancer was not preventable, and that treatment is more important than prevention. Finally, men were more likely to believe that alcohol problems are an individual's fault. Left and central voters were more likely to believe that society was responsible for addressing alcohol, tobacco, and obesity problems compared to right voters. Those with less than post-secondary education were less likely to believe that regular exercise, maintaining a healthy body weight, or eating sufficient fruits and vegetables were linked to cancer - or that society should address obesity - compared to those with more education. Households making above the median income (versus below) were more likely to link a balanced diet with cancer and were less likely to think that tobacco problems were caused by external circumstances. CONCLUSIONS: These results provide insight into the importance of health literacy, message framing, and how socio-demographic factors may impact healthy policy. Men, those with less education, and those with less income are important target groups when promoting health literacy and chronic disease prevention initiatives.

Policy Influencer and General Public Support for Proposed Alcohol Healthy Public Policy Options in Alberta and Quebec, Canada.

OBJECTIVE: Although alcohol consumption is considered a major modifiable risk factor for chronic disease, policies to reduce alcohol-related harm remain low on the Canadian policy agenda. The objective of this study was to understand support for population-level healthy public policies to reduce alcohol-related harm by assessing the attitudes of policy influencers and the public in two Canadian provinces, and by sociodemographic characteristics. METHOD: A stratified sample of the general public (n = 2,400) and a census sample of policy influencers (n = 302) in Alberta and Quebec participated in the 2016 Chronic Disease Prevention Survey, which included questions to assess support for alcohol-specific policies. Differences in levels of support were determined by calculating differences in the proportion of support for alcohol control policies, comparing groups by regional and sociodemographic characteristics. The modified Nuffield Council on Bioethics Intervention Ladder was used to assess support according to the level of individual intrusiveness. RESULTS: We found that policy influencers and general public respondents were supportive of both information-based policies, with the exception of warning labels, and more restrictive policies targeting youth (e.g., enforcement). Both groups were less favorable to alcohol-specific policies that guided choice through disincentives (e.g., taxation). There were more differences in policy support by sociodemographic characteristics among the public. CONCLUSIONS: For health advocates to advance policies to reduce alcohol-related harms at the population level, they will need to mobilize additional support for more intrusive, yet more effective, policy interventions. Advocacy efforts should focus on communicating the effectiveness and positive outcomes of these interventions to help garner support.

The History of Mental Health Services in Modern England: Practitioner Memories and the Direction of Future Research.

Writing the recent history of mental health services requires a conscious departure from the historiographical tropes of the nineteenth and twentieth centuries which have emphasised the experience of those identified (and legally defined) as lunatics and the social, cultural, political, medical and institutional context of their treatment. A historical narrative structured around rights (to health and liberty) is now complicated by the rise of new organising categories such as 'costs', 'risks', 'needs' and 'values'. This paper, drawing on insights from a series of witness seminars attended by historians, clinicians and policymakers, proposes a programme of research to place modern mental health services in England and Wales in a richer historical context. Historians should recognise the fragmentation of the concepts of mental illness and mental health need, acknowledge the relationship between critiques of psychiatry and developments in other intellectual spheres, place the experience of the service user in the context of wider socio-economic and political change, understand the impacts of the social perception of 'risk' and of moral panic on mental health policy, relate the politics of mental health policy and resources to the general determinants of institutional change in British central and local government, and explore the sociological and institutional complexity of the evolving mental health professions and their relationships with each other and with their clients. While this is no small challenge, it is perhaps the only way to avoid the perpetuation of 'single-issue mythologies' in describing and accounting for change.

'The solution to his own enigma': connecting the life of Montague David Eder (1865-1936), socialist, psychoanalyst, Zionist and modern saint.

This article examines the career of pioneer British psychoanalyst David Eder (1865-1936). Credited by Freud as the first practising psychoanalyst in England, active in early British socialism and then a significant figure in Zionism in post-war Palestine, and in between an adventurer in South America, a pioneer in the field of school medicine, and a writer on shell-shock, Eder is a strangely neglected figure in existing historiography. The connections between his interest in medicine, psychoanalysis, socialism and Zionism are also explored. In doing so, this article contributes to our developing understanding of the psychoanalytic culture of early twentieth-century Britain, pointing to its shifting relationship to broader ideology and the practical social and political challenges of the period. The article also reflects on the challenges for both Eder's contemporaries and his biographers in making sense of such a life.