Lived Experiences of Intimate Partner Violence and Help-seeking among Wives of Persons with Alcohol Dependence: A Thematic Analysis.

Background: Worldwide, intimate partner violence (IPV) is a significant public health problem. Most of the wives of persons with alcohol dependence (PwAD) experience IPV in their lifetime. The study examined lived experiences of IPV among wives of PwAD. Methods: Qualitative research study design was used. Twenty participants were recruited using the consecutive sampling method. The researcher used an in-depth interview guide to collect the data. ATLAS.ti.9 software was used to analyse the qualitative data. Thematic analysis was used for coding and emerging themes. The thematic analysis yielded four themes generated from the in-depth interview: (1) reasons for the IPV, (2) help-seeking, (3) barriers in help-seeking and (4) coping with IPV. Conclusion: Survivors of IPV do not seek help due to self-stigma, unavailable resources, and lack of awareness about treatment for alcohol dependence. Clinicians should routinely screen for IPV among female spouses of persons with alcohol-dependent syndrome and provide psychosocial interventions for the survivors of IPV.

A retrospective study of life skills promotes healthy Internet use among adolescents.

Background: Since the beginning of COVID-19 pandemic, studies highlight the augmentation in the use of Internet and smartphone, especially among the adolescents. However, little is known about the effect of technology addiction on adolescent mental health following reopening of the schools. Aim: The study aims to assess the level of technology addiction, life skills, and mental health impact among adolescents during the COVID-19 pandemic in India. Materials and Methods: A cross-sectional research was conducted from July 2021 to October 2022. A nonprobability convenience sampling was used to collect the data from 352 adolescents using an Internet addiction test, smartphone addiction scale, life skills scale, and patient health questionnaire. Results: More than half of the adolescents were moderately addicted to the Internet and Smartphone. Three-fourth of the adolescents had mild-to-moderate depression. Those with moderate life skills were found to be moderately addicted to the Internet and Smartphone. Religion was found to be associated with Internet addiction. Age, religion, and parental monthly income were significantly associated with smartphone addiction among adolescents. Furthermore, class and life skills were significantly associated with depression among adolescents. Conclusion: Early-life skills training can help to prevent dysfunctional Internet use and mental and psychological problems among adolescents in schools and colleges.

Predictors of long-stay in a tertiary care psychiatry hospital in India.

BACKGROUND: Many psychiatric patients continue to stay for longer duration in psychiatric institutions. Community reintegration and rehabilitation of such patients needs to be explored to ensure appropriate bed occupancy rates and access to in-patient care for newer patients in need of the same. OBJECTIVES: The aim is to identify the risk and protective factors leading to long-term admission of mentally ill patients in tertiary care hospital. METHODOLOGY: A cross-sectional study was conducted with all patients in the long-stay ward between May 2018 and February 2023. A retrospective chart review followed by cross sectional assessment of risks and disability was carried out with all the patients living in a long-stay psychiatric ward (N = 101) at a tertiary hospital in Bangalore, India, between May 2018 and February 2023. RESULTS: The hospital's average length of stay (LOS) was 5.70 ± 8.30 years. The risk and protective factors for LOS in psychiatric hospitals were analyzed using the Poisson Regression model. The results revealed that the male gender, diagnosis of schizophrenia or psychosis, clinicians' knowledge of family information, good clinical improvement, and higher participation in ward activities are the protective factors for a shorter hospital stay. While higher age, family history of mental illness, being married and employed, absence of children, and/or having family members rarely visiting the patient at the hospital were some factors that increased the risk of LOS. CONCLUSION: This study highlighted the importance of possible LOS predictors in the tertiary care psychiatric hospital. The multi-disciplinary team may utilize risk and protective factors for delayed LOS to introduce comprehensive psychosocial interventions and policies that reduce the risk of delays or length of stay in mental health hospitals.

Development of preparedness to respond to intimate partner violence scale among mental health professionals.

Objectives: Violence against women has been associated with serious health and mental health consequences. Health-care professionals play an important role in screening and providing care and support to victims of intimate partner violence (IPV) in the hospital setting. There is no culturally relevant tool to assess the mental health professional (MHP) preparedness to screen for partner violence in the clinical setting. This research aimed towards developing and standardizing scale to measure MHP preparedness and perceived skills in responding to IPV in the clinical setting. Materials and Methods: The scale was field tested with 200 subjects using consecutive sampling at a tertiary care hospital. Results: The exploratory factor analysis resulted in five factors constituting 59.2% of the total variance. The internal consistency Cronbach alpha 0.72 for the final 32-item scale was highly reliable and adequate. Conclusion: The final version of the Preparedness to Respond to IPV (PR-IPV) scale measures MHP PR-IPV in the clinical setting. Further, the scale can be used to evaluate the outcome of IPV interventions in different settings.

Conjoint Couple Therapy with a Woman Survivor of Intimate Partner Violence: Strengths and Challenges.

Intimate Partner Violence (IPV) or Domestic Violence (DV) affects the mental health of women. Systemic family therapy has been found to help bring change in a couple's relationship and the cessation of violence in the relationship, provided both couples are motivated by the therapy to preserve the marital relationship. This article presents a case of offering brief tailor-made individual intervention as well as couple therapy for a woman with depression experiencing violence.

Content analysis of cyberbullying coverage in Newspapers- A study from Bengaluru, India.

Cyberbullying affects the mental health of victims. Media especially print media plays a significant role in reporting of cyber-related crimes to the general public. A total of 549 leading English daily newspapers for a period of 6-months were reviewed. The data were content analyzed using frequently repeated themes/contents. Totally, 51 instances of individual cyberbullying stories were reported from 549 newspapers. Among the reported incidents of cyberbullying in the print media, online harassment and impersonation were the most common type of cyberbullying experienced by the people. The study highlights the need for framing local guidelines for reporting of cyberbullying incidents and preventive mechanisms in the print media.

Development and training of mental health professionals in providing psychological intervention and support for women survivors of intimate partner violence - A pre-post evaluation study.

Context: Health care providers play a significant role as they are the first contact for seeking help for intimate partner violence (IPV) survivors. Aims: This research aimed toward developing a comprehensive culturally appropriate intervention package for the mental health professionals (MHPs) to provide psychological intervention and support for women survivors of IPV and test the training impact on the level of attitude, knowledge, and preparedness to respond to IPV disclosure among MHPs. Settings and Design: A single group, pre-post intervention study, was conducted at Tertiary Mental Health Hospital in the Southern part of India, Bengaluru. Materials and Methods: A total of 30 MHPs were recruited for the study using purposive sampling. MHP Attitude, Knowledge, Preparedness to Manage IPV (MAP-IPV) questionnaire was used to collect the data. Statistical Analysis Used: Descriptive statistics were used to assess the sociodemographic characteristics of the participants. The pre-post evaluation was analyzed using the independent "t" test by comparing the means scores of the MAP-IPV questionnaire. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) - 20 version of the software. Results: The results revealed a lack of attitude, knowledge preparedness, and available resources materials among MHPs in addressing IPV cases. Pre-post evaluation showed statistically significant improvement in attitude, knowledge, and preparedness to identify and respond to IPV disclosure among MHPs after the intervention program. Conclusion: The comprehensive IPV intervention package effectively brings gain in attitude, knowledge, and preparedness among MHPs in addressing survivors of IPV. Practice guidelines and clear referral pathways following IPV disclosure need to be implemented to support the gains made through the training.

Developing a Screening Tool for Mental Health Professionals for Measuring Intimate Partner Violence among Women with Mental Illness at Tertiary Care Setting.

Background Intimate partner violence (IPV) is the major public health issue seen in all cultures. Mental health professionals play a significant role in screening IPV and providing needed care and support to the survivors. There is a dearth of scale to measure comprehensively different dimensions of violence. The study aimed to develop a screening tool for measuring IPV among women with mental illness (WwMI) in India. Methods The newly developed IPV scale was administered to 200 WwMI at a tertiary care hospital. Results The factor analysis revealed four factors constituted 67.15% of the variance. The internal consistency Cronbach's α (0.92) and split-half reliability coefficient value (0.80) for the final 31-item IPV scale were found to be highly adequate and reliable. Conclusion Psychometric properties of scale found to be an effective tool for screening IPV among WwMI by mental health professionals and planning effective intervention strategies to prevent the IPV.

Tele-Consultation for the Survivors of Intimate Partner Violence: Guidelines for Mental Health Professionals.

Providing psychosocial interventions through telehealth is an approach to mitigate intimate partner violence (IPV). However, tele-consultation for IPV survivors need to be handled perceptively considering the risk to safety of the survivor and need for emergency support. This article provides strategies to address such issues while providing interventions to IPV survivors using telehealth in the clinical settings. Strategies for screening, assessment, planning psychosocial interventions, and termination of sessions are also summarized with supportive guidelines.

Eventful past, stagnant present, and hopeful future: A time order analysis of experiences of homeless women with chronic mental illness residing in shelter care homes.

BACKGROUND: In developing countries like India, many women with mental illness are residing in shelter care homes (SCHs) without their wish. SCHs are residential facilities provided to the socially and economically backward women for free of cost. These facilities are funded by government or voluntary organizations. AIM: To understand the living experiences of homeless women with chronic mental illness (HWCMI) admitted in SCHs. METHOD: This article highlights learning from a qualitative study, 17 HWCMI participated in the research. Along with their past experiences, present life, and expectations in the future, other socio-demographic details also recorded. Qualitative data were analyzed using thematic analysis approach with the Atlas ti-8 software. Findings: Three main themes were emerged from the analysis such as 'Eventful past', 'Stagnant present', and 'Hopeful future'. The theme 'Eventful past' shows clear pathways to homelessness. 'Stagnant present' reflects upon trapped present life and their concerns and care-related aspects. The final theme, 'hopeful future', depicts strong hope in future and readiness for changing their living situations. The findings are discussed in the background of current trends in psychiatric rehabilitation and what is lacking in the Indian context. CONCLUSION: This study attempts to unveil the gender-specific and person-centric explanations of experiences associated with the combination of homelessness and mental illness.

Tele-Case Work Consultation to Woman Survivor of Domestic Violence During COVID 19 Pandemic.

The COVID-19 pandemic and subsequent lockdown to mitigate the spread of the COVID-19 have resulted in social isolation, reduced social support system, and increased domestic violence (DV) cases against women and children. The governments and NGOs have taken several measures to prevent DV by starting helpline, WhatsApp numbers, and counseling services during the lockdown to safeguard the women. This paper describes a case scenario of how we offered tele-case work consultation during the lockdown period due to the COVID-19 pandemic, the procedure adopted, and preventive measures followed while providing a tailor-made psychosocial intervention to a DV survivor. It also discusses the strengths and challenges while offering tele-consultation and possible steps to overcome the technological barriers to mental health professionals.

Quality of Life and Stigma among Women with Epilepsy during Their Reproductive Years.

BACKGROUND AND PURPOSE: The purpose of this study was to understand the relationship between quality of life and stigma among reproductive age group women with epilepsy. METHODS: A cross-sectional descriptive study was conducted to assess the data from the 49 women with epilepsy from a tertiary care hospital in India. Quality of life was evaluated with the quality of life in epilepsy-31 questionnaire and stigma was evaluated with the stigma scale of epilepsy. Data also included socio-demographic and clinical characteristics. RESULTS: The mean age of the participants was 24.67±3.72 years. Quality of life total score (r=-0.485**) and seizure worry domain (r=-0.427**) were significantly negatively correlated with stigma total score at p<0.01 level. Being uneducated, married, unemployed, having children, having generalized tonic-clonic seizures, duration of illness (>10 years), and consuming levetiracetam, anti-epileptic drug (AED), were the significant contributing factors for low quality of life among women with epilepsy during the reproductive age group. Belonging to lower socio-economic status and taking more than two AEDs were also associated with lower quality of life among women with epilepsy, which are trending towards significance. CONCLUSIONS: The study assessed the relationship between the quality of life and the Stigma scale of epilepsy and demonstrated the impact of stigma and quality of life on socio-demographic and clinical variables of women with epilepsy under the reproductive age group. To enhance the quality of life and reduce the stigma levels among women with epilepsy, some of the modifiable parameters can be considered by the multidisciplinary health care professionals from the findings of the current research.

Profile of Women with Mental Illness Admitted in Shelter Care Homes; A Co-relational Description of Changing Sociocultural Scenario in India.

BACKGROUND: The prevalent explanations of gender and mental illness in the Indian social structure often highlighted in terms of traditions and gender-colored norms which is confirmed with the patriarchal framework. The combination of women and diagnosis of mental illness disturbs the prescribed gender expectations which accelerate the family abandonment, and many women lead their life in shelter care homes after psychiatric hospitalization. The aim of the study is to assess the sociodemographic characteristics of the residents admitted in shelter care homes and understand the co-relational aspects of changing sociocultural scenario. SUBJECTS AND METHODS: Recruited 50 women residents living in 14 centers both the governmental and nongovernmental shelter care homes in Bengaluru, Karnataka. Utilized sociodemographic datasheet to assess the sociodemographic variables and retrospective file review to elicit commonalities among the sample. RESULTS: The current study reveals that majority (74%) belongs to the nuclear family, lived in a rented house before institutionalization (46%). The reason for stay in shelter care home reported to be family abandonment and rejection (72%) and majority of the residents experiencing chronic homelessness (92%) are unmarried/separated (82%) and majority revealed none of the family members ever visited them in shelter care homes (66%). CONCLUSION: It is imperative to understand the connection between sociodemographic details of the women admitted in shelter care homes and the rapid changes occurring in the sociocultural structure for comprehensive understanding of mental illness-homelessness-institutionalization nexus.

Women with Mental Illness - An Overview of Sociocultural Factors Influencing Family Rejection and Subsequent Institutionalization in India.

BACKGROUND: Family abandonment and rejection resulting in homelessness are detrimental to women diagnosed with mental illness in India. A majority of the literature related to homelessness holds a western background, and women's homelessness in relation to mental illness is relatively unexplored in the Indian context. This review was conducted to understand the sociocultural factors influencing family rejection and to synthesize the living situation of institutionalized women with mental illness in India. METHODS: Literature search in electronic databases (PubMed, Google Scholar), carried out using appropriate keywords, and a manual search in the library catalog. RESULTS: As per the selection criteria, 19 reports, including original research articles and conceptual papers, were included and reviewed. CONCLUSION: There is a shortage of methodologically sound research in understanding the connection of mental illness-women homelessness-and the institutionalization scenario. This review highlights the necessity of shifting focus from institutionalization to innovative psychiatric rehabilitation strategies using the Mental Healthcare Act, 2017.

Lives without Roots: Institutionalized Homeless Women with Chronic Mental Illness.

The spiral phenomenon of homelessness and mental ill-health are major growing epidemic in both developed and developing countries. Viewing from a socio-economic-political dimension, homelessness and mental ill-health cause detrimental effects on the individuals' lives as well as the nation-building process. The condition of women seems to be complex, as the gender perspectives are often described in terms of patriarchy and powerlessness. The bi-directionality of mental illness and homelessness creates a vicious cycle, and many women seem to end up in shelter care homes. The scenario of homeless women with chronic mental illness reflects the lack of community-based rehabilitation efforts and gender-sensitive policy level initiatives.

Sexual and Reproductive Health Concerns of Adolescents Living with Perinatally Infected HIV in India.

BACKGROUND: With improved access to highly active antiretrieval treatment, many children with perintally acquired HIV are now able live longer. These children are now reaching into adolescence and sexually active. This qualitative, explorative study examines the sexual and reproductive health (SRH) needs and concerns of adolescents living with HIV (ALHIV) in India. MATERIALS AND METHODS: We used qualitative research design to collect the data. Twenty participants were recruited from two nongovernmental organizations which provide shelter care, education, and emotional and social support to HIV/AIDS orphan children located in Bengaluru District of Karnataka State using purposive sampling. In-depth interview guide was prepared and used to elicit the adolescents' concerns, knowledge, and perspective related to sexuality, marriage, child bearing, and barriers in availing SRH services in the context of HIV. RESULTS: Totally, four themes were emerged from that qualitative data based on thematic analysis, which are as follows: "Perceived challenges in relation to romantic relationship;" "Confusion regarding whether to marry person with HIV positive or HIV negative;" "Aspiration to have children," and "Perspective of ALHIV in relation to SRH needs and concerns." CONCLUSION: The findings of the research brought out the need for policies and guidelines specifically targeting the SRH needs and concerns of ALHIV.

Barriers to Disclosure of Intimate Partner Violence among Female Patients Availing Services at Tertiary Care Psychiatric Hospitals: A Qualitative Study.

BACKGROUND: Intimate partner violence (IPV)/domestic violence is one of the significant public health problems, but little is known about the barriers to disclosure in tertiary care psychiatric settings. METHODOLOGY: One hundred women seeking inpatient or outpatient services at a tertiary care psychiatric setting were recruited for study using purposive sampling. A semi-structured interview was administered to collect the information from women with mental illness experiencing IPV to know about their help-seeking behaviors, reasons for disclosure/nondisclosure of IPV, perceived feelings experienced after reporting IPV, and help received from the mental health professionals (MHPs) following the disclosure of violence. RESULTS: The data revealed that at the patient level, majority of the women chose to conceal their abuse from the mental health-care professionals, fearing retaliation from their partners if they get to know about the disclosure of violence. At the professional level, lack of privacy was another important barrier for nondisclosure where women reported that MHPs discussed the abuse in the presence of their violent partners. CONCLUSION: The findings of the study brought out the need for mandatory screening of violence and designing tailor-made multicomponent interventions for mental health care professionals at psychiatric setting in India.