Coping with the stress of providing mental health-related informal support to peers in an LGBTQ context.

Many lesbian, gay, bisexual, trans or gender diverse, or queer-identifying (LGBTQ) people provide informal support to peers experiencing mental ill health. This reflects both the high prevalence of mental ill health in their communities - often a product of discrimination - and barriers to accessing formal services. In this article, we explore how LGBTQ people who help peers with their mental health seek to cope with the stress of providing such support. Drawing on interviews with 25 LGBTQ people in Melbourne, Australia, we consider how community members being 'leant on' engage in self-care practices and seek help from their communities to cope with the stress of their support roles. We demonstrate that participants' ways of coping, even when similar, can vary in effectiveness and often come with limitations. Thus, we conclude that LGBTQ people providing informal support to peers should be better assisted to do so, in ways that acknowledge the diversity of support provided in LGBTQ communities.

‶You look really good, I don't know why you came here″: persons with multiple sclerosis´ perspectives on social support.

The aim of this qualitative study is to gain insight into the perspectives of persons with multiple sclerosis on social support. Semi-structured interviews were conducted with eleven persons with multiple sclerosis. The results on informal support for persons with multiple sclerosis reveal perceived support and the lack of support from different persons. The results on formal support for persons with multiple sclerosis show perceived support from healthcare professionals, professionals working outside healthcare and social care systems, and associations of persons with MS, but also inadequate support from healthcare professionals and social workers. Close emotional relationship, empathy, knowledge and understanding are the basis for provision of all types of support from informal support system, while perceived support from formal support system is based on professionals´ empathy, their professionalism and knowledge. Persons with multiple sclerosis need accurate and timely emotional, informational, practical and financial support.

Support as described by fathers with intellectual disabilities.

BACKGROUND: Many fathers with intellectual disabilities experience some difficulties in fulfilling their parenting role due external factors. The quality of their parenting depends on various factors, including the availability and adequacy of support. The aim of this study was to understand the lived experiences associated with social support of fathers with intellectual disabilities. METHOD: The organisation of the research and data analysis were carried out in accordance with Interpretative Phenomenological Analysis. Semi-structured interviews were conducted with 20 fathers with intellectual disabilities. RESULTS: In the analysis, three interrelated themes emerged: Discrepancies between needs and provision of support; Discriminatory practices and feeling (dis)empowered; and Recognition of support. CONCLUSIONS: Fathers described negative aspects of their experiences that were not conducive to strengthening paternal competences and led to a sense of loneliness. Positive aspects also emerged, indicating that fathers were determined to fulfil their role despite the lack of adequate support for their needs.

[Older people living alone: the importance of informal non-kin care : Scoping review]. / Alleinlebende ältere Menschen: Stellenwert der informellen außerfamiliären Hilfe : Literaturübersicht.

BACKGROUND: The number of older people living alone is constantly increasing. This group faces special challenges regarding remaining at home when their care needs increase, especially in later life. When no family is available, friends and neighbors, so called non-kin carers, are important sources of support. OBJECTIVE: A literature review was conducted to evaluate existing research on the relevance of non-kin support for older people living alone, from initial limitations to the end of their lives, particularly when they wished to remain at home. METHOD: The literature search followed the criteria of a scoping review and was conducted in relevant databases and manually. A total of 22 studies were included in the analysis. RESULTS: Older people living alone are often embedded in complex support networks. Living alone at an advanced age creates tensions between the desire for independence and the need for help. Non-kin carers primarily provide instrumental, emotional, and informational support. Challenges arise due to difficult interpersonal dynamics and the overburdening of non-kin carers, especially when those they support are at the end of their lives. CONCLUSION: It is important to understand care networks as a complex interplay of different actors. Future research should focus on the specific burdens on non-kin carers as well as on the dynamics of relationships in these care networks.

Gender and family structures affecting intergenerational support from adult children to older parents: A cross-national study in a developing country.

In Latin America, informal support from adult children to their older parents ("upward support") is crucial with an aging population and insufficient coverage of social protection systems. This article examines variables associated with upward support, distinguishing by gender of parents and their children. The research design is quantitative, correlational, and cross-sectional. It is based on primary survey data collected by the authors for the study. The authors hypothesized that upward support depends on children's opportunities to provide support and on the needs of parents. The results show that upward support depends more on children's opportunities than on parents' needs, although upward support is higher for parents with poorer health. Daughters are more supportive than sons, but sibling characteristics do not moderate associations between children's gender and receipt of support. Cohabiting with the parent, receiving support from the parent, and having a good relationship were also associated with greater upward support. Therefore, policies should consider the gender of adult children when allocating resources to older people.

Diabetes Distress Among Dyads of Patients and Their Health Supporters: Links With Functional Support, Metabolic Outcomes, and Cardiac Risk.

BACKGROUND: Patients with diabetes (PWD) often experience diabetes distress which is associated with worse self-management and glycemic control. In contrast, PWD who receive support from family and friends (supporters) have better diabetes outcomes. PURPOSE: To examine the associations of PWD diabetes distress and supporters' distress about PWDs' diabetes with supporters' roles and PWD cardiometabolic outcomes. METHODS: We used baseline data from 239 adults with Type 2 diabetes and their supporters participating in a longitudinal trial. PWD and supporter diabetes distress (high vs. low) were determined using the Problem Areas in Diabetes Scale-5. Outcomes included PWD-reported help from supporters with self-care activities, supporter-reported strain, PWD metabolic outcomes (glycemic control [HbA1c], systolic blood pressure [SBP], and non-HDL cholesterol) and 5 and 10 year risk of cardiac event (calculated using the United Kingdom Prospective Diabetes Study algorithm). RESULTS: PWDs with high diabetes distress were more likely to report that their supporters helped with taking medications, coordinating medical care, and home glucose testing (p's < .05), but not more likely to report help with diet or exercise. High supporter distress was associated with greater supporter strain (p < .001). High supporter diabetes distress was associated with higher PWD HbA1c (p = .045), non-HDL cholesterol (p = .011), and 5 (p = .002) and 10 year (p = .001) cardiac risk. CONCLUSIONS: Adults with high diabetes distress report more supporter help with medically focused self-management but not with diet and exercise. Supporter distress about PWD diabetes was consistently associated with worse outcomes. PWD diabetes distress had mixed associations with their diabetes outcomes.

Patterns of stress and support in social support networks of in-home hospice cancer family caregivers.

Family caregivers of home hospice cancer patients often experience burden and distress, which can be mitigated by perceived social support. However, less attention has been paid to the non-family sources of support within social networks, or to how sources of support may also be sources of stress. We describe support and stress in social networks of hospice family caregivers and identify caregiving characteristics associated with classes identified in our data. We collected demographic and psychosocial self-report data from family caregivers providing in-home hospice care for advanced cancer patients (N = 90). Caregivers also reported perceived support and stress from specific family and non-family relationships. We identified three classes with unique patterns of stress and support within caregivers' support networks using a latent class analysis. Classes include: 1) high support, low stress across family and non-family network members ("supportive"; 53% of caregivers); 2) high support, high stress across family and non-family network ("ambivalent maximizers"; 26%); and 3) high support, high stress across family network only ("family-focused ambivalent"; 21%). Caregivers in the ambivalent maximizer class reported more burden than caregivers in the supportive class (p = .024). This is one of the first studies to systematically explore the role of non-family support, as well as how stress and support co-occur within relationships and across networks. As informal support networks of hospice family caregivers are complex and multifaceted, understanding the patterns of support and stress across various network members is essential to offer services to more effectively manage caregiver burden.

A model of intention to provide mental health first aid in college students.

BACKGROUND: Psychologically distressed college students' peers are often the first line of mental health support. Mental health first aid (MHFA) focuses on the quality of early intervention provided by peers to those in psychological distress but has neglected what motivates college students to provide MHFA. AIMS: The current study used the MHFA framework and bystander theory as a foundation to examine factors influencing college students' intention to provide MHFA. METHODS: Participants were 778 U.S. college students from a larger group of college students (N = 29,765) from the 2015-2016 Healthy Minds Study archival dataset. Secondary data analysis using path analysis modeling was used to test for both direct and indirect effects. RESULTS: The specified path analysis model demonstrated exact fit to the data, χ2(67) = 82.359, p = 0.098. Personal stigma decreased MHFA intention, whereas both perceived MHFA efficacy and personal responsibility increased MHFA intention. Of note, perceiving campus climate as supportive of helping others indirectly increased MHFA intention. CONCLUSIONS: The current study supports a theory-driven framework rooted in the MHFA and bystander theory literature that could facilitate targeted interventions aimed at improving mental health prevention via college student prosocial behavior.

Church support networks of African Americans: The impact of gender and religious involvement.

We examined the sociodemographic and religious involvement correlates of church support networks in a nationally representative sample of African Americans across the adult life span. Data from the National Survey of American Life was used for analysis. Ordinary least squares regression was conducted to identify correlates of frequency of contact, subjective closeness, provision and receipt of overall support, receipt of emotional support, and negative interactions with church members. We also investigated differences in church support networks separately for men and women. Religious involvement was positively associated with church support network indicators (i.e., frequency of contact). Church support network indicators also varied by age, gender, education, family income, marital status, and region. The findings indicate that for many African Americans, church members are an integral component of their support networks and underscore the importance of social integration in church networks for social support exchanges. Moreover, these church support network characteristics are patterned by sociodemographic characteristics.

The association between medical diagnosis and caregiver burden: a cross-sectional study of recipients of informal support and caregivers from the general population study 'Good Aging in Skåne', Sweden.

BACKGROUND: Different kinds of chronic diseases might imply different dimensions of caregiver burden, not previously described among the caregivers to recipients from the general elder population. AIM: The main objective was to examine differences in burden between the 343 caregivers to persons with different diagnoses. METHODS: A group of elderly recipients of informal care (n = 343) from the general population study 'Good Aging in Skåne' (GÅS) Sweden, were divided into five diagnostic groups: dementia (n = 90), heart and lung diseases (n = 48), stroke (n = 62), fractures (n = 66), depression (n = 40) and the group "other", consisting of different diagnoses (n = 37) according to ICD-10. Differences in burden were analyzed using the Caregiver Burden Scale (CBS), a 22-item scale consisting of five dimensions: general strain, isolation, disappointment, emotional involvement and environmental burden. A total burden index comprises the mean of all the 22 items and a higher score indicates a higher burden. RESULTS: The most common diagnosis associated to caregiving was dementia and fracture and the median hours weekly for informal support with instrumental ADL for the five diagnostic groups ranged from 7 to 45 h for spouses and from 4 to 7 h for parents. The highest proportion of caregivers scoring high total burden was seen among recipients with dementia (50%) and depression (38%); the OR for high total burden for the dementia group was 4.26 (2.29-7.92) and depression group 2.38 (1.08-5.24) adjusted for covariates like age, gender and ADL and these two groups had higher self-perception of burden in all the dimensions, especially the dimension's emotional burden and strain. CONCLUSION: Informal support constitutes a substantial time for instrumental ADL for the diseased elders. Caregivers to persons with dementia and depression experience high burden.

Materialities of mundane care and the art of holding one's own.

The focus of this special issue is on how everyday or mundane materialities actively mediate health and care practices. This article extends this concern with the mundane to care itself and explores how specific materialities, such as shared spaces and everyday objects, not only mediate mundane care but enable it to happen. Our focus is on mundane help in the context of ill health, between people who are not immediate family, such as neighbours, acquaintances and others with whom we interact in our daily lives. Drawing on recent empirical studies of low-level support in two different parts of the UK, we show how the materialities of care can mediate the affective risks associated with receiving such help. Specifically, we investigate how materialities help people to balance the expression of their vulnerability with a need to retain their dignity, a practice referred to as 'holding one's own'. In doing so, we argue that materialities are not just the conduits for care - what care passes through - or things that mediate care. We suggest instead that materialities are part of how relationships of mundane care are constituted and maintained.

Stroke survivors' long-term QALY-weights in relation to their spouses' QALY-weights and informal support: a cross-sectional study.

BACKGROUND: Healthcare interventions that have positive effects on the stroke survivors' health-related quality of life (HRQoL) and quality-adjusted life-years (QALYs) might also have positive effects for their spouses in terms of improved HRQoL and/or reduced spousal informal support. However, knowledge about stroke survivors' HRQoL and QALY and the consequences for their spouses' HRQoL and QALY is limited. Therefore, the aim of this study was to describe the HRQoL and QALY-weights in dyads of stroke survivors in comparison with dyads of healthy controls, and to study the relationship between the stroke survivors' QALY-weights and consequences for spouses in terms of QALY-weight and annual cost of informal support, using a long-term perspective. METHODS: Data on stroke survivors, controls, and spouses were collected from the seven-year follow-up of the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS). HRQoL was assessed by the SF-36, and the preference-based health state values were assessed with the SF-6D. The magnitude of the support was assessed with a study specific time-diary. An ordinary least squares (OLS) regression was used to estimate the association between stroke survivors' and spouses' QALY-weights. A two-part econometric model was used to estimate the association between stroke survivors' QALY-weights and the time spent and cost of spouses' informal support. RESULTS: Cohabitant dyads of 248 stroke survivors' aged <70 at stroke onset and 245 controls were included in the study. Stroke survivors had lower HRQoL in the SF-36 domains physical functioning, physical role, general health, vitality (P < 0.001), and social functioning (P = 0.005) in comparison with their cohabitant spouses. There was no significant difference in HRQoL for the dyads of controls. The results from the regression analyses showed that lower QALY-weights of the stroke survivors were associated with lower QALY-weights of their spouses and increased annual cost of spousal informal support. CONCLUSION: Our results show that the QALY-weights for stroke survivors had consequences for their spouses in terms of annual cost of spousal informal support and QALY-weights. Hence, economic evaluation of interventions that improve the HRQoL of the stroke survivors but ignore the consequences for their spouses may underestimate the value of the intervention.

Strategies for Working with Asian Americans in Mental Health: Community Members' Policy Perspectives and Recommendations.

This qualitative study used snowball sampling of individuals known to provide informal assistance to Asian American community members with their mental health problems in a locality in the South where there has been an exponential increase of the Asian American population. The major themes found include: (1) the existence of cultural, language, knowledge, and transportation barriers and the importance of policy in addressing them; (2) the impact of the model minority myth and the need for inclusive policymaking; and (3) the unique service and policy needs of immigrants. Findings demonstrate the importance and value of including diverse Asian American individuals in mental health policymaking efforts.

The Willingness of Military Members to Seek Help: The Role of Social Involvement and Social Responsibility.

Anchored in the social organization theory of action and change, we use data from a large sample of active-duty Air Force members to examine the direct and indirect influence of social involvement and social responsibility on willingness to seek help in times of need via trust in formal systems and informal supports. Group comparisons are conducted between junior male, junior female, senior male, and senior female service members. The key mediational path in the model for all groups is the connection between social involvement and willingness to seek help via trust in formal systems. These results can inform both unit- and community-level interventions intended to increase the likelihood that active-duty AF members will seek help in times of need.

Church-Based Social Support Among Caribbean Blacks in the United States.

An emerging body of research notes the importance of church-based social support networks in the daily lives of Americans. However, few studies examine church-based support, and especially among ethnic subgroups within the U.S. Black population, such as Caribbean Blacks. This study uses data from the National Survey of American Life (NSAL) to examine demographic and religious participation (e.g., attendance, interaction) correlates of church-based social support (e.g., receipt of emotional support, receipt of general support, provision of support to others, and negative interaction) among Caribbean Blacks residing in the U.S. Multiple regression analyses indicated that religious participation was associated with all four dependent variables. Church attendance was positively associated with receiving emotional support, general social support, and providing support to others, but was not associated with negative interaction. Frequency of interaction with fellow congregants was positively associated with receiving emotional support, receiving general support, providing support to others and negative interaction. Demographic findings indicated that women provided more support to church members and experienced more negative interactions with members than did men. Education was positively associated with frequency of support; household income was negatively associated with receiving emotional support and providing social support to others. Findings are discussed in relation to the role of church-based support networks in the lives of Caribbean Black immigrants and communities.

Whom Do Centenarians Rely on for Support? Findings From the Second Heidelberg Centenarian Study.

This paper provides a detailed picture of the sources and types of informal support available to centenarians, depending on their housing and care arrangements. Participants were 112 centenarians and 96 primary contacts of centenarians enrolled in the population-based Second Heidelberg Centenarian Study. Findings indicate that children of centenarians were their primary source of support in daily life. Those without living children had overall less help. Most frequently reported was help with administrative tasks, regardless of centenarians' residence or living arrangement. All other types of help (e.g., with activities of daily living and housework) were reported by about one-third and were mostly provided by children; centenarians without children were more likely to have friends/neighbors involved in some of these tasks. The one category reported by a third of the centenarians regardless of residence, living arrangements, or presence of a child was help with socializing/companionship. Findings constitute an important step toward identifying and meeting the support needs of centenarians and their families. Policy implications are discussed.

Going the Extra Mile: How High School Staff Use Informal Strategies to Support, Protect, and Care for LGBTQ+ Students.

BACKGROUND: High school staff can play a key role in supporting students with LGBTQ+ identities through informal strategies; however, more research is needed to understand how staff are employing these strategies. METHODS: We conducted semi-structured interviews, collecting information on informal strategies used to support students identifying as LGBTQ+ from a diverse sample of 23 school staff from high schools across the United States. RESULTS: Staff employed informal support strategies across social ecological levels: within the school community, staff interacted with parents/guardians of students and advocated for more inclusive policies. Within the classroom, staff created inclusive physical environments, implemented inclusive curricula, and employed bullying prevention strategies. Interpersonally, staff listened to and affirmed students and collaborated to employ support strategies. Intrapersonal qualities, including having a personal connection to the LGBTQ+ community and demonstrating open-mindedness, facilitated staff efforts to support students. CONCLUSIONS: Supporting staff in the implementation of the strategies we identified could foster more inclusive school environments, advancing equity for students identifying as LGBTQ+.

Parenting children with disabilities in Sweden: a cluster-analysis of parenting stress and sufficiency of informal and formal support.

Objective: To investigate patterns of parenting stress and access to sufficient informal and formal support among parents of children with disabilities. To explore whether child cognitive level, conduct problems and the need of language interpretation in contacts between parents and professionals are associated with patterns of parenting stress and support. Method: Parents (N = 140) of children with disabilities in Sweden completed a questionnaire about parenting stress and support. Patterns of three variables-parenting stress and access to sufficient informal and formal support-were investigated using cluster analysis. The relationship of child cognitive level, level of conduct problems and of language interpretation needs between parents and professionals to cluster membership was explored using multinomial logistic regression. Results: Five different clusters of parenting stress and support emerged. Parents in cluster 1 had lower than sample mean ratings on all three variables. Cluster 2 had elevated parenting stress, cluster 3 had elevated insufficient informal support and cluster 4 had elevated insufficient formal support. Cluster 5 had elevated ratings on all three variables. Greater child cognitive difficulties increased the likelihood of parent membership in cluster 2 (elevated stress), cluster 3 (elevated insufficient informal support), or cluster 5 (elevated ratings on all variables). Child conduct problems increased the likelihood of membership in cluster 2 (elevated stress) or cluster 5 (elevated ratings on all variables). No relationship between language interpretation needs and cluster membership was found. Conclusions: Patterns of parenting stress and sufficiency of support, and their associations with child characteristics, vary substantially. However, families of children with conduct problems experiencing elevated parenting stress in combination with insufficient informal and formal support, may be particularly vulnerable. The results of the current study highlight the clinical importance of exploring and identifying individual parenting stressors and perceived levels of support, to be able to adapt services to better suit a variety of needs, and thus promote equitable care.

The Extended Social Network-Oriented Support Model for Intimate Partner Violence Survivors.

Intimate partner violence (IPV) transcends cultural, social and economic boundaries, affecting countless individuals globally. Recovery for IPV survivors is supported by their social networks, yet the readiness of these networks is often poorly understood. This perspective paper proposes an extension to existing network-oriented IPV support models by integrating a focus on the readiness and well-being of informal supporters towards the goal of enhancing IPV survivor recovery through effective networks. This paper presents the extended social network-oriented support model, incorporating the Informal Supporter Readiness Inventory. This tool assesses the readiness of informal supporters, incorporating factors, such as normative and individual beliefs about IPV, and context-specific factors, to enable identification and targeted assistance where needed. Additionally, the proposed model emphasises the importance of supporting the well-being of informal supporters, who frequently endure elevated levels of stress, anxiety and depression. By integrating these elements, the extended social network-oriented support model is designed to help professional supporters foster resilient and sustainable support networks for IPV survivors, with potential applicability across various healthcare disciplines. The extended model underscores the necessity of assessing and fostering both the readiness and well-being of informal supporters to enhance the recovery journey for IPV survivors.

Accessing supports due to others' harmful drinking.

INTRODUCTION: Alcohol's harm to others (AHTO) refers to harms caused to those other than the drinker. The current paper estimates the prevalence of formal and informal supports sought due to AHTO and examines whether the type of support accessed varies by sociodemographic, economic and harm-related characteristics. METHODS: An Australian sample of 2574 people completed the 2021 AHTO survey, out of which 888 perceived they experienced harm from another's drinking. Prevalence of accessing services and supports was measured. Additionally, several sociodemographic factors, economic factors and harm-related factors were included in multivariable logistic regression models predicting service/support use. Specifically, four models were constructed probing use of any service/support, use of police, use of counselling services and use of family/friend support. RESULTS: Of the survey sample, 12.4% accessed any support/service. Seeking support from family and/or friends was most common, followed by police, counselling, healthcare services and being admitted to hospital. Women had higher odds of accessing counselling and family/friend support. Respondents with a higher education level and two or more financial stressors had higher odds of accessing police and counselling. Respondents harmed by a stranger had higher odds of accessing police, whereas respondents harmed by someone they know had higher odds of seeking support from family/friends. Experiencing more severe harm was associated with greater odds of accessing any support. DISCUSSION AND CONCLUSIONS: Several sociodemographic and economic factors were associated with accessing different supports. These findings may inform service development, interventions and policy changes for people affected by others' drinking.