Speaker
Mr Graham Zulu
Phd Student
University Of North Carolina At Chapel Hill, Global Social Development Innovations
Health and Mental Health
Prof Magnus Mfoafo-M’Carthy
PhD,Associate Professor
Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University
Hope deferred… Meeting the Challenges of Mental Health Stigma in Ghana
Abstract Narrative
Despite advances in human rights and treatments for individuals diagnosed with mental illness in the Global North, the situation is very different in Africa. Across the African continent, this population suffers from widespread stigma, discrimination, neglect, and abuse. As a result, effective treatment remains elusive for many people. This presentation will explore the experiences of stigma and social exclusion among individuals diagnosed with mental illness and receiving treatment in a psychiatric facility in Ghana. The study is based on in-depth, semi-structured interviews with individuals diagnosed with serious mental illness between the ages of 19 to 40 years, all of whom were receiving treatment on an inpatient or outpatient basis. Using an inductive methodology, the interviews were conducted individually, and the data coded and analysed for common themes relating to the lived experience of the participants. The findings highlight the significance of social exclusion, discrimination, marginalization and spiritual beliefs as the main roots of stigma and point to the importance of education and awareness-raising as tools for anti-stigma work in Ghana and the global South.
Biography
Magnus Mfoafo-M’Carthy is an Associate Professor at the Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Ontario, Canada. He teaches an array of courses mostly at the micro and macro levels. Dr. Mfoafo-M’Carthy holds a Master’s and PhD in Social Work from Columbia University and the University of Toronto respectively. He is the 2009 recipient of the Hilary M. Weston scholarship for scholastic achievement and commitment to mental health. A former Associate Director of Laurier’s Tshepo Institute for the Study of Contemporary Africa (TISCA) and a former Carnegie Diasporan Fellow at the University of Ghana, he has extensive policy, teaching, and research experience and has worked in adolescent and adult mental health organizations in New York City, British Columbia, and Ontario, including the Centre for Addiction and Mental Health (CAMH) in Toronto. He has previously taught at the Factor-Inwentash Faculty of Social Work, University of Toronto and the University of Windsor. Dr. Mfoafo-M’Carthy’s research focuses on community-based / global mental health practice, disability, inclusive education, international social work, and Afrocentric social work practice. Dr. Mfoafo-M’Carthy has held numerous Canadian research grants exploring stigma, mental health, and disability. He travels regularly to Ghana and other African countries where he is involved in research in mental health and disability.
Prof Daniel Gottlieb
The Hebrew University of Jerusalem, Israel
Self-Perceived Health, Precarious Employment, Poverty and Healthy Life Expectancy
Abstract Narrative
Advances in medical knowledge and technology have helped raise both general and healthy life expectancy (HLE). These developments have caused a secular rise in the elderly’s population share. This trend challenges PAYGO systems of Social Insurance (SI) by increasing their default risk. One way to tackle this problem is to raise the age of old-age-benefit entitlement, also referred to as retirement age. However, such a policy requires the unpopular decision to extend working life, thus creating an adverse policy bias. An automatic linkage of the entitlement age to life expectancy (LE) has been suggested as a possible solution to increased default risk of SI and pension funds. Such an extension of employment presumes a steady improvement of people’s health with increasing life expectancy. Analyzing the determinants of self-perceived health (SPH) by use of the SHARE longitudinal multi-country database, combined with data on life expectancy and its healthy part, from EUROSTAT, and where missing, from WHO, we find that past and present employment improve health, while the gender effect of job quality on self-perceived health is detrimental for women and positive for men. We found that precarious jobs are particularly widespread among women, and that their negative effect on health rises with age, whereas job quality among men is mainly positive peaking in the mid 50ies. This empirical result has an important implication for the policy of automatically linking retirement age to healthy life expectancy: It justifies a reduction of the linkage progressively, certainly for women, with increasing age. One way to achieve this is to attach weights to the existing and the linked retirement age, a weight increasing with age to the existing RA and a complementarily falling weight with age to the linked RA. As a result, the linking of RA to healthy life expectancy should not be front-loaded as it is in the typical discretionary RA policies today. We find health being reduced among other things by poverty and various disabilities. Longevity is found to raise self-perceived health, while SPH, employment and job quality are found to affect each other simultaneously. Age dynamics and job quality are also found to differ substantively by gender. The negative effects of job quality for women need to be addressed in any suggested automatic balancing mechanism of the retirement age. Our findings show that for countries with an elasticity coefficient exceeding 1, healthy life expectancy at age 65 rises faster than general life expectancy at a given age, implying that people’s capability to work until a higher age is improving over time, thus making the retirement age a potentially powerful tool to improve social insurance sustainability. We also find that LE and HLE raise SPH, the effect of HLE on SPH being dominant. We conclude that SI sustainability should be linked to healthy LE, rather than to general LE. We also find poverty rates to affect SPH negatively. However, we find that there is no evidence of poverty feminization with respect to its effect on SPH.
Keywords: Self-perceived health, self-assessed health, precarious employment, job quality, job stress, job satisfaction, job security, Healthy life expectancy, retirement age, SHARE, poverty, social insurance sustainability.
Dr Francis Okello
Secretary General
ICSD
Measuring the differential influence of socio-economic conditions on HIV risk behaviour in Uganda: A comparative analysis of men and women
Abstract Narrative
Objective: The purpose of this study was to investigate the effect of individual wealth quintile on practising protective behaviours for HIV prevention in Uganda, comparing men and women. This study investigated whether females’ wealth quintile was more likely than the males to influence their practising abstinence, be faithful or condom use (ABC) HIV prevention methods after controlling for other background characteristics? The null hypothesis was that the individual wealth quintile of women compared to men does not affect their use of ABC HIV prevention methods after controlling for other background characteristics. The alternative hypothesis was that the individual wealth quintile of women compared to men affects their use of ABC HIV prevention methods after controlling for other background characteristics
.
Methodology: A quantitative methodology was used. Inference was ascertained using generalised linear mixed-effects models. A secondary analysis was conducted on a combined dataset with 11,803 men and 42,957 women from four rounds of the Uganda Demographic and Health Surveys conducted between 2000/1 and 2016. The analysis examined the extent to which Ugandan adults practised the ABC HIV prevention strategies as dependent variables, with wealth quintile as the predictor variable, controlling for respondent’s background characteristics. Abstinence was categorised as primary if the respondent (aged 15 to 24 years only) never had sex or secondary if respondent aged 15+ years ever had sex but abstained in the past 12 months.
Findings: Wealth quintile was associated with practising primary and secondary abstinence, having one sex partner in the past 12 and using a condom at last sex in women but not in men. Women aged 15-24 years in the poor wealth quintile were nearly 50% more likely to have never had sex than in the poorest wealth quintile. Women in the middle wealth quintile were 19% more likely to have abstained from sex in the past 12 months than women in the poorest wealth quintile. At a 10% significance level, women in the poor quintile were 9% less likely to have abstained from sex in the past 12 months than women in the poorest quintile. Widowed, divorced, or separated women and men were less likely to have had only one sex partner in the past 12 months. At a 10% significance level, women in the poor wealth quintile were less likely to have one sex partner in the past 12 months than those in the poorest quintile, but women in the richer category were more likely than in the women in the poorest quintile to have only one sex partner. Lastly, women in the poor wealth quintile were more likely than women in the poorest quintile to have used a condom at last sex.
Conclusions: This study concludes that socio-economic conditions disproportionately predispose Ugandan women to a higher risk of HIV infection than men. Programmes for mitigating high-risk sexual behaviours of widowed, divorced, and separated men and women are also critical for improving HIV prevention in Uganda.
Biography
Mr Okello is a finalist Doctoral student with Charles Sturt University, Australia, School of Humanities and Social Sciences. Professionally, he is a research, monitoring and evaluation expert with over 25 years of experience in the international development sector. He currently works with FHI 360, an International Non-Governmental Organization (INGO), where he serves as the Director of Monitoring, Evaluation and Learning for USAID’s global Medicines, Technologies and Pharmaceutical Services (MTaPS) Program, implemented in partnership with Management Sciences for Health (MSH). Before re-joining FHI 360 in 2020, Mr Okello was Chief of Party for the USAID/Ethiopia Performance Monitoring and Evaluation Services Activity implemented by Social Impact. Other recent positions held by Mr Okello include Principal Associate at Abt Associates, where he was Deputy Research Director for the SHOPS Project and Principal Investigator for AstraZeneca’s Kenya Healthy Heart Africa project evaluation and Chief of Party for the PROGRESS project from 2010-2014 and later as Country Director. In his several years of experience, Mr Okello has designed, led, and conducted various studies of program, project and activity impact, outcome evaluations, and results monitoring in reproductive health, HIV, malaria, health systems and economic growth fields and contributed to strengthening RMELA capacity in several sub-Saharan Africa, Asia countries mainly, but also in the US, Columbia, and Surinam.
Mr Okello holds a Bachelor of Arts in Social Sciences (Sociology & Social Administration) and Master of Arts (Sociology) degrees from Makerere University. His Doctoral thesis title: HIV Prevention in Uganda Through 20 Years: A Social Ecological Analysis Using Mixed Methods has been examined and passed.
Stephanie Sacco
Buffalo University
Case Studies: Resilience of Puerto Ricans in Buffalo, NY: Adults in Mental Health and Addictions treatment with Intersecting Conditions of Poverty, Lack of Access to Resources, Language Barriers, and Co-Occurring Disorders
Abstract Narrative
As an administrator and clinician at an outpatient addictions and mental health clinic in Buffalo, NY, I have observed first-hand the incredible resilience, grit, and creativity of the individuals and families in the Puerto Rican community of Western New York. Our clinic offers services to individuals with addictions and mental health disorders. We have several bilingual and multilingual staff at our clinic, and within the behavioral health agency, serve a unique and incredibly diverse array of individuals including refugees, asylees, immigrants, and indigenous peoples. At this particular clinic, a sense of community and family has evolved, particularly amongst the Puerto Rican clientele, and is strengthened by relationships with Puerto Rican and other Spanish-speaking staff.
This presentation will provide in-depth detail, analysis, and insights of individual clients (de-identified). The presentation will involve rich data related to individual histories, including what led them to move from Puerto Rico to Buffalo, NY, their mental health and other co-occurring conditions, intersectional conditions including past and current conditions of poverty, family and other formal and informal supports, and skills that promote resiliency. The presentation takes a non-judgmental, strengths-based approach to each case study, with the aim of bringing the individual, the personal, and the unique experiences of each participant to light.
Finally, this presentation concludes with some recommendations for future innovations in outpatient treatment. Recommendations are focused on ways to reduce vulnerability among related populations, with a special focus on individuals with language barriers and co-occurring disorders or other intersecting conditions. These recommendations are specifically based on case study participants’ observations and self-report.
This proposal relates to Track 3 and is submitted to be considered for this particular theme within the conference. The Case Study subjects are from vulnerable groups including women, migrants, and people with disabilities, many of whom had other compounding vulnerabilities such as poverty, lack of access to transportation and other resources, lack of social supports, language barrier, and other medical conditions. Included in the presentation will be discussion of group therapies and other models to promote greater social inclusion.
This proposal also relates to themes in Track 1 of practice innovations in mental health and addictions treatment, in face of the global pandemic of COVID-19. We have used a variety of techniques to maintain engagement with the case study subjects despite digital barriers including lack of access to WiFi, computers, smart phones, or phone minutes. This presentation will also discuss efforts to address vulnerability due to co-occurring conditions, some of which were exacerbated due to the pandemic.
Finally, it is of not that this proposal also relates to Track 5, given its focus on individuals with children or individuals living in multi-generational households, such as seniors living with adults and grandchildren. It discusses the social norms of Puerto Rican culture as contrasted with the predominant culture of Western New York, and as a source of resilience. We will also explore methods of improving outcomes for the entire family with the integration of culturally relevant supports.
Dr Melinda du Toit
Registered Psychologist, Post-doctoral Research Fellow
Centre for Social Development in Africa, University of Johannesburg
Health and Mental Health
Biography
I am a postdoctoral Research fellow at the Centre for Social Development in Africa (CSDA). I see myself as a community psychologist and researcher for community development and flourishing. I completed a joint PhD in Psychology at KU-Leuven, Belgium and North-West University, South Africa. My PhD research focused on unemployment and micro entrepreneurship in under-resourced communities in South Africa. My Post-doctoral Research will focus on aspects pertaining to the qualitative fieldwork methodology in a South African context as well as follow-up research to arrive at a deeper understanding of the dynamics in under-resourced communities.