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Working through interpreters in old age psychiatry: a literature review
- Authors:
- FAROOQ Saeed, KINGSTON Paul, REGAN Jemma
- Journal article citation:
- Mental Health Review Journal, 20(1), 2015, pp.36-47.
- Publisher:
- Emerald
Purpose: A systematic appraisal of the effect of use of interpreters for mental health problems in old age. The primary objective of the review is to assess the impact of a language barrier for assessment and management in relation to mental health problems in the old age. The secondary objectives are to assess the effect of the use of interpreters on patient satisfaction and quality of care, identify good practice and make recommendations for research and practice in the old age mental health. Design/methodology/approach: The following data sources were searched for publications between 1966 and 2011: PubMed, PsycINFO, CINAHL and Cochrane Library. The authors also conducted a search of the World Wide Web using Google Scholar, employing the search term Medical Interpreters and Mental Health. The search included literature in all languages. Findings: Only four papers met the inclusion and exclusion criteria and present original research in the field of “old age”, “psychiatry” and “interpreting”. None of these papers present UK-based research. The studies are from Australia, Canada, a paper describing community interpreting in a Belgian old home and an American case study. Practical implications: Interviewing older patients for constructs like cognitive function and decision-making capacity through interpreters can pose significant clinical and legal problems. There is urgent need for training mental health professionals for developing skills to overcome the language barrier and for interpreters to be trained for work in psychogeriatrics. Social implications: Further studies are needed to understand the extent of problem and how effective interpreting and translating services can be provided in the routine clinical practice. It is also essential to develop a standard of translation services in mental health that can be measured for their quality and also efficiency. At present such a quality standard is not available in the UK (Edited publisher abstract)
Emotional support, negative interaction and DSM IV lifetime disorders among older African Americans: findings from the national survey of American life (NSAL)
- Authors:
- LINCOLN Karen D., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(6), June 2010, pp.612-621.
- Publisher:
- Wiley
While both emotional support and negative interaction (conflicts) with family members have been linked to mental health problems, few studies have examined the associations between emotional support and negative interaction and psychiatric disorders in late life. This study investigated the relationship between emotional support and negative interaction on lifetime incidence of mood and anxiety disorders among older African Americans. Data from the National Survey of American Life identified 786 African Americans aged 55 years and older to be included in the study. The DSM-IV World Mental Health Composite International Diagnostic Interview (WMH-CIDI) was used to assess mental disorders, and three dependent variables were examined: the prevalence of lifetime mood disorders; the prevalence of lifetime anxiety; and the prevalence of lifetime mood and anxiety disorders. Findings showed that emotional support was not associated with any of the three dependent variables. Negative interaction was significantly and positively associated with the chances of having a lifetime mood disorder, a lifetime anxiety disorder and the number of lifetime mood and anxiety disorders, with 23% of respondents reporting at least one mental disorder over their lifetime. The authors conclude that this study’s finding can alert clinicians to the potential negative impacts of family involvement and their implications for psychiatric disorders.
The early experience of consultant psychiatrists in application of the Mental Capacity Act: issues for black and minority individuals
- Authors:
- SHAH Ajit, et al
- Journal article citation:
- Ethnicity and Inequalities in Health and Social Care, 2(2), July 2009, pp.4-10.
- Publisher:
- Emerald
The Mental Capacity Act 2005 (MCA) was fully implemented in October 2007 in England and Wales. This article reports on two similar, but separate, pilot questionnaire studies that examined the experience of consultants in old age psychiatry and consultants in other psychiatric specialities in the early implementation of the MCA pertaining to issues relevant to black and minority ethnic (BME) groups. Fifty-two (27%) of the 196 consultants in old age psychiatry and 113 (12%) of the 955 consultants in other psychiatric specialities returned useable questionnaires. Eighty per cent or more of the consultants in old age psychiatry and consultants in other psychiatric specialities gave consideration to religion and culture and ethnicity in the assessment of decision-making capacity (DMC). Almost 50% of the consultants in old age psychiatry reported that half or more of the patients lacking fluency in English or where English was not their first language received an assessment of DMC with the aid of an interpreter and 40% of the consultants in other psychiatric specialities reported that no such patients received an assessment of DMC with the aid of an interpreter. The low rate of using interpreters is of concern. The nature of the consideration and implementation of factors relevant to culture, ethnicity and religion in the application of the MCA and the precise reasons for the low rate of using interpreters in patients lacking fluency in English or English not being their first language require clarification in further studies.
Prevalence and patterns of executive impairment in community dwelling Mexican Americans: results from the Hispanic EPESE Study
- Authors:
- ROYALL Donald R., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(10), October 2004, pp.926-934.
- Publisher:
- Wiley
Little is known about the prevalence of impaired executive control function (ECF) in community dwelling elderly or minority populations. We have determined the prevalence of cognitive impairment and impaired ECF in a community dwelling Mexican American elderly population, and their associations with functional status. Subjects were 1165 Mexican Americans age 65 and over who were administered CLOX as part of the third wave of the Hispanic Established Population for Epidemiological Study (HEPESE) conducted from 1998 to 1999. ECF was measured by an executive clock-drawing task (CDT) (i.e. CLOX1). Non-executive cognitive function was assessed by the Mini-Mental State Examination (MMSE) and a non-executive CDT (CLOX2). CLOX scores were combined to estimate the prevalence of global CLOX failure (i.e. Type 1 cognitive impairment) vs isolated CLOX1 failure (i.e. Type 2 cognitive impairment). 59.3% of subjects failed CLOX1. 31.1% failed both CLOX1 and CLOX2 (Type 1 cognitive impairment). 33.3% failed CLOX1 only (Type 2 cognitive impairment). 35.6% passed both measures [no cognitive impairment (NCI)]. Many subjects with CLOX1 impairment at Wave 3 had normal MMSE scores. This was more likely to occur in the context of Type 2 cognitive impairment. Both CLOX defined cognitive impairment groups were associated with functional impairment. A large percentage of community dwelling Mexican American elderly suffer cognitive impairment that can be demonstrated through a CDT. Isolated executive impairments appear to be most common. The ability of a CDT to demonstrate ECF impairments potentially offers a rapid, culturally unbiased and cost-effective means of assessing this domain. In contrast, the MMSE is relatively insensitive to ECF assessed by CLOX1.
Knowledge of Alzheimer's disease in four ethnic groups of older adults
- Authors:
- AVALON Liat, AREAN Patricia
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(1), January 2004, pp.51-57.
- Publisher:
- Wiley
The present study evaluated knowledge of Alzheimer's disease (AD) in four ethnic groups of older adults. Ninety-six Anglo, 37 Latino, 30 Asian, and 30 African American older adults completed a short survey about AD. Results indicated that Anglo older adults are significantly more knowledgeable about AD than African American, Asian, and Latino older adults. Level of education partially accounted for differences in knowledge of AD between Latino to Anglo older adults. After controlling for age, number of years of speaking English was associated with knowledge of AD in Asian older adults. The results suggest that certain ethnic minority groups do not have sufficient information about AD, and this may explain the lack of AD service use by minorities. Extensive evaluation of barriers to knowledge of AD is needed in order to specifically target minority groups and educate them about AD and the importance of early intervention.
The association of psychosocial factors and depression with hypertension among older adults
- Authors:
- BOSWORTH Hayden B., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(12), December 2003, pp.1142-1148.
- Publisher:
- Wiley
This article seeks to examine the relationship between depression and hypertension in an elderly population and how psychosocial variables influence this relationship. The study included 293 subjects, who met DSM-IV criteria for unipolar depression, and 151 subjects with no psychiatric disorder. All subjects were over the age of 58. Participants were administered the Duke Depression Evaluation Schedule at baseline and at yearly intervals for 3 years. Cross-sectional analyses of baseline data showed that hypertensive patients were more likely to be depressed and of non-white race. Bivariate analyses provided evidence that hypertension was associated with higher amounts of total stressors and lower social support. No differences in the prevalence of hypertension were found between men and women. In addition, there was no evidence of change in hypertension status over time. Patients, especially minorities, who experience depression, stress, or a lack of social support, are at an increased likelihood of having hypertension and clinicians should consider this risk when treating this population.
Gender in elderly suicide: analysis of coroners inquests of 200 cases of elderly suicide in Cheshire 1989-2001
- Authors:
- SALIB Emad, GREEN Laura
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(12), December 2003, pp.1082-1087.
- Publisher:
- Wiley
The aim of this study is to review gender differences in elderly suicide in relation to specific social aspects of the suicidal process and health care contact before death. Such information may have practical value in identifying and targeting vulnerable elderly in whom suicide may be potentially preventable. Data were extracted from the records of coroner's inquests into all reported suicide of persons aged 60 and over, in Cheshire over a period of 13 years 1989-2001. The Coroner's office covers the whole county of Cheshire (population 1 000 000). Men were less likely to have been known to psychiatric services (Odds Ratio [OR] 0.4 95% 0.2-0.6) and with less frequently reported history of previous attempted suicide compared to women (OR 0.5 95% Confidence Intervals [CI] 0.2-1). All deceased from ethnic minorities were men, none of whom had been known to psychiatric services. There was no significant difference between women and men in relation to, physical or psychiatric morbidity, GP contact prior to suicide, intimation of intent or living alone. Of suicide victims not known to services a surprisingly high proportion of 38% and 16% were found to have psychiatric morbidity in men and women respectively.
Chinese mental health issues in Britain: perspectives from the Chinese Mental Health Association
- Editors:
- YEE Lydia, AU Shun
- Publisher:
- Mental Health Foundation
- Publication year:
- 1997
- Pagination:
- 47p.
- Place of publication:
- London
Booklet presenting an overview of mental health issues facing the Chinese community in Britain. Includes chapters on: a brief history of the Chinese Mental Health Association; the mental health of Chinese children and young people in Britain; psychiatrists and Chinese mental health; the community mental health nursing perspective; Chinese medicine and mental health; Chinese carers of people with mental health problems; and Chinese elders and their mental health.
The haunt of misery: critical essays in social work and helping
- Editors:
- ROJEK Chris, PEACOCK Geraldine, COLLINS Stewart
- Publisher:
- Routledge
- Publication year:
- 1988
- Pagination:
- 195p., bibliogs.
- Place of publication:
- London
Exploration of some of the main problems facing social workers in a society which is becoming more materialistic and concerned with the individual reather than the community.
The effect of ethnicity and gender on first-contact rates for schizophrenia-like psychosis in Bangladeshi, Black and White elders in Tower Hamlets, London
- Authors:
- MITTER Pamina R., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(3), March 2004, pp.286-290.
- Publisher:
- Wiley
A recent study of very-late onset schizophrenia-like psychosis (SLP) in South London showed an increase in first contact rates amongst African- and Caribbean-born elders compared to British-born ones. This study investigates incident first contact rates in an area of East London with a high Bangladeshi population, to investigate if Bangladeshi-born elders also have an increased referral rate for SLP. Retrospective case note review of first contacts to the old age psychiatry service from 1997 to 2002 identifying cases of schizophrenia-like psychosis. In addition, a one-year review of first contacts for all diagnostic categories was completed. Gender, ethnicity and place of birth were established from the case notes. Among the African- and Caribbean-born, but not the Bangladeshi-born, the odds ratio (OR) of being referred with SLP was significantly higher than for the British-born population. We observed a loss of the reported effect of female gender. For Whites the odds ratio for female gender and psychosis was 2.5 (1.0-6.1) and for non-Whites 0.8 (0.3-2.7) which was a trend away from the expected male to female ratio. In the one-year review there was a higher rate of referrals for organic disease in Bangladeshi men compared to Bangladeshi women and British-born men and women. Bangladeshi elderly migrants do not have an increased rate of SLP compared to indigenous elders. The usual female preponderance of SLP is not apparent in this elderly migrant population. Old age psychiatry services in the UK should take into account the increasing needs of Bangladeshi elders with dementia.