Article Matrix and Analysis – Aspects of Mental Healthcare

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Author, year; Credentials Article #1	Dharmi Kapadia, 2023; Department of Sociology, The University of Manchester, Manchester, UK. Credentials not stated.
Article Focus/Title	Stigma, mental illness & ethnicity: Time to center racism and structural stigma
Research Design/Intervention	Review article. The article reviews previous research on the fields of mental illnesses, stigma, and ethnicities and details expert options on the same.
Level of Evidence and model used	Level V John Hopkins
Evaluation Tool	JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses, Score- 7/11
Sample/# of subjects, how recruited, power analysis?	The article fails to demonstrate how the chosen articles were previewed and selected. It, however, summarizes research studies conducted on the same and references these articles.
Data Collection Procedure	Data used to inform the study and the author’s postulations were drawn from previous research. The articles used are referenced appropriately. However, the author fails to demonstrate how these articles were arrived at.
Instruments and Reliability/validity of instruments	No instruments were used. However, the author summarizes previous research studies on stigma, mental illnesses, and ethnicity.
Data Analysis- id statistics, LOM, findings	The chosen articles were analyzed for their findings on mental illnesses and how these illnesses impact multivariate ethnicities. The articles were also analyzed for their findings on how these illnesses affect the way of life of those who suffer from them.
Results	Ethnic minority groups were found to be disproportionately affected by mental health illnesses. Studies from across the globe revealed higher levels of these illnesses across ethnic minority groups. Additionally, these groups had worse experiences with these illnesses. Racism was found to be a driving factor for worse clinical outcomes. Stigma was also found to be inherent in ethnic minority groups and a contributor to worsening outcomes.
Discussion/ Significance of findings	Findings revealed that mental health stigma, inherent in ethnic minority groups, has a predilection on the quality of mental healthcare for ethnic minority groups. It diminishes the level of uptake for mental healthcare services. These findings inform quality improvement measures for these groups.
Reliability and Validity of study, limitations	The article gives an expert opinion on the impact of stigma and ethnicity on mental health illnesses. It maintains reliability and validity as it is drawn from peer-reviewed studies on the same. A limitation of the article is the failure to indicate the author’s credentials.
Helpful/Reliable Compared to other articles	The article is helpful as it gives insights into quality improvement in mental healthcare. However, it should be used with caution as it does not detail the author’s credentials. Additionally, the author fails to detail how they arrived at the articles selected to inform their opinions.

Author, year; Credentials Article #2	Janeé R. Avent Harris, Loni Crumb, Allison Crowe, and Jasmine Garland McKinney; Department of Interdisciplinary Professions (IDP), East Carolina University
Article Focus/Title	African Americans’ perceptions of mental illness and preferences for treatment
Research Design/Intervention	Qualitative content analysis. No interventions
Level of Evidence and model used	Level IV John Hopkins
Evaluation Tool	CASP Qualitative checklist, Score 8/10
Sample/# of subjects, how recruited, power analysis?	The sample size was 210 African-Americans. Participants were drawn from a pool of 632 respondents.
Data Collection Procedure	Data was collected from electronic surveys administered to the participants. These surveys included quantitative measures such as perceived stress scales, satisfaction with life, self-stigma, and attitudes toward mental health illnesses.
Instruments and Reliability/validity of instruments	A structured survey was used in data collection. A large sample size was also used, thereby guaranteeing validity and reliability. An external auditor was drawn to the study to further enhance the trustworthiness of the data collected.
Data Analysis- id statistics, LOM,	An inductive approach was utilized to analyze the data obtained. This included studying the raw data and making evidence-based inferences through group coding.
Results	Findings revealed that stigma, violence and danger, perceptions of ability, dismissal of mental health illnesses, and religion and spirituality are the thematic mental health illnesses concerns among African Americans. These issues affected their healthcare-seeking behavior.
Discussion/ Significance of findings	Findings affirmed mental health stigma, among other issues, as an impediment to mental healthcare. These findings are a projection of mental healthcare issues among ethnic minority groups and provide the groundwork for improving mental healthcare in these populations.
Reliability and Validity of study, limitations	The study drew its findings from a large sample size. Additionally, it utilized literature to inform the thematic concerns that formed the basis for the surveys used in data collection. A limitation of the study is not detailing the author’s credentials.
Helpful/Reliable Compared to other articles	This article is helpful in mental healthcare. Its findings are comprehensive and point to the traditional issues affecting mental healthcare among ethnic minority groups. They can be used to establish a quality improvement framework for ethnic minority groups.

Author, year; Credentials Article #1	Eylem et al. (2020). Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands. All of the authors have a doctorate degree.
Article Focus/Title	Stigma for common mental disorders in racial minorities and majorities a systematic review and meta-analysis
Research Design/Intervention	Systematic review
Level of Evidence and model used	Level III John Hopkins
Evaluation Tool	JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses, Score- 9/11
Sample/# of subjects, how recruited, power analysis?	A total of 1732 papers were used in the systematic review. These were extracted from the PubMed, PsychInfo, and Embase databases. The PRISMA flow chart was used to identify the inclusion criteria.
Data Collection Procedure	A systematic literature search from bibliographic databases using search terms such as social stigma and common mental disorders was used to extract research papers that informed the review. The extracted data was screened and used based on the inclusion criteria.
Instruments and Reliability/validity of instruments	The PRISMA flow chart was used to identify the inclusion criteria. The quality of the included papers was assessed using the Effective Public Health Practice Project Quality Assessment Tool.
Data Analysis- id statistics, LOM, findings	A computer program called Comprehensive Meta-Analysis was used to analyze the extracted data. Publication bias on the papers was also tested by inspecting the funnel plot on the outcome measures.
Results	Findings revealed that ethnic minority groups had more mental stigma for common mental disorders compared with ethnic majorities.
Discussion/ Significance of findings	Findings suggested that ethnic minority groups are disproportionately affected by mental health stigma against common mental disorders. The robustness of these effects was demonstrated by their poor perception of these illnesses and their mental health-seeking behavior. These findings also inform on measures to improve mental healthcare across ethnic minority communities.
Reliability and Validity of study, limitations	A limitation of this study is that it generalizes its conclusion and does not focus on individual races. In as much as stigma is predominant in many ethnic minority groups, its effects are not prominent in others. A more racial-specific study is thus warranted.
Helpful/Reliable Compared to other articles	This paper is helpful as it utilizes a unified conceptual framework to pool research studies. This allows it to provide a more robust understanding of the effect of stigma on various races. Findings from this article can also be used to inform mental healthcare among ethnic minority groups.

Author, year; Credentials Article #1	Jeromey B. Temple, Bianca Brijnath, Joanne Enticott, Ariane Utomo, Ruth Williams, and Margaret Kelaher, 2020; Social Gerontology, National Ageing Research Institute (NARI), Parkville, Australia. The credentials of the authors are not listed.
Article Focus/Title	Discrimination reported by older adults living with mental health conditions: Types, contexts and association with healthcare barriers
Research Design/Intervention (describe intervention)	Secondary data analysis. No intervention.
Level of Evidence and model used to grade evidence	Level VII John Hopkins
Evaluation Tool (CASP or others- identify tool used)	JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses, Score- 7/11
Sample/# of subjects, how recruited, power analysis?	This research was based on the General Social Survey (GSS) conducted by the Australian Bureau of Statistics (ABS) in 2002, 2006, 2010, and 2014. Data from 4967 Australians aged 55 years and above was used in the study.
Data Collection Procedure	ABS utilized a computer-assisted interview questionnaire on domains such as discrimination, mental health conditions, barriers to healthcare, and measurements of financial well-being to understand the differences in people’s opportunities in community participation.
Instruments and Reliability/validity of instruments	GSS is a national tool that provides reliable estimates of social parameters such as education and health for Australians living in urban setups.
Data Analysis- ID statistics, LOM, findings	The authors did not demonstrate how the data collected was analyzed.
Results	Self-reported discrimination data revealed that the likelihood of discrimination in people with long-term mental health disorders is 22%. A higher prevalence of discrimination was noted in the elderly population.
Discussion/ Significance of findings	Findings revealed that discrimination against mental health disorders remains a concern in mental healthcare. Addressing this concern will considerably improve the clinical outcomes of elderly patients with mental health illnesses.
Reliability and Validity of study, limitations	A limitation of this study is that it only used data from urban setups to draw its findings. Notwithstanding, mental health disorders affect everyone, including those living in rural setups.
Helpful/Reliable Compared to other articles	This article is helpful as it informs barriers to mental healthcare care. Discrimination and subsequent stigma remain a concern in mental healthcare; therefore, addressing them may help enhance the quality of mental healthcare.

Summary Section

The articles detail aspects of mental healthcare. They provide a framework for understanding barriers to mental healthcare across populations. Kapadia (2023) explores the nexus between stigma, mental health disorders, and ethnicity. While the article succinctly describes the underlying reasons for the stigmatization of mental health disorders in some ethnicities, it gives recommendations for care areas that can be exploited in addressing this concern. As per the article, measures to lessen stigma across ethnic minority groups can help enhance mental healthcare in its entirety. Harris et al. (2020) affirm these findings by detailing how divergent perception across ethnicities contributes to stigma and, subsequently, poor mental healthcare. As per the article, poor perception of mental health disorders accustomed to inadequate knowledge of these illnesses, along with stigma, religion, and perception of ability, are the driving factors for the preferences of treating these disorders among African Americans. While these findings are specific to American blacks, they give an insight into the current state of mental health in the US and across the globe. Eylem et al. (2020) also confirm the presence of stigma against mental health disorders in ethnic minority groups. As per the article, ethnic minority groups are disproportionately affected by mental health disorders compared to ethnic majorities. This further warrants health promotional activities for these groups as a measure for elevating mental healthcare globally. Min (2019) further reiterates these sentiments. Min (2019) postulates that stigmatization of mental health illnesses negatively affects the effectiveness of treatment measures available for these disorders. While stigma maintains prominence in some ethnic groups, its footprints are also evident in the elderly groups. Temple et al. (2020) note that the elderly populations are increasingly being discriminated against for their mental health disorders-attributed incarcerations. As per the article, many older adults reported being discriminated against because of their disease.

The level of evidence varied in the articles selected. The first article by Kapadia (2023) is level V per the John Hopkins model, as it is a review article. The article by Harris et al. (2020) is level IV, while Eylem et al.’s (2020) article is level III since it is a systematic review. The article by Min (2019) draws its findings from meta-analyses and is thus Level I. The fifth article by Temple et al. (2020) is level VII. Notably, all of the articles were centered on mental healthcare. They all detail aspects of mental healthcare, with the majority of the articles detailing stigmatizations against mental health disorders as an impediment to quality mental healthcare for ethnic minority groups. Only one of the articles explores the impact of discrimination and stigma on the elderly groups.

The selected articles were high-quality research papers ranging from systematic reviews to expert opinion papers. Notwithstanding, more specific research is required to elucidate the racial-specific impacts of stigmatization. As Wong et al. (2021) note, not all ethnic minority groups and populations are impacted similarly by these disorders. Poor quality mental healthcare remains a gap in healthcare that requires addressing. Sustained health promotion that addresses the identified barriers to quality mental healthcare, such as stigma, can help improve the quality of mental healthcare. Population-specific interventions such as community outreach programs educating people on mental health disorders can play a role in optimizing mental healthcare. The selected articles gave me insight into pertinent problems affecting persons with mental illnesses. Reading them implored me to do more as a health educator to change individuals’ perspectives on these illnesses.

References

Eylem, O., de Wit, L., van Straten, A., Steubl, L., Melissourgaki, Z., Danışman, G. T., de Vries, R., Kerkhof, A. J., Bhui, K., & Cuijpers, P. (2020). Stigma for common mental disorders in racial minorities and majorities: a systematic review and meta-analysis. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-08964-3

Harris, J., Crumb, L., Crowe, A., & McKinney, J. (2020). African Americans’ perceptions of mental illness and preferences for treatment. Journal of Counselor Practice, 1–33. https://doi.org/10.22229/afa1112020

Kapadia, D. (2023). Stigma, mental illness & ethnicity: Time to center racism and structural stigma. Sociology of Health & Illness, 45(4), 855–871. https://doi.org/10.1111/1467-9566.13615

Min, J. W. (2019). The influence of stigma and views on mental health treatment effectiveness on service use by age and ethnicity: Evidence from the CDC BRFSS 2007, 2009, and 2012. SAGE Open, 9(3), 215824401987627. https://doi.org/10.1177/2158244019876277

Temple, J. B., Brijnath, B., Enticott, J., Utomo, A., Williams, R., & Kelaher, M. (2020). Discrimination reported by older adults living with mental health conditions: Types, contexts, and association with healthcare barriers. Social Psychiatry and Psychiatric Epidemiology, 56(6), 1003–1014. https://doi.org/10.1007/s00127-020-01914-9

Wong, E. C., Collins, R. L., McBain, R. K., Breslau, J., Burnam, M. A., Cefalu, M. S., & Roth, E. (2021). Racial-ethnic differences in mental health stigma and changes over the course of a statewide campaign. Psychiatric Services, 72(5), 514–520. https://doi.org/10.1176/appi.ps.201900630

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Question

Aspects of Mental Healthcare

This assignment will require you to take the PICO and 5 research articles and place them in a table for analysis. You will critique each article and identify the most important parts of the research, analysis, and findings.
Instructions:

Identify your PICO or research question of interest
Gather 5 research articles on your topic: be sure to save them and submit them along with the matrix; please make sure they are PDF documents.
Do not use clinical guidelines or Cochran Reviews, abstracts, future research reports, or poster presentations. You can search for research only by indicating “research” when you do an advanced search. If you can’t answer a lot of the questions, it is probably not a research article.
We do not recommend that you use more than one qualitative research article, systematic review, or meta-analysis. These are harder to evaluate because they have so much more information in them. Remember, it is not individuals in these studies- it is the articles. Use the reference list in the systematic reviews or meta-analyses to find individual studies that may be easier to understand and use.
Review sample matrices and summaries.
Use a matrix table- one for each article and critique the parts of the article using the rubric.
Be sure to identify the evaluation tool used to grade the evidence such as (See below for grading the evidence tools)
Identify where the articles have issues and what gaps were not addressed in the research. Be prepared that this may change the way you look at your topic or result in a slightly different direction for your area of interest. This is okay—that is what you want to accomplish with this assignment. It will really assist you as you move forward with your project.
A new addition for summary effective Fall 2, 2023: We want you to insert the verbatim summary that you copied from Elicit.org as part of your summary. DO NOT use it as a primary resource for this assignment. You will still be writing your own summary of the articles. What did you find missing from the Elicit summary? Did you still have to search for additional information to help inform your summary? This is a trial, so we will see how it goes. Please give us feedback if this tool was helpful.
For this assignment, you will turn in the matrix tables, summary, references, and pdf copies of your 5 articles.

Then, you will summarize the articles by grading the research and identifying gaps in the literature as well as possible interventions (see grading rubric and examples).

Article Matrix and Analysis – Aspects of Mental Healthcare