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Spirituality groups led by healthcare chaplains have been found to aid patients' recovery processes in US psychiatric units. In Norway, existential groups (EGs) led by healthcare chaplains and co-led by healthcare staff members are offered at psychiatric units; these groups share commonalities with spirituality groups, group psychotherapy, existential therapy and clinical pastoral care, facilitating patients' reflections regarding existential, spiritual and religious issues. The study aimed to examine associations between patients' participation and topics discussed in the EGs and their experiences of psychological distress, crisis of meaning and meaningfulness. A cross-sectional design was applied among 157 patients attending EGs led by healthcare chaplains across Norway. Multivariate regression analyses assessed the strength of possible associations, adjusted for relevant demographical variables. Significant association was found between lengthier EG participation and lower levels of psychological distress, while discussion topics concerning religious and spiritual issues were significantly associated with the experience of meaningfulness.

This public mental health study highlights the interactions among social determinants and resilience on mental health, PTSD and acculturation among Iraqi refugees in Sweden 2012-2013.

Objectives: The study aims to understand participants' health, resilience and acculturation, paying specific attention to gender differences.

Design: The study, using a convenience sampling survey design (N = 4010, 53.2% men), included measures on social determinants, general health, coping, CD-RISC, selected questions from the EMIC, PC-PTSD, and acculturation.

Results: Gender differences and reported differences between life experiences in Iraq and Sweden were strong. In Sweden, religious activity was more widespread among women, whereas activity reflecting religion and spirituality as a coping mechanism decreased significantly among men. A sense of belonging both to a Swedish and an Iraqi ethnic identity was frequent. Positive self-evaluation in personal and social areas and goals in life was strong. The strongest perceived source of social support was from parents and siblings, while support from authorities generally was perceived as low. Self-rated health was high and the incidence of PTSD was low. A clear majority identified multiple social determinants contributing to mental health problems. Social or situational and emotional or developmental explanations were the most common. In general, resilience (as measured with CD-RISC) was low, with women's scores lower than that of men.

Conclusions: Vulnerability manifested itself in unemployment after a long period in Sweden, weak social networks outside the family, unsupportive authorities, gender differences in acculturation, and women showing more mental health problems. Though low socially determined personal scores of resilience were found, we also identified a strong level of resilience, when using a culture-sensitive approach and appraising resilience as expressed in coping, meaning, and goals in life. Clinicians need to be aware of the risks of poorer mental health among refugees in general and women in particular, although mental health problems should not be presumed in the individual patient. Instead clinicians need to find ways of exploring the cultural and social worlds and needs of refugee patients. Authorities need to address the described post-migration problems and unmet needs of social support, together comprising the well-established area of the social determinants of health.

Despite the worldwide proliferation of suicide-prevention crisis-line networks, there is limited in-depth knowledge of how the volunteer call responders experience and manage emotional stressors. The study's purpose was to explore emotional stressors related to operating a diaconal suicide-prevention crisis line, and how these are managed in daily operations. In this qualitative study, 27 volunteers were interviewed in four focus groups. The material was analysed using systematic text condensation. The participants experienced emotional stressors related to being unable to actively intervene, encountering traumatised callers and feeling uncertain about representing the Church. They used a combination of personal coping strategies and organisational support factors. Implications for training and practice are further discussed.

This report explores the Swedish integration policies and practices as well as their implementation as experienced by newcomers. Integration refers to the permanent settlement period that sets in after the acquisition of a permanent residence permit, or when one starts mentally adapting to the host society. Through a multilevel governance approach, it highlights how legal, political, and institutional integration frameworks in Sweden affect integration outcomes. The latter refers specifically to the way newcomers establish themselves in the new society and negotiate their new social positions.

The report compiles data from different sources (academic literature, research reports, official texts, policies and other relevant texts, interviews conducted both at micro and meso level) in order to provide comprehensive insights into regulations, policies, practices and experiences of integration in Sweden. Thus, the report aims to paint an integrated picture of how different components interact and affect migrant populations. The results are also relevant for future research that will specifically include host populations. The report specifically highlights the effects of a post-migration context on mental health and psychosocial integration, while emphasizing that all areas of daily functioning, namely housing, access to education and the labour market, as well as access to citizenship and a general feeling of belonging, are interconnected and combine in a comprehensive view.

Suicide-prevention crisis lines worldwide offer support to individuals in crisis, nonetheless, there is limited in-depth knowledge as to the significance of contacting these services from the service-users' first-hand perspectives. This study aimed to provide a deeper understanding of the significance ascribed to contacting a diaconal suicide-prevention crisis line in Norway. In-depth qualitative interviews were conducted with nine callers. The material was analysed using systematic text condensation. The analysis revealed three main themes reflecting the crisis line's emotional, relational and existential support functions in terms of providing: (i) immediate emotional availability, (ii) experiences of connectedness and acceptance, and (iii) a safe space for existential meaning-making processes. The findings point to the need for future research on the value of integrating biopsychosocio-existential perspectives into intervention models within the field of crisis support.

Research has shown that addressing and integrating the existential dimension in treatment settings reduce symptoms like anxiety, depression and substance abuse. Healthcare chaplains are key personnel in this practice. A nationwide, cross-sectional survey influenced by a mixed-methods approach was used to examine the attitudes, practices, understanding and perceptions of mental health professionals, including healthcare chaplains, regarding the value of addressing the existential dimension in treatment programmes. The existential group practice was led by the healthcare chaplains as an integrated part of specialist mental health services. A positive and open attitude towards addressing the existential dimension was identified among the informants. Despite this, a small gap between attitude and practice was reported. Existential, religious and spiritual concerns are reported as part of the existential dimension and as relevant topics to be discussed in specialist mental health services. The findings indicate that the existential group practice could have a positive influence on the co-leaders' competence to address existential, religious and spiritual concerns; however, this should be further investigated.

Background: Volunteer crisis line responders are a valuable resource for suicide prevention crisis lines worldwide.

Aim: The aim of this study was to gain a deeper understanding of how volunteers operating a diaconal crisis line in Norway experienced challenges and how these challenges were met.

Method: A qualitative, explorative study was conducted. A total of 27 volunteers were interviewed through four focus groups. The material was analyzed using systematic text condensation.

Results: The greatest challenge to the volunteers was the perception of a gap between their expectations and the practice field. The experience of many volunteers was that the crisis line primarily served a broad ongoing support function for loneliness or mental illness concerns, rather than a suicide prevention crisis intervention function.

Limitations: The focus group design may have made the participants more reluctant to share experiences representing alternative perspectives or personally sensitive information.

Conclusion: The findings of this study suggest that a uniform response to callers using crisis lines as a source of ongoing support is warranted and should be implemented in volunteer training programs.

The Sources of Meaning and Meaning in Life Questionnaire (SoMe) offers dimensional measures of meaningfulness, crisis of meaning, and 26 sources of meaning. It allows for a clearer understanding of the variety of existential orientations, which are known to be linked to both mental and physical health. The Norwegian version of the SoMe was validated by testing 925 randomly selected individuals who were representative for the Norwegian population. Reliability scores were satisfactory; factor analyses suggested a 6-factor structure of the sources of meaning scales. Expected patterns of associations with mental health and quality-of-life factors attested the instrument's construct validity: Meaningfulness showed positive relationships to all quality-of-life factors. There was no relationship with anxiety but negative relationships with depression and distress. Crisis of meaning established a strong positive relationship with anxiety, depression, and distress and a negative relationship with quality-of-life factors. Criterion validity was documented by expected differences in meaningfulness and crisis of meaning between groups with and without presence of depression disorder. Self-efficacy correlated strongly with sources of meaning from the dimension "accomplishment" and moderately negatively with sources of meaning from the dimension "vertical selftranscendence."

The aims of this study were to investigate the type and extent to which women with substance abuse problems have been exposed to male violence during their lifetime, and to examine possible differences between women with a residence (WR) and homeless women (HW). The total sample included 79 women (WR, n = 35; HW, n = 44; M age = 47.8 years). Of the total sample, 72 women (91%) had experienced different kinds of male violence, 88% from former partners, and 26% from male friends or acquaintances. Of the 72 women, 71% further reported Countless occasions of violent events, and 36% had been forced to commit criminal acts. Abused women who had been forced to commit criminal acts were significantly more frequently found to be homeless, have reported parental alcohol and/or drug problems, have witnessed domestic violence in childhood, have been victims of sexual violence, have used illicit drugs as a dominant preparation, and have injected illicit drugs. Almost half of the abused women (46%) met criteria for posttraumatic stress disorder (PTSD), where HW showed an almost 4-time higher risk (RR 3.78) than WR. In conclusion there is a particular vulnerability in women with substance abuse to male violence, which has an important impact on their health status. Thus, from a public health perspective, it is suggested that for those women who have experienced male violence, treatment protocols need to include both assessing and addressing the impact of such experience in relation to substance abuse as well as concomitant health concerns.