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”Det är liksom en stor grej som händer just nu i våra liv”: Psykisk hälsa och stigma bland ungdomar
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap. (Socialmedicin Chap)ORCID-id: 0000-0003-0482-8094
2024 (Svenska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Fritextbeskrivning
Abstract [en]

Adolescents’ mental health is a current public health issue. However, research, on adolescents’ views on different aspects of mental health, and the prevalence of mental well-being, mental illness and related stigma, among adolescents is limited in Sweden. The overall aim of this thesis was to explore perceptions and status of mental health and stigma related to mental health problems among adolescents in a Swedish context. 

Study I and II were based on qualitative interviews with 32 adolescents on the Swedish island Gotland. Study I indicated that the adolescents had a complex understanding of various mental health concepts but labelled mental well-being as ‘feeling good’ and mental illness as ‘feeling bad’. In Study II, the adolescents described mental health problems as common due to current living conditions, e.g. stress related to school performance and social media and an increased openness about mental health problems. Stigmatisation of people with mental health problems was perceived as problematic, caused by lack of experience and knowledge, but also as related to rumour spreading and stereotypical gender norms. 

Study III and IV were based on the Life and Health Youth survey, conducted in secondary schools located on Gotland. In study III, the results according to the dual-factor model of mental health showed that most adolescents had vulnerable mental health status (47.5%), while 36.2% had complete mental health. A smaller proportion had troubled (13,9%) or symptomatic but content (2,5%) mental health status. Associations were observed between mental health status and gender, grades, truancy, stress level, resilience, and subjective social status in school. 

In study IV, the factor structure and internal consistency was acceptable for the modified Attitudes About Mental Illness and its Treatment scale, but the adolescents perceived it as difficult to answer. Further, negative attitudes towards people with mental health problems were present, and more common among boys and foreign-born adolescents. 

The findings of this thesis suggests the two-factor model of mental health and the three-part description of stigma, including stereotypes, prejudice and discrimination, to be applicable among adolescents. Further, the findings suggest a need for promotion of mental well-being and prevention of mental health problems such as interventions to reduce school-related stress, increase resilience and promote societal knowledge about mental health, stigma and gender stereotypes among adolescents. The findings also motivate support to adolescents with low mental wellbeing and minor mental health problems as well as to adolescents who have friends with mental health problems. 

Abstract [sv]

Ungdomars psykiska hälsa är en aktuell folkhälsofråga. Forskning om ungdomars syn inom området psykisk hälsa och om förekomst av psykiskt välbefinnande, psykisk ohälsa och relaterat stigma är dock begränsad i Sverige. Syftet med avhandlingen var att undersöka uppfattningar om och status för psykisk hälsa och stigma relaterat till psykisk ohälsa bland ungdomar i en svensk kontext.

Studie I och II byggde på kvalitativa intervjuer med 32 ungdomar på Gotland. I studie I framkom att ungdomarna hade en komplex förståelse för begrepp inom området psykisk hälsa, men benämnde psykiskt välbefinnande som att ”må bra” och psykisk ohälsa som att ”må dåligt”. I studie II beskrev ungdomarna psykisk ohälsa som vanligt förekommande utifrån nuvarande levnadstillståndsförhållanden med t.ex. stress relaterat till skolprestationer och sociala medier, samt ökad öppenhet kring psykisk ohälsa. Stigmatisering av personer med psykiska problem uppfattades som negativt och beroende på bristande erfarenhet och kunskap, men också relaterat till ryktesspridning och stereotypa könsnormer.

Studie III och IV byggde på enkäten Liv och Hälsa Ung Gotland som genomfördes i högstadiet och gymnasiet på Gotland. I studie III visade resultaten utifrån två-faktormodellen för psykisk hälsa att 36,2% hade fullständig psykisk hälsa. De flesta ungdomarna hade sårbar psykisk hälsa (47,5%). En mindre andel hade besvärad eller symtomatisk men nöjd psykisk hälsostatus (13,9% respektive 2,5%). Resultaten visade också samband mellan psykisk hälsostatus och kön, betyg, skolk, stressnivå, resiliens och subjektivt upplevd social status i skolan.

I studie IV uppvisade den modifierade versionen av skattningsskalan Attitudes About Mental Illness and its Treatment acceptabel faktorstruktur och intern konsistens. Ungdomarna upplevde den dock som svår att besvara. Vid mätningen med skattningsskalan återfanns viss förekomst av negativa attityder mot personer med psykisk ohälsa, vilket var vanligare bland pojkar och utlandsfödda ungdomar.

Avhandlingens resultat indikerar att två-faktormodellen för psykisk hälsa och den tredelade beskrivningen av stigma som innefattande stereotyper, fördomar och diskriminering är tillämpbar bland ungdomar. Resultaten tyder på behov av åtgärder för främjande av psykiskt välbefinnande och förebyggande av psykisk ohälsa. Exempelvis insatser för att minska skolrelaterad stress och öka resiliens bland ungdomar, samt för att främja kunskap om psykisk hälsa, stigma och stereotypa könsnormer i samhället. Stöd till ungdomar med lågt psykiskt välbefinnande, mildare psykisk ohälsa och med vänner med psykisk ohälsa är också motiverat.

 

Ort, förlag, år, upplaga, sidor
Uppsala: Uppsala universitet, 2024. , s. 135
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 2068
Nyckelord [en]
attitude, adolescent, dual-factor model, focus group, mental health, mental health problems, perception, qualitative interview, questionnaire, stigma, Sweden, view
Nyckelord [sv]
attityd, enkät, fokusgrupp, kvalitativ intervju, psykisk hälsa, psykisk ohälsa, stigma, Sverige, två-faktormodell, ungdom, uppfattning
Nationell ämneskategori
Folkhälsovetenskap, global hälsa och socialmedicin
Forskningsämne
Socialmedicin
Identifikatorer
URN: urn:nbn:se:uu:diva-535659ISBN: 978-91-513-2205-6 (tryckt)OAI: oai:DiVA.org:uu-535659DiVA, id: diva2:1887085
Disputation
2024-10-04, E22, Campus Gotland, Cramérgatan 3, Visby, 13:00 (Svenska)
Opponent
Handledare
Tillgänglig från: 2024-09-12 Skapad: 2024-08-06 Senast uppdaterad: 2025-02-20
Delarbeten
1. ‘Feeling down one evening doesn't count as having mental health problems’: Swedish adolescents' conceptual views of mental health
Öppna denna publikation i ny flik eller fönster >>‘Feeling down one evening doesn't count as having mental health problems’: Swedish adolescents' conceptual views of mental health
2023 (Engelska)Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 79, nr 8, s. 2886-2899Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Aims

To explore Swedish adolescents' conceptual views of mental health and mental health problems.

Design

A qualitative descriptive study design.

Methods

Semi-structured focus group interviews and individual interviews were conducted with, in total, 32 Swedish adolescents (15–18 years old) in October–November 2020. Data were analysed using systematic text condensation.

Results

Three themes were identified through the analysis: Mental health is about how we feel; One's mental health depends on one's situation, thoughts and ways of coping; and Mental health problems should be taken seriously and can get severe.

Conclusion

The results indicate that adolescents understand the complexity and holistic nature of mental health and mental health problems. According to the participating adolescents, positive mental health and mental health problems should be considered simultaneously to understand a young person's mental health state. Good health was described as having both absence of mental health problems and high levels of well-being: feeling well. Mental health problems were defined as something other than normal difficulties in life, but ranging from minor difficulties to more severe conditions. However, all kinds of mental health problems were termed as feeling unwell. The results suggest that adolescents are in need of support to cope with normal difficulties in life rather than lectures about life sometimes being challenging. In addition, the results highlight the need to prevent school-related stress and offer adolescents support for minor mental health problems.

Impact

The findings have implications for nurses and other professionals who encounter adolescents in their profession, for example specialist nurses, school nurses and public health professionals. The findings add knowledge that could be useful for communication with adolescents about their mental health and methods to assess their mental health status.

Patient or Public Contribution

The preliminary results were presented to three classes, in year nine in lower secondary school, for validation.

Ort, förlag, år, upplaga, sidor
John Wiley & Sons, 2023
Nyckelord
adolescents, focus group, mental health, mental health problems, nurses, public health, perceptions, qualitative interview
Nationell ämneskategori
Folkhälsovetenskap, global hälsa och socialmedicin
Forskningsämne
Socialmedicin
Identifikatorer
urn:nbn:se:uu:diva-477999 (URN)10.1111/jan.15496 (DOI)000881859400001 ()36369658 (PubMedID)
Forskningsfinansiär
Uppsala universitet, 19-10-28 5Länsförsäkringar AB, 19-12-16 #11 139Region Gotland, RS2020/663
Anmärkning

Title in the list of papers in Veronica Hermann's thesis: ‘Feeling down one evening doesn’t count as having mental health problems’ - A study on adolescents’ conceptual views of mental health

Tillgänglig från: 2022-06-23 Skapad: 2022-06-23 Senast uppdaterad: 2025-02-20Bibliografiskt granskad
2. Feeling mentally unwell is the "new normal": A qualitative study on adolescents' views of mental health problems and related stigma
Öppna denna publikation i ny flik eller fönster >>Feeling mentally unwell is the "new normal": A qualitative study on adolescents' views of mental health problems and related stigma
2022 (Engelska)Ingår i: Children and youth services review, ISSN 0190-7409, E-ISSN 1873-7765, Vol. 143, artikel-id 106660Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Young people suffering from mental health problems is a public health issue, and it is important to listen to adolescents’ views on the issues that affect their lives. This qualitative study describes adolescents’ perceptions of the prevalence of and public stigma towards mental health problems among young people. A total of 32 Swedish adolescents, aged 15–18 years old, took part in either semi-structured focus groups or individual interviews. The data were analyzed using systematic text condensation, resulting in three themes: Having mental health problems is the new normal; What others think of you affects you; If others lack experience and knowledge, they don’t respond well. The adolescents considered mental health problems to be common in young people and a normal feature of their lives. They displayed an in-depth understanding for reasons of the increase in mental health problems in young people, and factors such as pressure from school, stereotypical gender norms, rumors and prejudice were suggested as possible explanations for the increase, alongside improved openness about mental health problems. The adolescents’ perceptions of the stigmatization of mental health problems were consistent with a trifold definition of stigma, comprising stereotypes, prejudice and discrimination. The adolescents suggested that better education about mental health problems, and more inclusive gender norms, would help reduce stigma and improve young people’s mental health.

Ort, förlag, år, upplaga, sidor
Elsevier, 2022
Nyckelord
adolescents, focus group, mental health problems, perception, qualitative interviews, stigma
Nationell ämneskategori
Folkhälsovetenskap, global hälsa och socialmedicin Psykiatri
Forskningsämne
Socialmedicin
Identifikatorer
urn:nbn:se:uu:diva-478168 (URN)10.1016/j.childyouth.2022.106660 (DOI)000933948300008 ()
Forskningsfinansiär
Uppsala universitet, 19-10-28 5Länsförsäkringar AB, 19-12-16 11 139Region Gotland, RS2020/663
Anmärkning

Title in the list of papers of Hermann's thesis: Feeling mentally unwell is the "new normal". A qualitative study on adolescents' views of mental health problems and associated stigma

Tillgänglig från: 2022-06-23 Skapad: 2022-06-23 Senast uppdaterad: 2025-02-20Bibliografiskt granskad
3. Mental health status according to the dual-factor model in Swedish adolescents: A cross sectional study highlighting associations with stress, resilience, social status and gender
Öppna denna publikation i ny flik eller fönster >>Mental health status according to the dual-factor model in Swedish adolescents: A cross sectional study highlighting associations with stress, resilience, social status and gender
Visa övriga...
2024 (Engelska)Ingår i: PLOS ONE, E-ISSN 1932-6203, Vol. 19, nr 3, artikel-id e0299225Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

In this cross-sectional study, we aimed to I) investigate the dual-factor model of mental health by forming and describing four participant groups and II) examine associations between mental health status and background factors, school-related factors, stress, and resilience among adolescents in a community population in Sweden. Data were collected through a survey completed by 2,208 students in lower and upper secondary school on the Swedish island of Gotland. After missing data were removed, a total of 1,833 participants were included in the study. The survey included the Mental Health Continuum Short Form (MHC-SF) for the assessment of mental well-being and the Strengths and Difficulties Questionnaire (SDQ) for the assessment of mental health problems. These two measures were combined into a dual-factor model, forming four mental health status subgroups: Vulnerable (47.5%), Complete mental health (36.2%), Troubled (13.9%), and Symptomatic but content (2.5%). Associations between these groups were explored regarding background factors, school-related factors, stress, and resilience through chi-squared tests and logistic regressions. Girls (OR: 1.88) and participants with high stress levels (OR: 2.23) had elevated odds for Vulnerable mental health status, whereas higher resilience (OR: 0.87) and subjective social status in school (OR: 0.76) were factors associated with reduced odds for this mental health status classification. Female gender (OR: 5.02) was also associated with Troubled mental health status. Similarly, a high level of stress (ORs: 4.08 and 11.36) was associated with Symptomatic but content and Troubled mental health status, and participants with higher levels of resilience had decreased odds for being classified into these groups (ORs: 0.88 and 0.81). The findings highlight the importance of interventions to increase resilience, reduce stress, and address stereotypic gender norms as well as social status hierarchies to support adolescents’ mental health.

Ort, förlag, år, upplaga, sidor
Public Library of Science (PLoS), 2024
Nationell ämneskategori
Folkhälsovetenskap, global hälsa och socialmedicin
Forskningsämne
Vårdvetenskap
Identifikatorer
urn:nbn:se:uu:diva-524403 (URN)10.1371/journal.pone.0299225 (DOI)001181701600057 ()38427682 (PubMedID)
Forskningsfinansiär
Uppsala universitet, Planeringsrådet Campus Gotland 19-10-28 §5, 2019Länsförsäkringar AB, 19-12-16 #11 §139, 2019Region Gotland, RS2020/663, 2020
Tillgänglig från: 2024-03-04 Skapad: 2024-03-04 Senast uppdaterad: 2025-02-20Bibliografiskt granskad
4. Evaluation of a modified version of the Attitudes About Mental Illness and its Treatment instrument: psychometric assessment and attitudes among adolescents in Sweden
Öppna denna publikation i ny flik eller fönster >>Evaluation of a modified version of the Attitudes About Mental Illness and its Treatment instrument: psychometric assessment and attitudes among adolescents in Sweden
Visa övriga...
(Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
Nationell ämneskategori
Folkhälsovetenskap, global hälsa och socialmedicin
Identifikatorer
urn:nbn:se:uu:diva-535657 (URN)
Tillgänglig från: 2024-08-06 Skapad: 2024-08-06 Senast uppdaterad: 2025-02-20

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