Editorial

Mental Health and Social Inclusion has adopted a policy of publishing papers in order of acceptance. In this issue, we feature three papers all accepted in a short period from Professor Jairo Stefano Dote Pardo, an academic from the Catholic University of Temuco in Chile. Professor Pardo’s first paper on mental health and social inclusion is a systematic review of 85 papers over the last 24 years. He has recorded an increasing number of papers on social exclusion, showing a sustained academic interest in this area. The International Journal of Social Psychiatry recorded seven papers on this theme, with Mental Health and Social Inclusion registering four. As this covers only peer-reviewed papers, it is probably an under-estimate of the papers we publish, as it would exclude Viewpoint papers. Professor Pardo argues that discrimination, stigma and socio-economic deprivation are all major obstacles to inclusion. In a second paper co-authored with Pedro Severino-Gonzalez, he looks at the issue of debt. Here they analyse 66 papers, the majority of which have been published between 2021 and 2024. The work examines a number of economic psychological theories, such as the Scar Hypothesis. This states that economic adversity may leave enduring psychological scars. The bottom line is that financial hardship adversely affects mental wellbeing. His third paper is co-authored with Javier Parra-Dominguez. This third systematic literature review examined the findings of 32 research studies looking at the links between financial security and health. Financial insecurity can exacerbate mental health conditions, and that poor mental health can impair financial decision-making. Financial stress can be both a cause and a consequence of psychological distress. This is an impressive set of three papers which we are pleased to publish.Changing the tone of this Editorial completely is the paper by Rebecca Barnes, on stand-up comedy as a tool for improving mental health. Beccy is both a stand-up comic herself, as well as an academic. In this Viewpoint paper, she suggests that some comedians challenge perceptions of mental health, using humour as a tool for advocacy and personal storytelling. She notes that some comedians use their lived experience of depression, anxiety and trauma as central themes in their performances. Beccy further argues that the re-working of distressing material in stand-up helps comedians make sense of their own trauma. She comments, “The incomparable high that comes from connecting with an audience and making them all laugh is incredibly intoxicating”. Humour, she observes, can help performers re-write the script of their own mental health struggles. Beccy is going to follow this paper with a series of interviews with famous comics, which will show the links between their comedy routines and mental health.Mahimna Vyas and his father Rudresh Vyas have co-authored what may be the first paper in this journal written by a father and son. They look at each other’s respective character strengths. For readers unfamiliar with the concept of character strengths, there are 24 universal strengths (see Link to the website of viastrengths). From this free online questionnaire assessment, we can obtain our so-called “signature strengths”. Dr Vyas states, “I know that using humour in tense situations can diffuse the tension and help everyone involved relax”. One of the specific strengths of this paper is how Dr Vyas has fused Indian and Western psychologies, something his son Mahimna is currently working on in his doctoral research. Now, imagine you had a similar conversation with your own parents?Following on with this trend of self-exploration, Jana Hlavonkova introduces us to the concept of being a highly sensitive person (HSP). In another Viewpoint paper, Jana relates that when she was growing up she was often called “too shy”, “too anxious” or “too sensitive”. This left her wondering what was wrong with her. What her parents and teachers may have seen as “constructive feedback”, felt to her like evidence of personal failure. HSPs are often highly attuned to others needs. She notes how she observed her mother’s distress as she worked and parented with little support. This moved her to help her mother with household chores and to provide her with emotional support. This then secured her mother’s love and approval, which she craved. She came to realise that being highly sensitive was not her “flaw” but a trait to manage and embrace.Anna PP and Aditi Arur conducted a study of 302 transgender women (Hijira) in South India. Their detailed psychometric study looked at meaning in life, depression, anxiety and stress and quality of life. Using a range of statistical models, they showed that meaning in life enhanced quality of life. In contrast depression, anxiety and stress had a negative effect on quality of life. They speculate that interventions which target psychological distress might improve the quality of life of transgender women.Matt Broadway-Horner presents his Progress World View theory as a methodology for understanding the perspectives of people from sexual minorities. He draws on a wide range of theories, as well as his own life experiences, to construct his own model. Access to mental health services has often been blocked by individual and systemic barriers. His Progress World View theory aims to redress these difficulties through changing societal attitudes towards sexual minorities.Maria Alejandra Leguizamon-Vasquez and her colleagues interviewed 25 Colombian mental health professionals about their views on the treatment and management of people diagnosed as having schizophrenia. Three main treatments were suggested. First pharmacological treatments. They point out that “without pharmacological assistance, therapeutic plans are likely to fail”. Second, psychotherapies were recognised as important by all interviewees. These included CBT, psychoeducation for patients and families and including newer therapies like Acceptance and Commitment Therapy. The third intervention was occupational therapy, which was felt to be critical in identifying patients’ strengths and helping patients find meaningful activities. This last recommendation is especially significant as none of the research participants was an occupational therapist. Their most important finding was that there is a need for integrated treatment approaches combining medication with therapies. One interesting omission from this study was a lack of attention given by the participants to suicide in this population. The authors highlight that suicide attempts are especially prevalent in the first year after diagnosis.Breige Nugent and colleagues from Scotland examined the narratives of eight people who had come to Scotland to escape wars in their own countries. They were all part of an advisory group. They talked about being cut-off from their families at home and for those from Sudan, Syria and Nigeria, there has been comparatively little coverage or attention given to the plight of their fellow citizens, in contrast to the focus on Gaza and Ukraine. Three individuals felt guilty for feeling safe and secure, while their extended families at home suffered. Some were having to send money and resources back home to help their families. One Sudanese man said he was supporting 25 people in Sudan through his wages. All were trying to raise awareness of the problems faced by their fellow countrymen who were unable to escape the conflicts. The paper highlights the complexities of the situations that many asylum seekers find themselves in.Martine Vallarino and her collaborators from Canada look at recovery colleges. Their centre in Quebec is the only French speaking recovery college in Canada. They highlight the core principles of their approach as being inclusion, diversity, transformative learning, competency-based teaching, self-determination and a strengths-based approach. They developed a train-the-trainer method to spread the key elements of their model. In developing this approach, they were more concerned with the personal development of their trainers, rather than their efficacy as programme deliverers. This could be a hard approach to sell in more outcome focussed services.Antoni Brosa-Rodriguez from Spain studied debates in 24 different languages across Europe looking at mentions of mental health in parliamentary debates. The three countries where mental health was discussed most were Denmark, Sweden and Austria. From 1996, the frequency of mental health references increased massively, especially after 2014. It peaked during the Covid-19 pandemic. The main problem with this type of analysis, is we do not actually discover what topics were actually discussed in each of the parliaments and with what effect. Nonetheless, it is encouraging to learn that parliamentarians across Europe are focussing more on mental health issues.The final two papers in this issue concern mental health in universities. The first was a study of students and staff at the American University of Sharjah by Mishel Khalaf Thabet Makary and colleagues. They used the Lifestyle Medicine Assessment Screening Tool, the GAD-7 and the PHQ-9 with a stratified sample of 451 participants, of whom some 70% were students. Higher levels of anxiety and depression were associated with being younger, being female or being in lower academic positions. Protective factors were regular physical activity, a healthy diet and good social networks. Ambreen Wani conducted focus groups with 35 students at an Indian university. She wanted to study why some students were reluctant to use campus mental health services. Students new to university may be reluctant to talk about their mental health needs. Equally, fears about social exclusion, confidentiality and career progression may also inhibit students from accessing support.We continue to be pleased with the international appeal of the journal. This issue has four papers from Colombia, three from India and individual papers from Canada, Spain, the United Arab Emirates, Holland, Scotland, New Zealand and England. We also have a range of methodologies with three Viewpoint papers, two Conceptual Papers, three Qualitative Research papers, three Quantitative research papers and three Systematic Literature Reviews. We could not ask for a more diverse issue. Enjoy.Professor Jerome Carson,Dr Julie Prescott,Editor-in-Chief.Co-Editor.