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Article ; Online: Understanding gender inequity in brain health outcomes: missed stroke as a case study for intersectionality.

Berkhout, Suze G / Hashmi, Syeda / Pikula, Aleksandra

Frontiers in global women's health

2024 Volume 5, Page(s) 1350294

Abstract: Recent attention into sex and gender-based inequities surrounding outcomes for brain health disorders has generated momentum toward addressing what has been called the "brain health gap." Importantly though, "women" are not uniform demographic group. In ... ...

Abstract	Recent attention into sex and gender-based inequities surrounding outcomes for brain health disorders has generated momentum toward addressing what has been called the "brain health gap." Importantly though, "women" are not uniform demographic group. In this perspective piece, we discuss misdiagnosis in stroke as an aspect of access and quality of care within brain health. Drawing on narrative data from a mixed methods study of young stroke survivors we suggest that while missed stroke isn't only an issue of gender, if we are going to understand gender-based gaps in access and navigation through stroke care, we have to understand how intersections of gender with age, ethnoracial identity, nationality, language, (dis)ability, and other aspects of social identity come together to create affordances as well as biases that contribute to stroke outcomes.
Language	English
Publishing date	2024-02-12
Publishing country	Switzerland
Document type	Journal Article
ISSN	2673-5059
ISSN (online)	2673-5059
DOI	10.3389/fgwh.2024.1350294
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Article ; Online: Burnout and Distress Among Health Care Workers During COVID-19: Can We Offer More Than Band-Aid Solutions?

Berkhout, Suze G / Abbey, Susan / Sheehan, Kathleen A

The Canadian journal of cardiology

2023 Volume 39, Issue 6, Page(s) 761–763

MeSH term(s)	Humans ; COVID-19 ; Burnout, Psychological ; Health Personnel
Language	English
Publishing date	2023-02-02
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632813-1
ISSN	1916-7075 ; 0828-282X
ISSN (online)	1916-7075
ISSN	0828-282X
DOI	10.1016/j.cjca.2023.01.027
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Article ; Online: Paradigm shift? Purity, progress and the origins of first-episode psychosis.

Berkhout, Suze G

Medical humanities

2018 Volume 44, Issue 3, Page(s) 172–180

Abstract: First-episode psychosis has garnered significant attention and resources within mental health services in North America, Europe and Australia/New Zealand since the 1990s. Despite this widespread embrace, little scholarship exists that examines underlying ...

Abstract	First-episode psychosis has garnered significant attention and resources within mental health services in North America, Europe and Australia/New Zealand since the 1990s. Despite this widespread embrace, little scholarship exists that examines underlying concepts, ideologies and imagery embedded within the early intervention paradigm. In this paper, I offer a sociohistorical analysis of the emergence of first-episode psychosis and early intervention as entities in psychiatry, drawing on contemporary philosophical thought to explore various concepts embedded in them. Although scattered references to 'prodrome' and 'incipient cases' exist in the historic psychiatric literature, the notion of first-episode psychosis as a distinct chronological stage emerged in the late 1980s. This occurred in response to a desire for a homogeneous, medication-naive population within schizophrenia research. Thematically, concerns regarding 'purity' as well as notions of 'progress' can be read off of the body of work surrounding the creation of the term and its development into a clinical organising concept. Furthermore, examining the sociohistorical context of the term demonstrates its entanglement with the course of atypical antipsychotic drug development, the expansion of clinical rating scales and wider neoliberal biopolitics within healthcare. Within psychiatry, the early intervention model has been termed a 'paradigm shift,' with the promise that earlier interventions will translate into shorter durations of untreated illness, improved utilisation of services and better prognoses for recovery. While these are laudable goals, they are tied to assumptions about biomedical progress and idealisations of clinical populations that feminist and disability critiques problematise.
MeSH term(s)	Concept Formation ; Humans ; Mental Health Recovery ; Metaphor ; Models, Psychological ; Philosophy ; Prodromal Symptoms ; Psychiatry ; Psychotic Disorders/therapy ; Schizophrenia/therapy
Language	English
Publishing date	2018-02-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	2018219-3
ISSN	1473-4265 ; 1468-215X
ISSN (online)	1473-4265
ISSN	1468-215X
DOI	10.1136/medhum-2017-011383
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Article ; Online: Identity, politics, and the pandemic: Why is COVID-19 a disaster for feminism(s)?

Berkhout, Suze G / Richardson, Lisa

History and philosophy of the life sciences

2020 Volume 42, Issue 4, Page(s) 49

Abstract: COVID-19 has been called "a disaster for feminism" (Lewis in The coronavirus is a disaster for feminism, 2020) for numerous reasons. In this short piece, we make sense of this claim, drawing on intersectional feminism(s) to understand why an analysis ... ...

Abstract	COVID-19 has been called "a disaster for feminism" (Lewis in The coronavirus is a disaster for feminism, 2020) for numerous reasons. In this short piece, we make sense of this claim, drawing on intersectional feminism(s) to understand why an analysis that considers gender alone is inadequate to address both the risks and consequences of COVID-19.
MeSH term(s)	COVID-19 ; Coronavirus Infections/epidemiology ; Feminism ; Gender Identity ; Humans ; Pandemics ; Pneumonia, Viral/epidemiology ; Politics
Keywords	covid19
Language	English
Publishing date	2020-10-13
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2094240-0
ISSN	1742-6316 ; 0391-9714
ISSN (online)	1742-6316
ISSN	0391-9714
DOI	10.1007/s40656-020-00346-7
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Article ; Online: Individual- and Institutional-level Concerns of Health Care Workers in Canada During the COVID-19 Pandemic: A Qualitative Analysis.

Berkhout, Suze G / Sheehan, Kathleen A / Abbey, Susan E

JAMA network open

2021 Volume 4, Issue 7, Page(s) e2118425

Abstract: Importance: Mental health and coping difficulties among health care workers (HCWs) have been reported during pandemics and particularly during the COVID-19 pandemic.: Objective: To examine sources of distress and concern for HCWs in Canada during the ...

Abstract	Importance: Mental health and coping difficulties among health care workers (HCWs) have been reported during pandemics and particularly during the COVID-19 pandemic. Objective: To examine sources of distress and concern for HCWs in Canada during the COVID-19 pandemic. Design, setting, and participants: In this qualitative study, a critical discourse analysis was performed of questions posed by HCWs to hospital senior leadership between March 16, 2020, and December 1, 2020, through an online employee forum as part of a larger mixed-methods evaluation of a stepped-care mental health support program for HCWs at 1 of Canada's largest health care institutions. Questions could be submitted online anonymously in advance of the virtual forums on COVID-19 by any of the University Health Network's 21 555 employees, and staff members were able to anonymously endorse questions by upvoting, indicating that an already posed question was of interest. Main outcomes and measures: Themes, text structure, and rhetorical devices used within the questions were analyzed, taking into consideration their larger institutional and societal context. Results: Unique individual views of the forums ranged from 2062 to 7213 during the study period. Major individual-level concerns related to risks of contamination and challenges coping with increased workloads as a result of the pandemic intersected with institutional-level challenges, such as feeling or being valued within the health care setting and long-standing stratifications between types of HCWs. Concerns were frequently reported in terms of calls for clarity or demands for transparency from the institutional leadership. Conclusions and relevance: The findings of this qualitative study suggest that larger institutional-level and structural concerns need to be addressed if HCWs are to be engaged in support and coping programs. Potential service users may be dissuaded from seeing their needs as being met by workplace mental health interventions that solely relate to individual-level concerns.
MeSH term(s)	Adaptation, Psychological ; Attitude of Health Personnel ; COVID-19 ; Canada ; Health Personnel/psychology ; Hospitals ; Humans ; Leadership ; Mental Health ; Occupational Exposure ; Occupational Health ; Occupational Stress/etiology ; Occupational Stress/prevention & control ; Pandemics ; Personnel Management ; Psychological Distress ; Qualitative Research ; SARS-CoV-2 ; Surveys and Questionnaires ; Workload ; Workplace
Language	English
Publishing date	2021-07-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2021.18425
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Article: Identity, politics, and the pandemic: Why is COVID-19 a disaster for feminism(s)?

Berkhout, Suze G / Richardson, Lisa

Hist Philos Life Sci

Abstract	COVID-19 has been called "a disaster for feminism" (Lewis in The coronavirus is a disaster for feminism, 2020) for numerous reasons. In this short piece, we make sense of this claim, drawing on intersectional feminism(s) to understand why an analysis that considers gender alone is inadequate to address both the risks and consequences of COVID-19.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #848590
Database	COVID19

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Article ; Online: Identity, Subjectivity, and Disorders of Self in Psychosis.

Berkhout, Suze G / Zaheer, Juveria / Remington, Gary

Culture, medicine and psychiatry

2019 Volume 43, Issue 3, Page(s) 442–467

Abstract: Alterations in self-experience are increasingly attended to as relevant and important aspects of schizophrenia, and psychosis more broadly, through a burgeoning self-disorders (SD) literature. At the same time, issues of self, subject, and subjectivity ... ...

Abstract	Alterations in self-experience are increasingly attended to as relevant and important aspects of schizophrenia, and psychosis more broadly, through a burgeoning self-disorders (SD) literature. At the same time, issues of self, subject, and subjectivity within schizophrenia-spectrum illnesses have also gained attention from researchers across the social sciences and humanities, and from ethnographic research especially. This paper examines the subjective experience of disruptions in self-identity within a cohort of first episode psychosis (FEP) service users, critically engaging with the SD literature and bringing it into conversation with social sciences and humanities scholarship on self and schizophrenia. Drawing findings from an ongoing ethnographic study of young peoples' experiences with psychosis, we explore meanings of mental distress relating to psychotic episodes and attend to issues of self, identity, and subjectivity. We critique the division between "normal" and "pathological" self-experience that is endorsed within the SD literature, arguing against the notion that fragmentation of self-experience in schizophrenia-spectrum illnesses is indicative of psychopathology. We highlight how experiences categorized as psychosis are also important and complete aspects of one's social world and inner life and explore the ways in which at least some aspects of disruptions of self-identity stem from clinical situations themselves-in particular, from asymmetries of power within the mental health system. Relating our findings to feminist, postcolonial, and disability studies' approaches to the "self," we emphasize the complex interplay between interpersonal, cultural, and structural aspects of self-experience within FEP.
MeSH term(s)	Adult ; Female ; Humans ; Interviews as Topic ; Male ; Psychotic Disorders ; Qualitative Research ; Schizophrenia ; Self Concept ; Young Adult
Language	English
Publishing date	2019-04-12
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	752957-0
ISSN	1573-076X ; 0165-005X
ISSN (online)	1573-076X
ISSN	0165-005X
DOI	10.1007/s11013-019-09631-y
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Article ; Online: "Don't Just Study our Distress, Do Something": Implementing and Evaluating a Modified Stepped-Care Model for Health Care Worker Mental Health During the COVID-19 Pandemic.

Sheehan, Kathleen A / Schulz-Quach, Christian / Ruttan, Lesley A / MacGillivray, Lindsey / McKay, Martha S / Seto, Alison / Li, Adrienne / Stewart, Donna E / Abbey, Susan E / Berkhout, Suze G

Canadian journal of psychiatry. Revue canadienne de psychiatrie

2022 Volume 68, Issue 1, Page(s) 43–53

Abstract: Objective: Throughout the COVID-19 pandemic, there have been concerns about the mental health of health care workers (HCW). Although numerous studies have investigated the level of distress among HCW, few studies have explored programs to improve their ... ...

Abstract	Objective: Throughout the COVID-19 pandemic, there have been concerns about the mental health of health care workers (HCW). Although numerous studies have investigated the level of distress among HCW, few studies have explored programs to improve their mental well-being. In this paper, we describe the implementation and evaluation of a program to support the mental health of HCW at University Health Network (UHN), Canada's largest healthcare network. Methods: Using a quality improvement approach, we conducted a needs assessment and then created and evaluated a modified stepped-care model to address HCW mental health during the pandemic. This included: online resources focused on psychoeducation and self-management, access to online support and psychotherapeutic groups, and self-referral for individual care from a psychologist or psychiatrist. We used ongoing mixed-methods evaluation, combining quantitative and qualitative analysis, to improve program quality. Results: The program is ongoing, running continuously throughout the pandemic. We present data up to November 30, 2021. There were over 12,000 hits to the UHN's COVID mental health intranet web page, which included self-management resources and information on group support. One hundred and sixty-six people self-referred for individual psychological or psychiatric care. The mean wait time from referral to initial appointment was 5.4 days, with an average of seven appointments for each service user. The majority had moderate to severe symptoms of depression and anxiety at referral, with over 20% expressing thoughts of self-harm or suicide. Post-care user feedback, collected through self-report surveys and semistructured interviews, indicated that the program is effective and valued. Conclusions: Development of a high-quality internal mental health support for HCW program is feasible, effective, and highly valued. By using early and frequent feedback from multiple perspectives and stakeholders to address demand and implement changes responsively, the program was adjusted to meet HCW mental health needs as the pandemic evolved.
MeSH term(s)	Humans ; Mental Health ; COVID-19 ; Pandemics ; Health Personnel ; Referral and Consultation
Language	English
Publishing date	2022-07-19
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	304227-3
ISSN	1497-0015 ; 0008-4824 ; 0706-7437
ISSN (online)	1497-0015
ISSN	0008-4824 ; 0706-7437
DOI	10.1177/07067437221111372
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Article ; Online: Shared sources and mechanisms of healthcare worker distress in COVID-19: a comparative qualitative study in Canada and the UK.

Berkhout, Suze G / Billings, Jo / Abou Seif, Nada / Singleton, David / Stein, Hilarie / Hegarty, Siobhan / Ondruskova, Tamara / Soulios, Emilia / Bloomfield, Michael A P / Greene, Talya / Seto, Alison / Abbey, Susan / Sheehan, Kathleen

European journal of psychotraumatology

2022 Volume 13, Issue 2, Page(s) 2107810

Abstract: ... Background: ... COVID-19 has had a significant impact on the wellbeing of healthcare workers, with quantitative studies identifying increased stress, anxiety, depression, insomnia, and PTSD in a wide range of settings. Limited qualitative data so far ... ...

Abstract	Background: COVID-19 has had a significant impact on the wellbeing of healthcare workers, with quantitative studies identifying increased stress, anxiety, depression, insomnia, and PTSD in a wide range of settings. Limited qualitative data so far has offered in-depth details concerning what underlies these challenges, but none provide comprehensive comparison across different healthcare systems. Objective: To explore qualitative findings relating to healthcare worker distress from two different countries to understand the nuanced similarities and differences with respect to the sources and impact of distress relating to COVID-19. Method: A comparative interpretive thematic analysis was carried out between two qualitative data sets examining healthcare workers' experiences of distress during the COVID-19 pandemic. Data from Canada and the UK were collected in parallel and analyzed in an iterative, collaborative process. Results: A number of sources of distress cut across both study settings including concerns about safety and patient care, challenges at home or in one's personal life, communication issues, work environment, media and public perception, and government responses to the pandemic. These sit on a spectrum from individual to institutional sources and were mutually reinforcing. Our analysis also suggested that common mechanisms such as exacerbations in uncertainty, hypervigilance, and moral injury underpinned these sources, which contributed to how they were experienced as distressing. Conclusion: This is the first international collaboration utilising qualitative data to examine this pressing issue. Despite differences in the political, social, health service, and pandemic-related context, the sources and mechanisms of distress experienced by healthcare workers in Canada and the UK were remarkably similar. HIGHLIGHTS This international comparative qualitative study explores how mechanisms that lead to distress are shared across different geographies and cultures, even as the local context shapes the sources of distress themselves.
MeSH term(s)	COVID-19 ; Health Personnel ; Humans ; Pandemics ; Qualitative Research ; United Kingdom/epidemiology
Language	English
Publishing date	2022-08-11
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2586642-4
ISSN	2000-8066 ; 2000-8066
ISSN (online)	2000-8066
ISSN	2000-8066
DOI	10.1080/20008066.2022.2107810
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Article ; Online: Power to the people? A co-produced critical review of service user involvement in mental health professions education.

Kalocsai, Csilla / Agrawal, Sacha / de Bie, Lee / Beder, Michaela / Bellissimo, Gail / Berkhout, Suze / Johnson, Andrew / McNaughton, Nancy / Rodak, Terri / McCullough, Kim / Soklaridis, Sophie

Advances in health sciences education : theory and practice

2023 Volume 29, Issue 1, Page(s) 273–300

Abstract: Meaningful service user involvement in health professions education requires integrating knowledge held by "lay" people affected by health challenges into professional theories and practices. Involving service users redefines whose knowledge "counts" and ...

Abstract	Meaningful service user involvement in health professions education requires integrating knowledge held by "lay" people affected by health challenges into professional theories and practices. Involving service users redefines whose knowledge "counts" and implies a shift in power. Such a shift is especially significant in the mental health field, where power imbalances between health professionals and service users are magnified. However, reviews of the literature on service user involvement in mental health professional education do little to explore how power manifests in this work. Meanwhile critical and Mad studies scholars have highlighted that without real shifts in power, inclusion practices can lead to harmful consequences. We conducted a critical review to explore how power is addressed in the literature that describes service user involvement in mental health professions education. Our team used a co-produced approach and critical theories to identify how power implicitly and explicitly operates in this work to unearth the inequities and power structures that service user involvement may inadvertently perpetuate. We demonstrate that power permeates service user involvement in mental health professional education but is rarely made visible. We also argue that by missing the opportunity to locate power, the literature contributes to a series of epistemic injustices that reveal the contours of legitimate knowledge in mental health professions education and its neoliberal underpinnings. Ultimately, we call for a critical turn that foregrounds power relations to unlock the social justice-oriented transformative potential of service user involvement in mental health professions education and health professions education more broadly.
MeSH term(s)	Humans ; Health Personnel/education ; Educational Status ; Patient Participation ; Mental Health ; Health Occupations
Language	English
Publishing date	2023-05-29
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	1352832-4
ISSN	1573-1677 ; 1382-4996
ISSN (online)	1573-1677
ISSN	1382-4996
DOI	10.1007/s10459-023-10240-z
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