A2 2..2
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The Journal ushers in the New Year with some exciting research challenging several pieces of traditional wisdom, with respect to mental health and marriage, imprisonment and treatment by non-specialist workers. Married individuals have been shown to have improved levels of mental health, with some earlier data suggesting that this benefit may be greater for individuals who are married rather than in unmarried relationships, and that this benefit was greater for males than females. Gibb and colleagues (pp. 24–30) carried out a longitudinal study reporting that a longer duration of relationship, within or outside marriage, was protective for individuals’ mental health. This was associated with lower rates of depressive illness and suicidal behaviour, with equal benefit for both men and women, and lower rates of substance misuse showing a differential benefit for women. Incarceration in prison has traditionally been considered to have a detrimental effect on mental health, but Hassan et al (pp. 37–42) show that this is not invariably so. They found that psychiatric symptoms did not increase in any group over 2 months of imprisonment and actually declined in several groups, including males, convicted prisoners and those with depressive illness. However, being on remand and having a severe mental illness were related to increasing symptoms over time, and the crucial first week of imprisonment continued to be a period of high distress. Psychological treatments, predominantly cognitive–behavioural therapy (CBT), are recommended for the treatment of depressive illness. A more elementary behavioural activation approach, focused on the development of behavioural strategies, has been shown to deliver comparable results. Ekers et al (pp. 66–72) used generic mental health workers, rather than expert therapists, to deliver a behavioural activation treatment to individuals with depression, and demonstrated clear positive change. They suggest that this offers an efficient and cost-effective method for treating long-standing depressive illness.
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