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This exploratory study empirically shows how community social capital is related to post-disaster depression, whereas most disaster mental health research has focused on posttraumatic stress disorder. We tested the validity of earlier found multilevel social and individual mechanisms of posttraumatic stress for symptoms of post-disaster depression. We used data (n = 231) from a community study after a flood in Morpeth (2008), a rural town in northern England. At the salutary community level, our multilevel analyses showed that, in communities with high social capital, individuals employ less individual social support and coping effort, which protects individuals from developing symptoms of depression. Yet, on the ‘dark’ individual level of our model, we found that perceiving the disaster as less traumatic after a year was related to more feelings of depression in contrast to previous findings for posttraumatic stress. Our explanation of this finding is that, when the appraisal of the disaster as threatening fades into the background, individuals may perceive the full scope of the disaster aftermath and start to feel depressed. We also found that more social support is related to more depression. Although depressed people may attract or receive more social support, this social support can paradoxically become disabling by reinforcing a sense of dependence, thereby undermining self-esteem and leading to feelings of helplessness. Our results imply that to curb post-disaster depression, boosting community level social capital may be an important starting point for building resilience. At the same time, interventionists need to identify risk groups for whom the stressful experience becomes less intrusive and who experience the burden of dependency on an unequal relationship with ones’ social inner circle.

The COVID-19 pandemic : The 'black swan' for mental health care and a turning point for e-health.

Social capital is defined as the resources—for example, the exchange of favours, the maintenance of group norms, the stocks of trust and the exercise of sanctions—available to members of social groups. A social group can take different forms, such as a workplace, a voluntary organisation, or a tightly knit residential community.1 2 Scholars have assumed that high stocks of social capital exert their effect on health outcomes in a multilevel fashion as it provides both individuals and communities with the resources to deal with adversities, which in turn is salutary for individual health outcomes.3–5 Therefore, scholars and policy makers need to consider social capital as a starting point to improve individual health outcomes. Although a multilevel social capital intervention can be problematic to design, costly and difficult to implement, it may involve greater success affecting the environment of a whole group. In this editorial, we first summarise the status quo of research on social capital interventions in public health. Second, we highlight that researchers have generally approached social capital from a somewhat simplistic and binary assumption that social capital is either beneficial or has no effect. We postulate that research may advance by empirically answering the question why and how social capital is related to health outcomes, as this question has been largely left unanswered. We recently performed a systematic review in which we classified manuscripts developing social capital interventions with an emphasis on improving health outcomes. Yet, despite enthusiasm of policy makers for decades to implement social capital interventions, in this review we could only include 17 papers that analysed the effect of social capital interventions on health outcomes.1 In this systematic review, we developed a framework to distinguish between individual level, community level and multilevel social capital interventions and to investigate if in those interventions …

To date, reviews show inconclusive results on the association between social capital and mental health. Evidence that social capital can intentionally be promoted is also scarce. Promotion of social capital may impact post-conflict recovery through both increased social cohesion and better mental health. However, studies on community interventions and social capital have mostly relied on cross-sectional study designs. We present a longitudinal study in Rwanda on the effect on social capital and mental health of sociotherapy, a community-based psychosocial group intervention consisting of fifteen weekly group sessions. We hypothesized that the intervention would impact social capital and, as a result of that, mental health. We used a quasi-experimental study design with measurement points pre- and post-intervention and at eight months follow-up (2007–2008). Considering sex and living situation, we selected 100 adults for our experimental group. We formed a control group of 100 respondents with similar symptom score distribution, age, and sex from a random community sample in the same region. Mental health was assessed by use of the Self Reporting Questionnaire, and social capital through a locally adapted version of the short Adapted Social Capital Assessment Tool. It measures three elements of social capital: cognitive social capital, support, and civic participation. Latent growth models were used to examine whether effects of sociotherapy on mental health and social capital were related. Civic participation increased with 7% in the intervention group versus 2% in controls; mental health improved with 10% versus 5% (both: p

IntroductionVery little is known on the impact of recurrent disasters on mental health.AimThe present study examines the immediate impact of a recurrent flood on mental health and functioning among an affected population in the rural district of Bahraich, Uttar Pradesh, India, compared with a population in the same region that is not affected by floods.MethodsThe study compared 318 affected respondents with 308 individuals who were not affected by floods. Symptoms of anxiety and depression were assessed by the Hopkins Symptom Checklist-25 (HSCL-25). Psychological and physical functioning was assessed by using the Short Form-12 (SF-12).ResultsThe affected group showed large to very large differences with the comparison group on symptoms of anxiety (D = .92) and depression (D = 1.22). The affected group scored significantly lower on psychological and physical functioning than the comparison group (respectively D = .33 and D = .80). However, hierarchical linear regressions showed no significant relationship between mental health and the domains of functioning in the affected group, whereas mental health and the domains of functioning were significantly related in the comparison group.ConclusionThis study found a large negative impact of the recurrent floods on mental health outcomes and psychological and physical functioning. However, in a context with recurrent floods, disaster mental health status is not a relevant predictor of functioning. The findings suggest that the observed mental health status and impaired functioning in this context are also outcomes of another mechanism: Both outcomes are likely to be related to the erosion of the social and environmental and material context. As such, the findings refer to a need to implement psychosocial context-oriented interventions to address the erosion of the context rather than specific mental health interventions.WindTR, JoshiPC, KleberRJ, KomproeIH. The impact of recurrent disasters on mental health: a study on seasonal floods in northern India. Prehosp Disaster Med. 2013;28(3):1-7.

Many scholars question the immense variation in rates of mental health outcomes across disaster studies. This study explains this variation by putting forward 2 methodological problems that are inherent to the effect of a disaster context on mental health screening scores. The Hopkins Symptom Checklist-25 was administered in a flood-affected group (n = 318) and a nonaffected group (n = 304) in Uttar Pradesh, India. The affected group showed much higher mean scores on subscales of anxiety and depression. However, factor analyses (i.e., confirmatory factor analyses [CFA] and multilevel confirmatory factor analyses [MCFA]; Muthen, 1994) revealed 2 methodological phenomena that account for the differences in scores. First, the outcomes revealed that a large proportion of covariance between observed mental health variables did not refer to the latent concepts of interest (depression and anxiety), but to the context of both groups (disaster affected vs. nonaffected). The shared effect of the disaster on the context explained a large proportion of the covariances between the items and biased outcomes. Second, after dissecting this group variance, the construct validity of the assessments of anxiety and depression was revealed to be poor and unstable across both groups. The subscales of anxiety and depression referred to different concepts in both groups. These 2 methodological problems have not been discussed thus far, but they contribute to the variation in mental health outcomes across disaster studies.