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Sim CSL, Asharani PV, Subramaniam M, Yi H. Roles and Dynamics within Community Mental Health Systems During the COVID-19 Pandemic: A Qualitative Systematic Review and Meta-Ethnography. Health Syst Reform 2024; 10:2314525. [PMID: 38598726 DOI: 10.1080/23288604.2024.2314525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/01/2024] [Indexed: 04/12/2024] Open
Abstract
Globally, COVID-19 had an immense impact on mental health systems, but research on how community mental health (CMH) systems and services contributed to the pandemic mental health response is limited. We conducted a systematic review and meta-ethnography to understand the roles of CMH services, determinants of the quality of CMH care, and dynamics within CMH systems during COVID-19. We searched and screened across five databases and appraised study quality using the CASP tool, which yielded 27 qualitative studies. Our meta-ethnographic process used Noblit and Hare's approach for synthesizing findings and applying interpretive analysis to original research. This identified several key themes. Firstly, CMH systems played the valuable pandemic role of safety nets and networks for the broader mental health ecosystem, while CMH service providers offered a continuous relationship of trust to service users amidst pandemic disruptions. Secondly, we found that the determinants of quality CMH care during COVID-19 included resourcing and capacity, connections across service providers, customized care options, ease of access, and human connection. Finally, we observed that power dynamics across the CMH landscape disproportionately excluded marginalized groups from mainstream CMH systems and services. Our findings suggest that while the pandemic role of CMH was clear, effectiveness was driven by the efforts of individual service providers to meet demand and service users' needs. To reprise its pandemic role in the future, a concerted effort is needed to make CMH systems a valuable part of countries' disaster mental health response and to invest in quality care, particularly for marginalized groups.
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Affiliation(s)
- Cheryl Su Ling Sim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - P V Asharani
- Department of Research Division, Institute of Mental Health, Singapore, Singapore
| | - Mythily Subramaniam
- Department of Research Division, Institute of Mental Health, Singapore, Singapore
| | - Huso Yi
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- National University Health System, Singapore, Singapore
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Palmeiro-Silva Y, Aravena-Contreras R, Izcue Gana J, González Tapia R, Kelman I. Climate-related health impact indicators for public health surveillance in a changing climate: a systematic review and local suitability analysis. LANCET REGIONAL HEALTH. AMERICAS 2024; 38:100854. [PMID: 39171197 PMCID: PMC11334688 DOI: 10.1016/j.lana.2024.100854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 07/18/2024] [Accepted: 07/19/2024] [Indexed: 08/23/2024]
Abstract
Climate change challenges public health. Effective management of climate-related health risks relies on robust public health surveillance (PHS) and population health indicators. Despite existing global and country-specific indicators, their integration into local PHS systems is limited, impacting decision-making. We conducted a systematic review examining population health indicators relevant to climate change impacts and their suitability for national PHS systems. Guided by a registered protocol, we searched multiple databases and included 41 articles. Of these, 35 reported morbidity indicators, and 39 reported mortality indicators. Using Chile as a case study, we identified three sets of indicators for the Chilean PHS. The high-priority set included vector-, food-, and water-borne diseases, as well as temperature-related health outcomes indicators due to their easy integration into existing PHS systems. This review highlights the importance of population health indicators in monitoring climate-related health impacts, emphasising the need for local contextual factors to guide indicator selection. Funding This research project was partly funded by ANID Chile and University College London. None of these sources had any involvement in the research conceptualisation, design, or interpretation of the results.
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Affiliation(s)
| | | | - José Izcue Gana
- Institute for Global Prosperity, University College London, London, United Kingdom
| | | | - Ilan Kelman
- Institute for Global Health, University College London, London, United Kingdom
- Institute for Risk and Disaster Reduction, University College London, London, United Kingdom
- University of Agder, Norway
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Getahun M, Mathai MA, Rota G, Allen A, Burger RL, Opiyo E, Oluoch D, Wangia J, Wambura R, Mbwayo A, Muchembre P, Obura RR, Neylan TC, Aarons GA, Ongeri L, Meffert SM. "The peace that I wanted, I got": Qualitative insights from patient experiences of SMART DAPPER interventions for major depression and traumatic stress disorders in Kenya. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002685. [PMID: 39236052 PMCID: PMC11376547 DOI: 10.1371/journal.pgph.0002685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 07/26/2024] [Indexed: 09/07/2024]
Abstract
SMART DAPPER is an implementation science study responding to mental health treatment gaps for depression and trauma-related disorders in Sub-Saharan Africa (SSA). We report on patient experiences in a study using a Sequential, Multiple Assignment Randomized Trial (SMART) design to test first and second line non-specialist treatment using psychotherapy (Interpersonal Psychotherapy [IPT] or medication (fluoxetine [FLX]), integrated within public sector primary care in western Kenya. An embedded qualitative study conducted in-depth interviews (n = 17) and three (n = 3) focus group discussions with participants (May to October 2021). Audio-recorded interviews were transcribed and translated into English; we deductively and inductively analyzed transcripts guided by grounded theoretical approaches and content analysis. We drew on the health belief model and socio-ecological framework to present findings, including perceived severity (motivations for taking part in the intervention), impacts of the intervention at the individual, interpersonal, and community and health systems levels as well as barriers and facilitators. Participants discussed family and marital conflict, loss of a child, loss of income or a job, and traumatic events such as a death or illness. Impacts at the individual level included reduced headaches, improved appetite and weight management, increased energy, improved sleep, better self-efficacy, and improved concentration, which was reported to lead to increased economic opportunities. At the interpersonal level, participants noted a reduction in conflict, better conflict management and resolution, increased harmony with family and community members, and improved relationships with their partners and children. Perceived challenges included balancing the intervention with livelihoods, preference for traditional medicines, actual or anticipated side effects with medication (FLX), mental health stigma, major life events, and perceived inadequate counseling and challenges with providers. The findings demonstrate the potential of the SMART DAPPER intervention for depression and trauma-related disorder treatments and underscore the challenges and barriers that must be addressed when scaling similar interventions. Trial registration: ClinicalTrials.gov identifier: NCT03466346.
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Affiliation(s)
- Monica Getahun
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, United States of America
| | | | - Grace Rota
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
| | - Ammon Allen
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
| | - Rachel L Burger
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California, United States of America
| | - Elizabeth Opiyo
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
| | - Dennis Oluoch
- Global Programs for Research and Training, Nairobi, Kenya
| | - Josyline Wangia
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
| | | | - Anne Mbwayo
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
| | | | | | - Thomas C Neylan
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California, United States of America
| | - Gregory A Aarons
- Department of Psychiatry, University of California San Diego, San Diego, California, United States of America
| | - Linnet Ongeri
- Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Susan M Meffert
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California, United States of America
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Sharma V, Sharma P, Singh TG. Therapeutic potential of transient receptor potential (TRP) channels in psychiatric disorders. J Neural Transm (Vienna) 2024; 131:1025-1037. [PMID: 39007920 DOI: 10.1007/s00702-024-02803-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/28/2024] [Indexed: 07/16/2024]
Abstract
Psychiatric disorders such as Bipolar disorder, Anxiety, Major depressive disorder, Schizophrenia, Attention-deficit/hyperactivity disorder, as well as neurological disorders such as Migraine, are linked by the evidence of altered calcium homeostasis. The disturbance of intra-cellular calcium homeostasis disrupts the activity of numerous ion channels including transient receptor potential (TRP) channels. TRP channel families comprise non-selective calcium-permeable channels that have been implicated in variety of physiological processes in the brain, as well as in the pathogenesis of psychiatric disorders. Through a comprehensive review of current research and experimentation, this investigation elucidates the role of TRP channels in psychiatric disorders. Furthermore, this review discusses about the exploration of epigenetics and TRP channels in psychiatric disorders.
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Affiliation(s)
- Veerta Sharma
- Chitkara College of Pharmacy, Chitkara University, Rajpura, 140401, Punjab, India
| | - Prateek Sharma
- Chitkara College of Pharmacy, Chitkara University, Rajpura, 140401, Punjab, India
| | - Thakur Gurjeet Singh
- Chitkara College of Pharmacy, Chitkara University, Rajpura, 140401, Punjab, India.
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Whitehorne-Smith P, Lalwani K, Martin R, Mitchell G, Milbourn B, Abel W, Burns S. A grounded theory exploration of the enablers and barriers of public healthcare access for people with comorbid serious mental and chronic physical illnesses in Jamaica. PLoS One 2024; 19:e0309678. [PMID: 39213323 PMCID: PMC11364246 DOI: 10.1371/journal.pone.0309678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 08/15/2024] [Indexed: 09/04/2024] Open
Abstract
Chronic physical illnesses (CPI) are highly prevalent among people with serious mental illnesses (PWSMI) yet people in this population experience significant challenges accessing healthcare. This study utilised a constructivist grounded theory approach to collect and analyse data related to the enablers and barriers to public healthcare access for PWSMI & CPI. Data were collected through semi-structured interviews conducted with fifty-seven participants comprising PWSMI &CPI and their caregivers, health policymakers, primary care physicians, psychiatrists, and mental health nurses. Enablers and barriers to healthcare access were represented using a socio-ecological model consisting of five levels: wider society, health system, clinician, family and community, and individual. Jamaica's free public healthcare system was the most pronounced enabler of healthcare access, while poverty, stigma, and discrimination were the most pronounced barriers. Factors such as social support, time, clinician beliefs, attitudes and training, and individual characteristics were identified as consisting of dimensions that were both enablers and barriers to healthcare access. These findings indicated that factors that influenced healthcare access for PWSMI & CPI were aligned with the social determinants of health. Improved healthcare access for PWSMI & CPI necessitates strategies that incorporate a multi-sectoral approach to address social and environmental factors influencing healthcare access across all levels of the socio-ecological model.
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Affiliation(s)
| | - Kunal Lalwani
- School of Global, Urban, and Social Studies, RMIT University, Melbourne, Australia
| | - Robyn Martin
- Department of Community Health and Psychiatry, University of the West Indies, Kingston, Jamaica
| | | | - Ben Milbourn
- School of Allied Health, Curtin University, Bentley, Western Australia, Australia
| | - Wendel Abel
- Department of Community Health and Psychiatry, University of the West Indies, Kingston, Jamaica
| | - Sharyn Burns
- School of Population Health, Curtin University, Bentley, Western Australia, Australia
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6
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Yoon S, Goh H, Low XC, Weng JH, Heaukulani C. User perceptions and utilisation of features of an AI-enabled workplace digital mental wellness platform 'mindline at work '. BMJ Health Care Inform 2024; 31:e101045. [PMID: 39153756 PMCID: PMC11331828 DOI: 10.1136/bmjhci-2024-101045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 07/29/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND The working population encounters unique work-related stressors. Despite these challenges, accessibility to mental healthcare remains limited. Digital technology-enabled mental wellness tools can offer much-needed access to mental healthcare. However, existing literature has given limited attention to their relevance and user engagement, particularly for the working population. AIM This study aims to assess user perceptions and feature utilisation of mindline at work, a nationally developed AI-enabled digital platform designed to improve mental wellness in the working population. METHODS This study adopted a mixed-methods design comprising a survey (n=399) and semistructured interviews (n=40) with office-based working adults. Participants were asked to use mindline at work for 4 weeks. We collected data about utilisation of the platform features, intention for sustained use and perceptions of specific features. RESULTS Participants under 5 years of work experience reported lower utilisation of multimedia resources but higher utilisation of emotion self-assessment tools and the AI chatbot compared with their counterparts (p<0.001). The platform received a moderate level of satisfaction (57%) and positive intention for sustained use (58%). Participants regarded mindline at work as an 'essential' safeguard against workplace stress, valuing its secure and non-judgmental space and user anonymity. However, they wanted greater institutional support for office workers' mental wellness to enhance the uptake. The AI chatbot was perceived as useful for self-reflection and problem-solving, despite limited maturity. CONCLUSION Identifying the unique benefits of specific features for different segments of working adults can foster a personalised user experience and promote mental well-being. Increasing workplace awareness is essential for platform adoption.
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Affiliation(s)
- Sungwon Yoon
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
- Centre for Population Health Research and Implementation, SingHealth, Singapore
| | - Hendra Goh
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
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Ann Johns D, Quirk SE, Pasco JA, Hyde NK, Williams LJ. Parental mental health during preconception years in association with offspring attention deficit hyperactivity disorder (ADHD): a systematic review protocol. BMJ Open 2024; 14:e082958. [PMID: 39122396 PMCID: PMC11331898 DOI: 10.1136/bmjopen-2023-082958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 07/24/2024] [Indexed: 08/12/2024] Open
Abstract
INTRODUCTION Attention deficit hyperactivity disorder (ADHD) is a neuropsychiatric condition prevalent in both children and adults. With growing awareness of the importance of the preconception period in health, it is essential to understand whether preconception parental mental health and related factors are related to onset of offspring ADHD. This protocol presents the methodology for undertaking a systematic review to investigate associations between parental mental health and/or psychotropic use during the preconception years and offspring ADHD. METHODS AND ANALYSIS Peer-reviewed literature will be identified by searching relevant electronic databases including Medline complete, Embase, PsycINFO and CINAHL; reference lists of eligible articles will be hand searched and grey literature considered. Eligible study designs include population-based and/or clinically based cohort or case-control studies. The primary exposure and outcome of interest is parental history of mental health conditions in the preconception period and offspring ADHD, respectively (ie, according to semistructured interviews/confirmed diagnosis by a relevant health professional or screening instruments). Critical appraisal will be undertaken. A descriptive synthesis will be presented including characteristics of the included studies, critical appraisal scores and a summary of main findings (eg, presented in tables, text and figures). A meta-analysis will be conducted, if possible, and statistical techniques will be employed if heterogeneity is detected. ETHICS AND DISSEMINATION Ethical permissions are not required for this systematic review since the study will only use published data. Findings from this systematic review will be published in a peer-reviewed scientific journal/presented at national and international conferences relevant to the field. PROSPERO REGISTRATION NUMBER CRD42023460379.
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Affiliation(s)
- Ditty Ann Johns
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Shae E Quirk
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Julie A Pasco
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
- University Hospital, Geelong, Victoria, Australia
- Department of Medicine, Western Health, University of Melbourne, St. Albans, Victoria, Australia
- Department of Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Natalie K Hyde
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
- University Hospital, Geelong, Victoria, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Lana J Williams
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
- University Hospital, Geelong, Victoria, Australia
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Jahanshad N, Lenzini P, Bijsterbosch J. Current best practices and future opportunities for reproducible findings using large-scale neuroimaging in psychiatry. Neuropsychopharmacology 2024:10.1038/s41386-024-01938-8. [PMID: 39117903 DOI: 10.1038/s41386-024-01938-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/05/2024] [Accepted: 07/09/2024] [Indexed: 08/10/2024]
Abstract
Research into the brain basis of psychopathology is challenging due to the heterogeneity of psychiatric disorders, extensive comorbidities, underdiagnosis or overdiagnosis, multifaceted interactions with genetics and life experiences, and the highly multivariate nature of neural correlates. Therefore, increasingly larger datasets that measure more variables in larger cohorts are needed to gain insights. In this review, we present current "best practice" approaches for using existing databases, collecting and sharing new repositories for big data analyses, and future directions for big data in neuroimaging and psychiatry with an emphasis on contributing to collaborative efforts and the challenges of multi-study data analysis.
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Affiliation(s)
- Neda Jahanshad
- Mark and Mary Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, 90292, USA.
| | - Petra Lenzini
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | - Janine Bijsterbosch
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO, 63110, USA.
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Alavi M, Hungerford C, Ghelbash Z, Le Lagadec D, Cleary M. Promoting High-Quality Research to Improve Global Mental Health and Well-Being. Issues Ment Health Nurs 2024; 45:881-882. [PMID: 38412447 DOI: 10.1080/01612840.2024.2309524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Affiliation(s)
- Mousa Alavi
- Department of Mental Health Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Catherine Hungerford
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, NSW, Australia
| | - Zakiye Ghelbash
- Student Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Danielle Le Lagadec
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Bundaberg, Queensland, Australia
| | - Michelle Cleary
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, NSW, Australia
- Edited by Michelle Cleary, RN, PhD School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, NSW, Australia
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Zuo X, Tang Y, Chen Y, Zhou Z. Effects of Electronic Serious Games on Older Adults With Alzheimer's Disease and Mild Cognitive Impairment: Systematic Review With Meta-Analysis of Randomized Controlled Trials. JMIR Serious Games 2024; 12:e55785. [PMID: 39083796 PMCID: PMC11324188 DOI: 10.2196/55785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 02/19/2024] [Accepted: 06/26/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Serious games (SGs) are nonpharmacological interventions that are widely applied among older adults. To date, no evidence has been published regarding the effect of digital SGs on cognitive ability, daily behavioral capacity, or depression in older adults with Alzheimer's disease (AD) and mild cognitive impairment (MCI). OBJECTIVE This study aimed to assess the effect of SGs on older adults with AD and MCI by summarizing and pooling the results of previous studies. METHODS This meta-analysis examined the effectiveness of digital SGs in improving cognitive ability, enhancing daily behavioral capacity, and alleviating depression in older adults with AD and MCI. We searched the following databases up to December 31, 2023, to identify relevant high-quality randomized controlled trials (RCTs): PubMed, Embase, Web of Science, Scopus, and Cochrane Library. Stata 15.1 and Review Manager 5.3 were used to screen the 14 studies, extract data, code the data, and perform meta-analysis. Mean differences and standardized mean differences (SMDs) with 95% CIs were used to calculate continuous variables. The Cochrane risk-of-bias assessment tool was used to evaluate the risk of bias. Eligibility criteria were developed in accordance with the Population, Intervention, Comparison, Outcomes, and Study Design framework: (1) population (older adults with AD and MCI), (2) intervention (digital SG intervention), (3) comparison (digital SG intervention vs routine health care), (4) outcomes (cognitive ability, daily behavioral capacity, and depression), and (5) study or research design (RCT). Sensitivity analysis was performed, and a funnel plot was constructed. RESULTS From January 2017 to December 2023, we enrolled 714 individuals across 14 RCTs, with 374 (52.4%) in the severe game group using digital SGs and 340 (47.6%) in the control group using traditional methods. The results of our meta-analysis indicated that using digital SGs in older adults with AD and MCI is more effective than traditional training methods in several key areas. Specifically, digital SG therapy significantly increased cognitive ability, as found in the Mini-Mental State Examination (SMD 2.11, 95% CI 1.42-2.80; P<.001) and the Montreal Cognitive Assessment (SMD 2.75, 95% CI 1.98-3.51; P<.001), significantly increased daily behavioral capacity (SMD 0.53, 95% CI 0.06-0.99; P=.03), and significantly reduced depression (SMD -2.08, 95% CI -2.94 to -1.22; P<.001) in older adults with AD and MCI. No publication bias was detected based on the results of Begg and Egger tests. CONCLUSIONS Digital SGs offer a viable and effective nonpharmacological approach for older adults with AD and MCI, yielding better results compared to traditional formats. However, caution is warranted in interpreting these findings due to limited RCTs, small sample sizes, and low-quality meta-analyzed evidence. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews: CRDCRD42023486090; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=486090.
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Affiliation(s)
- Xinyi Zuo
- Sociology Department, School of Government, Shenzhen University, Shenzhen, Guangdong, China
| | - Yong Tang
- Sociology Department, School of Government, Shenzhen University, Shenzhen, Guangdong, China
| | - Yifang Chen
- Institution of Policy Studies, Lingnan University, Tuen Mun, Hong Kong SAR, China (Hong Kong)
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Lawrence HR, Schneider RA, Rubin SB, Matarić MJ, McDuff DJ, Jones Bell M. The Opportunities and Risks of Large Language Models in Mental Health. JMIR Ment Health 2024; 11:e59479. [PMID: 39105570 DOI: 10.2196/59479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 05/31/2024] [Accepted: 06/01/2024] [Indexed: 08/07/2024] Open
Abstract
Unlabelled Global rates of mental health concerns are rising, and there is increasing realization that existing models of mental health care will not adequately expand to meet the demand. With the emergence of large language models (LLMs) has come great optimism regarding their promise to create novel, large-scale solutions to support mental health. Despite their nascence, LLMs have already been applied to mental health-related tasks. In this paper, we summarize the extant literature on efforts to use LLMs to provide mental health education, assessment, and intervention and highlight key opportunities for positive impact in each area. We then highlight risks associated with LLMs' application to mental health and encourage the adoption of strategies to mitigate these risks. The urgent need for mental health support must be balanced with responsible development, testing, and deployment of mental health LLMs. It is especially critical to ensure that mental health LLMs are fine-tuned for mental health, enhance mental health equity, and adhere to ethical standards and that people, including those with lived experience with mental health concerns, are involved in all stages from development through deployment. Prioritizing these efforts will minimize potential harms to mental health and maximize the likelihood that LLMs will positively impact mental health globally.
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Affiliation(s)
| | | | | | - Maja J Matarić
- Google LLC, Mountain View, CA, 90291, United States, 13103106000
| | - Daniel J McDuff
- Google LLC, Mountain View, CA, 90291, United States, 13103106000
| | - Megan Jones Bell
- Google LLC, Mountain View, CA, 90291, United States, 13103106000
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Vanderlee E, Abate AT, Godfrey C, Duhn L, Camargo-Plazas P. Experiences of accessing mental health services for women living on a low income in Canada: a qualitative systematic review protocol. JBI Evid Synth 2024:02174543-990000000-00335. [PMID: 39054878 DOI: 10.11124/jbies-23-00505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
OBJECTIVE The objective of this review is to comprehensively analyze qualitative evidence on the experiences of Canadian women aged 18 years or above living on a low income. The review will examine the intersectionality of their identities and privileges when accessing mental health services, with the aim of informing targeted interventions and policy improvements. INTRODUCTION Despite the growing body of research on mental health disparities and a call for improved mental health care, both globally and in Canada, there is a need to identify recommendations for system enhancement and to improve gender equality by understanding the nuanced experiences of accessing mental health care for Canadian women living on a low income. INCLUSION CRITERIA This review will include qualitative studies conducted within the past decade about women of diverse backgrounds aged 18 years or above who identify as living on a low income and who have resided in Canada for 6 months or longer. Studies using any qualitative methodology will be included. METHODS The following databases will be searched for published studies: MEDLINE and PsycINFO (Ovid); CINAHL and Pre-CINAHL (EBSCOhost); LiSSa; and Google Scholar. Searches for unpublished studies will include the Primo Central Index, ProQuest Dissertations and Theses Global, and the Canadian Women's Foundation Studies. The review will include studies published in English and French in Canada, from 2013 to the present. The JBI methodology for systematic reviews of qualitative evidence will be followed, informing study selection, appraisal, extraction, synthesis, and assessment of confidence, which will be conducted by 2 independent reviewers. REVIEW REGISTRATION PROSPERO CRD42023430100.
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Affiliation(s)
- Emma Vanderlee
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Addisu Taye Abate
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Christina Godfrey
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
| | - Lenora Duhn
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
| | - Pilar Camargo-Plazas
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
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Mutamba BB, Twikirize G, Ssemalulu J, Babirye R, Semakula L, Cappo D. Diagnostic pattern of mental, neurological and substance use disorders at primary health care facilities in Uganda. Int J Ment Health Syst 2024; 18:26. [PMID: 39010128 PMCID: PMC11247730 DOI: 10.1186/s13033-024-00643-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 06/12/2024] [Indexed: 07/17/2024] Open
Abstract
Integration of diagnosis and treatment for mental, neurological, and substance use (MNS) disorders into primary health care is a recommended strategy to improve access to services in low-and middle-income countries. Despite numerous initiatives for integration of mental health care in Uganda, there has not been an evaluation of health management information system (HMIS) records to determine whether MNS disorders are routinely diagnosed. We sought to determine diagnostic pattern of MNS disorders at primary health facilities in Wakiso and Kampala districts, the most populous regions of Uganda. Lower-level primary health facilities were visited to obtain records from HMIS registers, to document diagnoses of MNS disorders. Secondary data analysis was conducted and descriptive statistics reported. A total of 40 primary health care facilities were visited representing 58.6% of the health facilities in the study districts. More than half (54.8%) and almost all (87.5%) of the lower-level health facilities in Wakiso district and Kampala district respectively were visited. The proportion of MNS disorders diagnosed at lower-level primary health facilities in Uganda is very low with Epilepsy the most common MNS diagnosis recorded. Reasons for such low numbers of diagnoses at primary health facilities are discussed as are possible solutions.
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Affiliation(s)
- Byamah B Mutamba
- YouBelong Uganda, Kampala, Uganda.
- Butabika National Referral Mental Hospital, Kampala, Uganda.
| | - Gad Twikirize
- Butabika National Referral Mental Hospital, Kampala, Uganda
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Poddar A, Chhajer R. Detection and disclosure of workplace mental health challenges: an exploratory study from India. BMC Public Health 2024; 24:1874. [PMID: 39004708 PMCID: PMC11247900 DOI: 10.1186/s12889-024-19422-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 07/09/2024] [Indexed: 07/16/2024] Open
Abstract
Workplace mental health challenges have emerged as a significant concern post-pandemic. Despite this, the pervasive stigma surrounding mental illness leads to the concealment of symptoms and reluctance to seek professional help among employees. This study aims to explore the perception of different stakeholders towards the 'Detection and disclosure' of workplace mental health challenges in the Indian context. Fifteen semi-structured interviews were conducted with human resource professionals, counselors, and employees who had previously experienced mental health challenge(s). Thematic analysis was done to identify recurring themes and sub-themes. Three critical pathways were identified: minimizing the inhibitory factors, including lack of awareness, denial, low self-efficacy, stigma, and underestimating organizational capability; maximizing the encouraging factors, including psychological safety, perceived social support, and communicating success stories; and implementing supportive organizational practices, including generating awareness and literacy, build the organizational capability, strengthen the role of managers, leadership advocacy, policies, and processes. By fostering a culture of support and prioritizing employee well-being, organizations in India can create healthier and more resilient work environments, benefiting both individuals and the larger society.
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Affiliation(s)
- Ankur Poddar
- Indian Institute of Management Indore, Faculty Office J-223, Indore, India
| | - Raina Chhajer
- Indian Institute of Management Indore, Faculty Office J-223, Indore, India.
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15
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Skar AMS, Engebretsen IMS, Braathu N, Aber H, Bækkelund H, Kühl MJ, Mukisa M, Nalugya JS, Skokauskas N, Skylstad V, Wentzel-Larsen T, Babirye JN. Study protocol for a stepped-wedge implementation study investigating the intersectoral collaboration of implementering the TREAT INTERACT intervention for primary school teachers and the mhGAP for health care workers for child mental health promotion in Uganda. Trials 2024; 25:465. [PMID: 38982328 PMCID: PMC11234609 DOI: 10.1186/s13063-024-08312-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 07/03/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Mental and neuropsychological disorders make up approximately 14% of the total health burden globally, with 80% of the affected living in low- and middle-income countries (LMICs) of whom 90% cannot access mental health services. The main objective of the TREAT INTERACT study is to adapt, implement, and evaluate the impact of a novel, intersectoral approach to prevent, identify, refer, and treat mental health problems in children through a user centred task-sharing implementation of the TREAT INTERACT intervention, inspired by the World Health Organization (WHO) Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) for primary school staff in Mbale, Uganda. Health care personell will be trained in the mhGAP-IG. METHODS This is a pragmatic mixed-methods hybrid Type II implementation-effectiveness study utilizing a co-design approach. The main study utilize a stepped-wedged trial design with six starting sequences, randomizing three schools to the intervention at each interval, while the remaining act as "controls". Other designs include a nested prospective cohort study, case control studies, cross-sectional studies, and qualitative research. Main participants' outcomes include teachers' mental health literacy, stigma, and violence towards the school children. Implementation outcomes include detection, reach, sustainability, and service delivery. Child and caregiver outcomes include mental health, mental health literacy, and help-seeking behaviour. DISCUSSION Based on the results, we will develop sustainable and scalable implementation advice on mental health promotion and draft implementation guidelines in line with current WHO guidelines. This project will generate new knowledge on the structure, organization, delivery, and costs of mental health services in a LMIC setting, as well as new knowledge on the implementation and delivery of new health services. TRIAL REGISTRATION ClinicalTrials, NCT06275672, 28.12.2023, retrospectively registered.
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Affiliation(s)
- Ane-Marthe Solheim Skar
- Norwegian Center for Violence and Traumatic Stress Studies, Gullhaugveien 1, Oslo, 0484, Norway.
- Global Health Cluster, Division for Health Services, the Norwegian Institute of Public Health, Oslo, Norway.
| | - Ingunn Marie S Engebretsen
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway
| | - Nora Braathu
- Norwegian Center for Violence and Traumatic Stress Studies, Gullhaugveien 1, Oslo, 0484, Norway
| | - Harriet Aber
- School of Public Health, Makerere University College of Health Sciences, MakSPH, Kampala, Uganda
| | - Harald Bækkelund
- Norwegian Center for Violence and Traumatic Stress Studies, Gullhaugveien 1, Oslo, 0484, Norway
| | - Melf-Jakob Kühl
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway
| | - Marjorie Mukisa
- School of Public Health, Makerere University College of Health Sciences, MakSPH, Kampala, Uganda
| | - Joyce Sserunjogi Nalugya
- School of Public Health, Makerere University College of Health Sciences, MakSPH, Kampala, Uganda
| | - Norbert Skokauskas
- Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Vilde Skylstad
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway
| | - Tore Wentzel-Larsen
- Norwegian Center for Violence and Traumatic Stress Studies, Gullhaugveien 1, Oslo, 0484, Norway
| | - Juliet Ndimwibo Babirye
- School of Public Health, Makerere University College of Health Sciences, MakSPH, Kampala, Uganda
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Chaisanam R, Wattanathorn J, Thukham-mee W, Piyavhatkul N, Paholpak P. Anxiolytic, Antidepression, and Memory-Enhancing Effects of the Novel Instant Soup RJ6601 in the Middle-Aged of Female Rats. Foods 2024; 13:2170. [PMID: 39063255 PMCID: PMC11276534 DOI: 10.3390/foods13142170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Revised: 07/01/2024] [Accepted: 07/02/2024] [Indexed: 07/28/2024] Open
Abstract
Due to the health benefits of polyphenols and dietary fiber in combating mental disorders, we hypothesized that a polyphenol- and dietary fiber-enriched soup (RJ6601) would improve mental wellness in a rat model of middle-aged women. To test this hypothesis, female Wistar rats aged 18 months (350-450 g) were orally administered RJ6601 at doses of 200 and 400 mg/kg BW for 28 days. The anxiolytic, antidepression, and memory-enhancing effects were assessed every 7 days throughout the study period. The neuron density and levels of activities of AChE, total MAO, MAO-A, MAO-B, MDA, SOD, CAT, GSH-Px, IL-1β, IL-6, and BDNF in the prefrontal cortex at the end of study were also investigated. Furthermore, the amounts of Lactobacillus spp. and Bifidobacterium spp. in their feces were also determined. The results revealed that the developed soup shows anxiolytic, antidepression, and memory-enhancing effects. An increased neuron density; reductions in AChE, total MAO, MAO-A, MAO-B, and MDA; and an elevation of serum BDNF, together with increased amounts of both bacterial species in feces, were also observed. Our results suggest that RJ6601 is a potential mental wellness promotion supplement that enhances BDNF levels, brain plasticity, neurotransmitter balance, and oxidative stress and inflammation status, along with improving microbiota.
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Affiliation(s)
- Rujikan Chaisanam
- Department of Physiology and Graduate School (Neuroscience Program), Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand;
| | - Jintanaporn Wattanathorn
- Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand;
- Research Institute for High Human Performance and Health Promotion, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Wipawee Thukham-mee
- Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand;
- Research Institute for High Human Performance and Health Promotion, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Nawanant Piyavhatkul
- Department Psychiatry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; (N.P.); (P.P.)
| | - Pongsatorn Paholpak
- Department Psychiatry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; (N.P.); (P.P.)
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17
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Franco D'Souza R, Mathew M, Amanullah S, Edward Thornton J, Mishra V, E M, Louis Palatty P, Surapaneni KM. Navigating merits and limits on the current perspectives and ethical challenges in the utilization of artificial intelligence in psychiatry - An exploratory mixed methods study. Asian J Psychiatr 2024; 97:104067. [PMID: 38718518 DOI: 10.1016/j.ajp.2024.104067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 04/29/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND The integration of Artificial Intelligence (AI) in psychiatry presents opportunities for enhancing patient care but raises significant ethical concerns and challenges in clinical application. Addressing these challenges necessitates an informed and ethically aware psychiatric workforce capable of integrating AI into practice responsibly. METHODS A mixed-methods study was conducted to assess the outcomes of the "CONNECT with AI" - (Collaborative Opportunity to Navigate and Negotiate Ethical Challenges and Trials with Artificial Intelligence) workshop, aimed at exploring AI's ethical implications and applications in psychiatry. This workshop featured presentations, discussions, and scenario analyses focusing on AI's role in mental health care. Pre- and post-workshop questionnaires and focus group discussions evaluated participants' perspectives, and ethical understanding regarding AI in psychiatry. RESULTS Participants exhibited a cautious optimism towards AI, recognizing its potential to augment mental health care while expressing concerns over ethical usage, patient-doctor relationships, and AI's practical application in patient care. The workshop significantly improved participants' ethical understanding, highlighting a substantial knowledge gap and the need for further education in AI among psychiatrists. CONCLUSION The study underscores the necessity of continuous education and ethical guideline development for psychiatrists in the era of AI, emphasizing collaborative efforts in AI system design to ensure they meet clinical needs ethically and effectively. Future initiatives should aim to broaden psychiatrists' exposure to AI, fostering a deeper understanding and integration of AI technologies in psychiatric practice.
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Affiliation(s)
- Russell Franco D'Souza
- Department of Education, UNESCO Chair in Bioethics, Melbourne, Australia; Department of Organizational Psychological Medicine, International Institute of Organisational Psychological Medicine, 71 Cleeland Street, Dandenong Victoria, Melbourne 3175, Australia
| | - Mary Mathew
- Department of Pathology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Tiger Circle Road, Madhav Nagar, Manipal, Karnataka 576104, India
| | - Shabbir Amanullah
- Division of Geriatric Psychiatry, Queen's University, Providence Care Hospital, 752 King Street West, Postal Bag 603 Kingston, ON K7L7X3, Canada
| | - Joseph Edward Thornton
- Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
| | - Vedprakash Mishra
- School of Higher Education & Research, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Nagpur, Maharashtra, India
| | - Mohandas E
- Department of Psychiatry, Sun Medical and Research Centre, Thrissur, Kerala 680 001, India
| | - Princy Louis Palatty
- Department of Pharmacology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Elamakkara P.O., Kochi, Kerala 682 041, India
| | - Krishna Mohan Surapaneni
- Department of Biochemistry, Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai, Tamil Nadu 600 123, India; Department of Medical Education, Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai, Tamil Nadu 600 123, India.
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18
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Lee YJ, Christ R, Mbabazi R, Dabagia J, Prendergast A, Wykoff J, Dasari S, Safai D, Nakaweesi S, Aturinde SR, Galvin M, Akena D, Ashaba S, Waiswa P, Rosenheck R, Tsai AC. Differences in Mental Illness Stigma by Disorder and Gender: Population-Based Vignette Randomized Experiment in Rural Uganda. PLOS MENTAL HEALTH 2024; 1:e0000069. [PMID: 39188639 PMCID: PMC11345708 DOI: 10.1371/journal.pmen.0000069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/28/2024]
Abstract
Understanding and eliminating mental illness stigma is crucial for improving population mental health. In many settings, this stigma is gendered, from the perspectives of both the stigmatized and the stigmatizers. We aimed to find the differences in the level of stigma across different mental disorders while considering the gender of the study participants as well as the gender of the people depicted in the vignettes. This was a population-based, experimental vignette study conducted in Buyende District of Eastern Uganda in 2023. We created 8 vignettes describing both men and women with alcohol use disorder, major depressive disorder, generalized anxiety disorder, and schizophrenia consistent with DSM-5 criteria. Participants from 20 villages in rural Buyende District of Uganda (N=379) were first read a randomly selected vignette and administered a survey eliciting their attitudes (Personal Acceptance Scale [PAS] and Broad Acceptance Scale [BAS]) towards the person depicted in the vignette. We used analysis of variance (ANOVA) with Bonferroni-adjusted, empirical p-values to compare levels of acceptance across disorders and genders. Attitudes towards people with mental illness, as measured by the PAS, varied across different mental disorders (p=0.002). In pairwise mean comparisons, the greater acceptance of anxiety disorder vs. schizophrenia was statistically significant (Mean [SD] PAS: 2.91 [3.15] vs 1.62 [1.95], p=0.008). Secondary analyses examining differences in acceptance across gender combinations within mental disorders showed that PAS varied across gender combinations for depression (p=0.017), suggesting that acceptance is higher for women with depression than men with depression. In this population-based vignette study from rural Uganda, we found that people with schizophrenia were less accepted compared to people with anxiety disorders. We also found that there was greater acceptance of women with depression than men with depression. Anti-stigma initiatives may need to be targeted to specific disorders and genders.
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Affiliation(s)
- Yang Jae Lee
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, United States of America
- Empower Through Health, St. Louis, Missouri, United States of America
| | - Ryan Christ
- Department of Genomics, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Rita Mbabazi
- Empower Through Health, St. Louis, Missouri, United States of America
| | - Jackson Dabagia
- College of Arts and Sciences, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Alison Prendergast
- College of Arts and Sciences, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Jason Wykoff
- Empower Through Health, St. Louis, Missouri, United States of America
| | - Samhitha Dasari
- College of Arts and Sciences, University of Georgia, Athens, Georgia, United States of America
| | - Dylan Safai
- Williams College, Williamstown, Massachusetts, United States of America
| | - Shakira Nakaweesi
- Empower Through Health, St. Louis, Missouri, United States of America
| | | | - Michael Galvin
- Department of Psychiatry, Boston Medical Center, Boston, Massachusetts, United States of America
| | - Dickens Akena
- Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda
| | - Scholastic Ashaba
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Peter Waiswa
- Department of Psychiatry, Makerere University School of Public Health, Kampala, Uganda
| | - Robert Rosenheck
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Alexander C. Tsai
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
- Center for Global Health and Morgan Institute, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, United States of America
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19
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Holliday N, Mulear V. Effects of the COVID-19 Pandemic on the Wellbeing of LGBTQ+ Individuals in Moldova: A Mixed Methods Analysis. JOURNAL OF HOMOSEXUALITY 2024; 71:1808-1835. [PMID: 37129469 DOI: 10.1080/00918369.2023.2206935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Research on the effects of the COVID-19 pandemic for LGBTQ+ people is limited, particularly in eastern Europe. This mixed methods study explored the direct and indirect effects of the pandemic on the mental and physical wellbeing of LGBTQ+ individuals in Moldova. From June to the end of July 2022, 86 surveys and 12 interviews were completed by self-identified LGBTQ+ adults in Moldova. Survey data were analyzed with descriptive statistics and interviews were coded and analyzed using the grounded theory methodology. The two data sets were interpreted concurrently to identify emergent themes. Overall, data suggest LGBTQ+ people experienced both negative and positive effects on their mental wellbeing due to the pandemic. Participants expressed feelings of anxiety, loneliness, and depression, and an inability to be their authentic selves. Conversely, participants had more capacity to explore their identities and they demonstrated social support within the LGBTQ+ community. Regarding physical impacts, there were interruptions to transgender medical care and concerns about housing affordability. Findings highlight the unique impacts of the pandemic on LGBTQ+ people and stress the importance of further research in this area and policies and plans to address the needs of LGBTQ+ people in response to the pandemic and future health crises.
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Affiliation(s)
- Nicole Holliday
- Faculty of Medicine, University of Freiburg, Freiburg, Germany
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20
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Sarfraz Z, Sarfraz A, Amin SZ. Evaluating cognitive behavioral therapy as a solution for postnatal depression in economically disadvantaged regions. Arch Womens Ment Health 2024; 27:459-475. [PMID: 38294495 DOI: 10.1007/s00737-024-01428-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 01/19/2024] [Indexed: 02/01/2024]
Abstract
PURPOSE Postnatal depression (PND) impacts numerous women after childbirth, leading to various impairments in their lives. Mental health interventions, such as cognitive behavioral therapy (CBT), need further evaluation in low- and middle-income countries (LMICs) where resources may be scarce. This study aimed to assess the effectiveness of CBT in treating PND in women from LMICs, comparing it to standard care. METHODS A systematic review and meta-analysis were conducted following the PRISMA Statement 2020 guidelines. Databases such as PubMed, CINAHL Plus, Cochrane Library, and PsycINFO were searched until September 2022. A modified Delphi process was employed to identify relevant studies. The primary outcome was mean depression scores, measured by the Edinburgh postnatal depression scale at baseline and post-intervention. RESULTS Out of 487 studies identified, five trials were included, totaling 1056 participants (520 in the intervention group and 536 in the comparator group). At baseline, a minor, insignificant positive effect size was found (Cohen's d = 0.1, 95% CI = - 0.15, 0.35). Post-CBT, the intervention group showed significant improvements in depression scores (Cohen's d = - 1.9, 95% CI = - 3.8, 0). When accounting for the influence of one study, (Ngai et al., Psychother Psychosom 84:294-303, 2015), which held substantial weight in the initial analysis, the effect size was adjusted to d = 0.5, highlighting a lesser but still significant difference. CONCLUSIONS CBT appears to be effective in improving PND symptoms among women in LMICs and may be considered a first-line treatment for at-risk mothers, including those who are displaced. However, the significant impact of one study on the results emphasizes the need for more rigorous research. The study also highlights the challenges and limitations of providing psychotherapies across LMICs, emphasizing the need for culturally adapted and contextually appropriate interventions to ensure successful implementation and sustainability of mental health care for postnatal women in these settings.
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Affiliation(s)
- Zouina Sarfraz
- Department of Medicine, Fatima Jinnah Medical University, Queen's Road, Mozang Chungi, Lahore, 54000, Punjab, Pakistan.
| | - Azza Sarfraz
- Department of Pediatrics, The Aga Khan University, Karachi, Pakistan
| | - Shah Zaib Amin
- Department of Research, King Edward Medical University, Lahore, Pakistan
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Harkness A, Giusto A, Hamilton AB, Hernandez‐Ramirez RU, Spiegelman D, Weiner BJ, Beidas RS, Larson ME, Lippman SA, Wainberg ML, Smith JD. Navigating grey areas in HIV and mental health implementation science. J Int AIDS Soc 2024; 27:e26271. [PMID: 38923301 PMCID: PMC11197965 DOI: 10.1002/jia2.26271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 04/29/2024] [Indexed: 06/28/2024] Open
Abstract
INTRODUCTION Implementation science (IS) offers methods to systematically achieve the Ending the HIV Epidemic goals in the United States, as well as the global UNAIDS targets. Federal funders such as the National Institutes of Mental Health (NIMH) have invested in implementation research to achieve these goals, including supporting the AIDS Research Centres (ARCs), which focus on high-impact science in HIV and mental health (MH). To facilitate capacity building for the HIV/MH research workforce in IS, "grey areas," or areas of IS that are confusing, particularly for new investigators, should be addressed in the context of HIV/MH research. DISCUSSION A group of IS experts affiliated with NIMH-funded ARCs convened to identify common and challenging grey areas. The group generated a preliminary list of 19 grey areas in HIV/MH-related IS. From the list, the authors developed a survey which was distributed to all ARCs to prioritize grey areas to address in this paper. ARC members across the United States (N = 60) identified priority grey areas requiring clarification. This commentary discusses topics with 40% or more endorsement. The top grey areas that ARC members identified were: (1) Differentiating implementation strategies from interventions; (2) Determining when an intervention has sufficient evidence for adaptation; (3) Integrating recipient perspectives into HIV/MH implementation research; (4) Evaluating whether an implementation strategy is evidence-based; (5) Identifying rigorous approaches for evaluating the impact of implementation strategies in the absence of a control group or randomization; and (6) Addressing innovation in HIV/MH IS grants. The commentary addresses each grey area by drawing from the existing literature (when available), providing expert guidance on addressing each in the context of HIV/MH research, and providing domestic and global HIV and HIV/MH case examples that address these grey areas. CONCLUSIONS HIV/MH IS is key to achieving domestic and international goals for ending HIV transmission and mitigating its impact. Guidance offered in this paper can help to overcome challenges to rigorous and high-impact HIV/MH implementation research.
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Affiliation(s)
- Audrey Harkness
- School of Nursing and Health StudiesUniversity of MiamiCoral GablesFloridaUSA
| | - Ali Giusto
- Department of PsychiatryColumbia University Irving Medical CenterNew York State Psychiatric InstituteNew YorkNew YorkUSA
| | - Alison B. Hamilton
- Center for the Study of Healthcare InnovationImplementation & Policy, VA Greater Los Angeles Healthcare SystemLos AngelesCaliforniaUSA
- Department of Psychiatry & Biobehavioral SciencesUniversity of California Los AngelesLos AngelesCaliforniaUSA
| | - Raul U. Hernandez‐Ramirez
- Department of BiostatisticsCenter for Interdisciplinary Research on AIDSand Center for Methods in Implementation and Prevention ScienceYale School of Public HealthNew HavenConnecticutUSA
| | - Donna Spiegelman
- Department of BiostatisticsCenter for Interdisciplinary Research on AIDSand Center for Methods in Implementation and Prevention ScienceYale School of Public HealthNew HavenConnecticutUSA
| | - Bryan J. Weiner
- School of Public HealthUniversity of WashingtonSeattleWashingtonUSA
| | - Rinad S. Beidas
- Department of Medical Social SciencesFeinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
| | - Michaela E. Larson
- School of Nursing and Health StudiesUniversity of MiamiCoral GablesFloridaUSA
- Division of Prevention ScienceUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Sheri A. Lippman
- Division of Prevention ScienceUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Milton L. Wainberg
- Department of PsychiatryColumbia University Irving Medical CenterNew York State Psychiatric InstituteNew YorkNew YorkUSA
| | - Justin D. Smith
- Department of Population Health SciencesSpencer Fox Eccles School of Medicine at the University of UtahSalt Lake CityUtahUSA
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22
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Zhang Z, Hu Y, Liu S, Feng X, Yang J, Cheng LJ, Ramazanu S, Wu XV. The effectiveness of e-mental health interventions on stress, anxiety, and depression among healthcare professionals: a systematic review and meta-analysis. Syst Rev 2024; 13:144. [PMID: 38816879 PMCID: PMC11138032 DOI: 10.1186/s13643-024-02565-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 05/17/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Many healthcare professionals are experiencing psychological distress. Electronic mental health (e-mental health) interventions are convenient and multifunctional. This review aimed to examine the effectiveness of e-mental health interventions in enhancing the well-being of healthcare professionals and to identify moderating factors. METHODS A comprehensive and systematic retrieval of randomized controlled trial (RCT) studies was conducted across eight databases. Population, intervention, comparison, and outcome (PICO) were used to define eligibility criteria. Stress, anxiety, and depression were included as the main outcomes. The overall effect was calculated based on the random effect model, and the effect size was presented using the standardized mean difference. The characteristics of the research design, intervention object, and intervention design were further selected as potential moderating factors for subgroup analysis. Meta-regression analyses were finally performed, incorporating intervention duration and sample size as independent variables. RESULTS A total of 20 studies were included in the systematic review, and 17 were included in the meta-analysis. A large effect on relieving stress and anxiety and a small-to-medium effect on reducing depression were observed. Subgroup analyses showed that features including mindfulness approaches, online courses, computer use, group interventions, and professional guidance were more favorable in the design of services. Meta-regression revealed that intervention duration only affected anxiety symptoms. Caution should be exercised, as some subgroups had fewer studies and higher heterogeneity. For the secondary outcomes, a large effect on emotional exhaustion and a small-to-medium effect on well-being were observed. CONCLUSION In general, e-mental health interventions significantly improve the psychological health of healthcare staff. Future high-quality, large-scale studies targeting healthcare professionals and specific intervention scenarios are warranted.
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Affiliation(s)
- Zemiao Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yinhuan Hu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Sha Liu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiandong Feng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinhong Yang
- Xiangya School of Nursing, Central South University, Changsha, China
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Ling Jie Cheng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Sheena Ramazanu
- School of Nursing and Health Studies, The Jockey Club Institute of Healthcare (IOH), Hong Kong Metropolitan University, Hong Kong, China
| | - Xi Vivien Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Alhuwaydi AM. Exploring the Role of Artificial Intelligence in Mental Healthcare: Current Trends and Future Directions - A Narrative Review for a Comprehensive Insight. Risk Manag Healthc Policy 2024; 17:1339-1348. [PMID: 38799612 PMCID: PMC11127648 DOI: 10.2147/rmhp.s461562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/10/2024] [Indexed: 05/29/2024] Open
Abstract
Mental health is an essential component of the health and well-being of a person and community, and it is critical for the individual, society, and socio-economic development of any country. Mental healthcare is currently in the health sector transformation era, with emerging technologies such as artificial intelligence (AI) reshaping the screening, diagnosis, and treatment modalities of psychiatric illnesses. The present narrative review is aimed at discussing the current landscape and the role of AI in mental healthcare, including screening, diagnosis, and treatment. Furthermore, this review attempted to highlight the key challenges, limitations, and prospects of AI in providing mental healthcare based on existing works of literature. The literature search for this narrative review was obtained from PubMed, Saudi Digital Library (SDL), Google Scholar, Web of Science, and IEEE Xplore, and we included only English-language articles published in the last five years. Keywords used in combination with Boolean operators ("AND" and "OR") were the following: "Artificial intelligence", "Machine learning", Deep learning", "Early diagnosis", "Treatment", "interventions", "ethical consideration", and "mental Healthcare". Our literature review revealed that, equipped with predictive analytics capabilities, AI can improve treatment planning by predicting an individual's response to various interventions. Predictive analytics, which uses historical data to formulate preventative interventions, aligns with the move toward individualized and preventive mental healthcare. In the screening and diagnostic domains, a subset of AI, such as machine learning and deep learning, has been proven to analyze various mental health data sets and predict the patterns associated with various mental health problems. However, limited studies have evaluated the collaboration between healthcare professionals and AI in delivering mental healthcare, as these sensitive problems require empathy, human connections, and holistic, personalized, and multidisciplinary approaches. Ethical issues, cybersecurity, a lack of data analytics diversity, cultural sensitivity, and language barriers remain concerns for implementing this futuristic approach in mental healthcare. Considering these sensitive problems require empathy, human connections, and holistic, personalized, and multidisciplinary approaches, it is imperative to explore these aspects. Therefore, future comparative trials with larger sample sizes and data sets are warranted to evaluate different AI models used in mental healthcare across regions to fill the existing knowledge gaps.
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Affiliation(s)
- Ahmed M Alhuwaydi
- Department of Internal Medicine, Division of Psychiatry, College of Medicine, Jouf University, Sakaka, Saudi Arabia
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24
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Liu C, Zhao Y, Zhao WJ. Positive Effect of 6-Gingerol on Functional Plasticity of Microglia in a rat Model of LPS-induced Depression. J Neuroimmune Pharmacol 2024; 19:20. [PMID: 38758335 DOI: 10.1007/s11481-024-10123-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 05/09/2024] [Indexed: 05/18/2024]
Abstract
Neuroinflammation has emerged as a crucial factor in the development of depression. Despite the well-known anti-inflammatory properties of 6-gingerol, its potential impact on depression remains poorly understood. This study aimed to investigate the antidepressant effects of 6-gingerol by suppressing microglial activation. In vivo experiments were conducted to evaluate the effect of 6-gingerol on lipopolysaccharide (LPS)-induced behavioral changes and neuroinflammation in rat models. In vitro studies were performed to examine the neuroprotective properties of 6-gingerol against LPS-induced microglial activation. Furthermore, a co-culture system of microglia and neurons was established to assess the influence of 6-gingerol on the expression of synaptic-related proteins, namely synaptophysin (SYP) and postsynaptic density protein 95 (PSD95), which are influenced by microglial activation. In the in vivo experiments, administration of 6-gingerol effectively alleviated LPS-induced depressive behavior in rats. Moreover, it markedly suppressed the activation of rat prefrontal cortex (PFC) microglia induced by LPS and the activation of the NF-κB/NLRP3 inflammatory pathway, while also reducing the levels of inflammatory cytokines IL-1β and IL-18. In the in vitro experiments, 6-gingerol mitigated nuclear translocation of NF-κB p65, NLRP3 activation, and maturation of IL-1β and IL-18, all of which were induced by LPS. Furthermore, in the co-culture system of microglia and neurons, 6-gingerol effectively restored the decreased expression of SYP and PSD95. The findings of this study demonstrate the neuroprotective effects of 6-gingerol in the context of LPS-induced depression-like behavior. These effects are attributed to the inhibition of microglial hyperactivation through the suppression of the NF-κB/NLRP3 inflammatory pathway.
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Affiliation(s)
- Chong Liu
- Department of Cell Biology, Wuxi School of Medicine, Jiangnan University, 1800 Lihu Dadao, Binhu District, Wuxi, Jiangsu, 214122, P.R. China
| | - Yan Zhao
- College of Environmental Science and Engineering, Qingdao University, Qingdao, 266071, China
| | - Wei-Jiang Zhao
- Department of Cell Biology, Wuxi School of Medicine, Jiangnan University, 1800 Lihu Dadao, Binhu District, Wuxi, Jiangsu, 214122, P.R. China.
- Center for Neuroscience, Shantou University Medical College, Shantou, Guangdong, 515041, P.R. China.
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Karaçar Y, Çaynak S, Boyacıoğlu NE, Meriç M, Öz F. Factors Predicting Mental Health Literacy in Older Adults: A Community-Based Cross-Sectional Study. J Psychosoc Nurs Ment Health Serv 2024:1-10. [PMID: 38709101 DOI: 10.3928/02793695-20240424-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
PURPOSE To determine mental health literacy (MHL) levels of older adults and the predictive factors of MHL. METHOD This cross-sectional study was conducted between October and December 2022, with 410 older adults aged ≥65 years. A Personal Information Form and the Mental Health Literacy Scale were used for data collection. Independent samples t test, analysis of variance, and multiple linear regression were used to analyze the data. RESULTS Significant predictors of MHL in older adults were being aged 65 to 69 years, being female, being a university graduate, having an income more than expenses, receiving information from a health professional, interest in mental health, having friends or family members with mental illness, and good perception of health. CONCLUSION Older adults were found to have low levels of MHL. Mental health professionals should focus on community-based education and interventions to increase the MHL levels of older adults. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].
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Wainberg ML, Gouveia L, McKinnon K. Generating better implementation evidence to improve mental health care everywhere. Lancet Psychiatry 2024; 11:317-319. [PMID: 38552664 DOI: 10.1016/s2215-0366(24)00090-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 03/04/2024] [Indexed: 04/19/2024]
Affiliation(s)
- Milton L Wainberg
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons and New York State Psychiatric Institute, New York, NY 10032, USA.
| | | | - Karen McKinnon
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons and New York State Psychiatric Institute, New York, NY 10032, USA
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27
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Yang J, Deng Z, Pei S, Zhang N. A feasibility study on indoor therapeutic horticulture to alleviate sleep and anxiety problems: The impact of plants and activity choice on its therapeutic effect. Complement Ther Med 2024; 81:103032. [PMID: 38452859 DOI: 10.1016/j.ctim.2024.103032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/19/2024] [Accepted: 03/04/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION Therapeutic horticulture (TH) is increasingly being applied for sub-health or patient mental health care. Whether plant and activity type will affect TH's effectiveness is unclear. AIM To evaluate the feasibility of an indoor TH for alleviating the anxiety symptoms and sleeping problems of people with poor sleep quality, and explore the potential affection of plant and activity type on health benefits. METHOD Thirty subjects (all with sleep problems and half with anxiety problems) were randomly assigned to three groups to do horticultural activities with ornamental plants, general aromatic plants, or aromatic plants with reported mental health functions, respectively. Six indoor TH activities were then held sequentially within two weeks. Psychological scales, subjective feedback questionnaires, and physiological indicators were used as evaluation indexes before and after horticulture activities. RESULTS The TH relieved subjects' sleep and anxiety problems and was particularly effective in alleviating anxiety among people with high anxiety levels. Using ornamental plants was more effective in relieving stress while functional aromatic plants performed better in sleep improvement and satisfaction to TH. Each horticultural activity could improve mood state but showed different effects on the vitality of the participants. CONCLUSION The above findings provided some basis for the potential benefits of selecting plants and activities based on psychological care needs in the development of TH plans. Future research that expands upon the current project is warranted. A larger sample size is beneficial for obtaining more powerful statistical results.
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Affiliation(s)
- Jingqi Yang
- Department of Landscape Architecture, School of Design, Shanghai Jiao Tong University, 800 Dong Chuan Road, Shanghai, China
| | - Zhuoping Deng
- Department of Landscape Architecture, School of Design, Shanghai Jiao Tong University, 800 Dong Chuan Road, Shanghai, China; Aromatic Plant R&D Center, Shanghai Jiao Tong University, 800 Dong Chuan Road, Shanghai, China
| | - Shichun Pei
- Department of Landscape Architecture, School of Design, Shanghai Jiao Tong University, 800 Dong Chuan Road, Shanghai, China; Aromatic Plant R&D Center, Shanghai Jiao Tong University, 800 Dong Chuan Road, Shanghai, China
| | - Nan Zhang
- Department of Landscape Architecture, School of Design, Shanghai Jiao Tong University, 800 Dong Chuan Road, Shanghai, China; Aromatic Plant R&D Center, Shanghai Jiao Tong University, 800 Dong Chuan Road, Shanghai, China.
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Stecher C, Cloonan S, Domino ME. The Economics of Treatment for Depression. Annu Rev Public Health 2024; 45:527-551. [PMID: 38100648 DOI: 10.1146/annurev-publhealth-061022-040533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
The global prevalence of depression has risen over the past three decades across all socioeconomic groups and geographic regions, with a particularly rapid increase in prevalence among adolescents (aged 12-17 years) in the United States. Depression imposes large health, economic, and societal costs, including reduced life span and quality of life, medical costs, and reduced educational attainment and workplace productivity. A wide range of treatment modalities for depression are available, but socioeconomic disparities in treatment access are driven by treatment costs, lack of culturally tailored options, stigma, and provider shortages, among other barriers. This review highlights the need for comparative research to better understand treatments' relative efficacy, cost-effectiveness, scalability, and potential heterogeneity in efficacy across socioeconomic groups and country and cultural contexts. To address the growing burden of depression, mental health policy could consider reducing restrictions on the supply of providers, implementing digital interventions, reducing stigma, and promoting healthy lifestyles.
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Affiliation(s)
- Chad Stecher
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA;
- The Center for Health Information and Research, Arizona State University, Phoenix, Arizona, USA
| | - Sara Cloonan
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - Marisa Elena Domino
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA;
- The Center for Health Information and Research, Arizona State University, Phoenix, Arizona, USA
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Abdel-Qader DH, Albassam A, Taybeh E, Al Mazrouei N, Meer SMA, Al-Kubaisi KA, Ibrahim R, Elnour AA, Mohamed Ibrahim O, AbuRuz S. Lipid and Glucose Profile across Different Mental Disorders. J Clin Med 2024; 13:2499. [PMID: 38731028 PMCID: PMC11084216 DOI: 10.3390/jcm13092499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 04/14/2024] [Accepted: 04/20/2024] [Indexed: 05/13/2024] Open
Abstract
Objectives: Schizophrenia, unipolar depression, bipolar disorder, bipolar mania, and bipolar depression are a few of the severe psychiatric diseases that affect millions of individuals and their overall life quality. This study aimed to look at differences in TGA, TC, HDL, LDL, and FPG levels in people who were going through acute episodes of listed diseases. Materials and methods: A cross-sectional prospective study was carried out in Jordan between January and November of 2023, involving all patients with the aforementioned diseases who attended three psychiatric clinics. This study encompassed results from 1187 patients (women N = 675, 56.87%) who were classified into the following ranges: <25, 25-45, 45-65, and >65. Results: The average level of LDL was the highest in bipolar depression (112.442 ± 36.178 mg/dL) and the lowest in bipolar mania (111.25 ± 33.14 mg/dL). The average level of HDL was the highest in schizophrenia (58.755 ± 16.198 mg/dL) and the lowest in bipolar depression (45.584 ± 12.128 mg/dL). Both average levels of TC and TGA were the highest in patients with bipolar depression (188.403 ± 37.396 mg/dL and 149.685 ± 96.951 mg/dL, respectively) and the lowest in bipolar mania (164.790 ± 40.488 mg/dL and 100.679 ± 54.337 mg/dL, respectively). The average level of FPG was the highest in unipolar depression (94.00 ± 21.453 mg/dL) and the lowest in bipolar mania (89.492 ± 14.700 mg/dL). Conclusions: The results confirmed that lipid and glucose abnormalities were more common in people with schizophrenia and mood disorders (unipolar and bipolar).
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Affiliation(s)
- Derar H. Abdel-Qader
- Faculty of Pharmacy & Medical Sciences, University of Petra, Amman 11196, Jordan;
| | - Abdullah Albassam
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait 12037, Kuwait;
| | - Esra’ Taybeh
- Department of Applied Pharmaceutical Sciences, School of Pharmacy, Isra University, Amman 11622, Jordan;
| | - Nadia Al Mazrouei
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates; (N.A.M.); (S.M.A.M.); (K.A.A.-K.); (R.I.)
| | - Sara Murad Albarkat Meer
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates; (N.A.M.); (S.M.A.M.); (K.A.A.-K.); (R.I.)
| | - Khalid Awad Al-Kubaisi
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates; (N.A.M.); (S.M.A.M.); (K.A.A.-K.); (R.I.)
| | - Rana Ibrahim
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates; (N.A.M.); (S.M.A.M.); (K.A.A.-K.); (R.I.)
| | - Asim Ahmed Elnour
- College of Pharmacy, Al Ain University, Abu Dhabi 112612, United Arab Emirates;
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi 112612, United Arab Emirates
| | - Osama Mohamed Ibrahim
- Department of Clinical Pharmacy, School of Pharmacy, New Giza University, Giza 3296121, Egypt;
| | - Salah AbuRuz
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, The United Arab Emirates University, Al Ain 15551, United Arab Emirates
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Khosravi M, Azar G. A systematic review of reviews on the advantages of mHealth utilization in mental health services: A viable option for large populations in low-resource settings. Glob Ment Health (Camb) 2024; 11:e43. [PMID: 38690573 PMCID: PMC11058521 DOI: 10.1017/gmh.2024.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/29/2024] [Accepted: 03/20/2024] [Indexed: 05/02/2024] Open
Abstract
Global mental health services face challenges such as stigma and a shortage of trained professionals, particularly in low- and middle-income countries, which hinder access to high-quality care. Mobile health interventions, commonly referred to as mHealth, have shown to have the capacity to confront and solve most of the challenges within mental health services. This paper conducted a comprehensive investigation in 2024 to identify all review studies published between 2000 and 2024 that investigate the advantages of mHealth in mental health services. The databases searched included PubMed, Scopus, Cochrane and ProQuest. The quality of the final papers was assessed and a thematic analysis was performed to categorize the obtained data. 11 papers were selected as final studies. The final studies were considered to be of good quality. The risk of bias within the final studies was shown to be in a convincing level. The main advantages of mHealth interventions were categorized into four major themes: 'accessibility, convenience and adaptability', 'patient-centeredness', 'data insights' and 'efficiency and effectiveness'. The findings of the study suggested that mHealth interventions can be a viable and promising option for delivering mental health services to large and diverse populations, particularly in vulnerable groups and low-resource settings.
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Affiliation(s)
- Mohsen Khosravi
- Department of Healthcare Management, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ghazaleh Azar
- Department of Consultation and Mental Health, Yasuj University of Medical Sciences, Yasuj, Iran
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Silva-Valencia J, Lapadula C, Westfall JM, Gaona G, de Lusignan S, Kristiansson RS, Ling ZJ, Goh LH, Soto-Becerra P, Cuba-Fuentes MS, Wensaas KA, Flottorp S, Baste V, Chi-Wai Wong W, Pui Ng AP, Ortigoza A, Manski-Nankervis JA, Hallinan CM, Zingoni P, Scattini L, Heald A, Tu K. Effect of the COVID-19 pandemic on mental health visits in primary care: an interrupted time series analysis from nine INTRePID countries. EClinicalMedicine 2024; 70:102533. [PMID: 38495523 PMCID: PMC10940140 DOI: 10.1016/j.eclinm.2024.102533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/19/2024] [Accepted: 02/22/2024] [Indexed: 03/19/2024] Open
Abstract
Background The COVID-19 pandemic impacted mental health disorders, affecting both individuals with pre-existing conditions and those with no prior history. However, there is limited evidence regarding the pandemic's impact on mental health visits to primary care physicians. The International Consortium of Primary Care Big Data Researchers (INTRePID) explored primary care visit trends related to mental health conditions in Argentina, Australia, Canada, China, Norway, Peru, Singapore, Sweden, and the USA. Methods We conducted an interrupted time series analysis in nine countries to examine changes in rates of monthly mental health visits to primary care settings from January 1st, 2018, to December 31st, 2021. Sub-group analysis considered service type (in-person/virtual) and six categories of mental health conditions (anxiety/depression, bipolar/schizophrenia/other psychotic disorders, sleep disorders, dementia, ADHD/eating disorders, and substance use disorder). Findings Mental health visit rates increased after the onset of the pandemic in most countries. In Argentina, Canada, China, Norway, Peru, and Singapore, this increase was immediate ranged from an incidence rate ratio of 1·118 [95% CI 1.053-1.187] to 2.240 [95% CI 2.057-2.439] when comparing the first month of pandemic with the pre-pandemic trend. Increases in the following months varied across countries. Anxiety/depression was the leading reason for mental health visits in most countries. Virtual visits were reported in Australia, Canada, Norway, Peru, Sweden, and the USA, accounting for up to 40% of the total mental health visits. Interpretation Findings suggest an overall increase in mental health visits, driven largely by anxiety/depression. During the COVID-19 pandemic, many of the studied countries adopted virtual care in particular for mental health visits. Primary care plays a crucial role in addressing mental ill-health in times of crisis. Funding Canadian Institutes of Health Research grant #173094 and the Rathlyn Foundation Primary Care EMR Research and Discovery Fund.
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Affiliation(s)
- Javier Silva-Valencia
- Center for Research in Primary Health Care (CINAPS), Universidad Peruana Cayetano Heredia, Peru
| | - Carla Lapadula
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Zheng Jye Ling
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lay Hoon Goh
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | | | - Knut-Arne Wensaas
- Research Unit for General Practice, NORCE Norwegian Research Centre AS, Bergen, Norway
| | - Signe Flottorp
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
- Department of General Practice, University of Oslo, Oslo, Norway
| | - Valborg Baste
- National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen, Norway
| | - William Chi-Wai Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Amy Pui Pui Ng
- Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Angela Ortigoza
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jo-Anne Manski-Nankervis
- Department of General Practice and Primary Care, The University of Melbourne, Melbourne, Victoria, Australia
| | - Christine Mary Hallinan
- Department of General Practice and Primary Care, The University of Melbourne, Melbourne, Victoria, Australia
| | - Paula Zingoni
- Ministry of Health of the Autonomous City of Buenos Aires, Buenos Aires, Argentina
| | - Luciano Scattini
- Ministry of Health of the Autonomous City of Buenos Aires, Buenos Aires, Argentina
| | - Adrian Heald
- School of Medical Sciences, Division of Diabetes, Endocrinology and Gastroenterology, University of Manchester, UK
| | - Karen Tu
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Departments of Research and Innovation and Family Medicine-North York General Hospital, Toronto Western Family Health Team-University Health Network, Toronto, Ontario, Canada
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Yanguela J, Pence BW, Udedi M, Banda JC, Kulisewa K, Zimba CC, Malava JK, Akiba C, Dussault JM, Morrison AM, Mphonda S, Hosseinipour MC, Gaynes BN, Wheeler SB. Implementation strategies to build mental health-care capacity in Malawi: a health-economic evaluation. Lancet Glob Health 2024; 12:e662-e671. [PMID: 38408461 PMCID: PMC10958395 DOI: 10.1016/s2214-109x(23)00597-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/10/2023] [Accepted: 12/12/2023] [Indexed: 02/28/2024]
Abstract
BACKGROUND Depression is a major contributor to morbidity and mortality in sub-Saharan Africa. Due to low system capacity, three in four patients with depression in sub-Saharan Africa go untreated. Despite this, little attention has been paid to the cost-effectiveness of implementation strategies to scale up evidence-based depression treatment in the region. In this study, we investigate the cost-effectiveness of two different implementation strategies to integrate the Friendship Bench approach and measurement-based care in non-communicable disease clinics in Malawi. METHODS The two implementation strategies tested in this study are part of a trial, in which ten clinics were randomly assigned (1:1) to a basic implementation package consisting of an internal coordinator acting as a champion (IC-only group) or to an enhanced package that complemented the basic package with quarterly external supervision, and audit and feedback of intervention delivery (IC + ES group). We included material costs, training costs, costs related to project-wide meetings, transportation and medication costs, time costs related to internal champion activities and depression screening or treatment, and costs of external supervision visits if applicable. Outcomes included the number of patients screened with the patient health questionnaire 2 (PHQ-2), cases of remitted depression at 3 and 12 months, and disability-adjusted life-years (DALYs) averted. We compared the cost-effectiveness of both packages to the status quo (ie, no intervention) using a micro-costing-informed decision-tree model. FINDINGS Relative to the status quo, IC + ES would be on average US$10 387 ($1349-$17 365) more expensive than IC-only but more effective in achieving remission and averting DALYs. The cost per additional remission would also be lower with IC + ES than IC-only at 3 months ($119 vs $223) and 12 months ($210 for IC + ES; IC-only dominated by the status quo at 12 months). Neither package would be cost-effective under the willingness-to-pay threshold of $65 per DALY averted currently used by the Malawian Ministry of Health. However, the IC + ES package would be cost-effective in relation to the commonly used threshold of three times per-capita gross domestic product per DALY averted. INTERPRETATION Investing in supporting champions might be an appropriate use of resources. Although not currently cost-effective by Malawian willingness-to-pay standards compared with the status quo, the IC + ES package would probably be a cost-effective way to build mental health-care capacity in resource-constrained settings in which decision makers use higher willingness-to-pay thresholds. FUNDING National Institute of Mental Health.
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Affiliation(s)
- Juan Yanguela
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Brian W Pence
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Michael Udedi
- Non-Communicable Diseases and Mental Health Division, Malawi Ministry of Health and Population, Department of Clinical Services, Lilongwe, Malawi
| | - Jonathan Chiwanda Banda
- Non-Communicable Diseases and Mental Health Division, Malawi Ministry of Health and Population, Department of Clinical Services, Lilongwe, Malawi
| | - Kazione Kulisewa
- Department of Mental Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | | | - Jullita K Malava
- Malawi Epidemiology and Intervention Research Unit, Chilumba, Karonga District, Malawi
| | | | | | - Abigail M Morrison
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Steve Mphonda
- University of North Carolina Project-Malawi, Lilongwe, Malawi
| | - Mina C Hosseinipour
- University of North Carolina Project-Malawi, Lilongwe, Malawi; Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Bradley N Gaynes
- Division of Global Mental Health, Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Stephanie B Wheeler
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
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Amanyi-Enegela JA, Badaki JA, Pali M, Okunade F, Kumbur J, Omoi S, Ishaya R, Ogoshi C, Emereuwa I, Sankar G, Qureshi B. Lessons from integrating mental health as part of lymphatic filariasis morbidity management and disability prevention services in Jigawa State, Nigeria. Int Health 2024; 16:i22-i29. [PMID: 38547349 PMCID: PMC10977946 DOI: 10.1093/inthealth/ihae002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/30/2023] [Accepted: 01/08/2024] [Indexed: 04/02/2024] Open
Abstract
Lymphatic filariasis (LF) is a neglected tropical disease affecting >120 million people worldwide. LF has debilitating effects on humans and leads to morbidity and sometimes irreversible disability. A significant proportion of persons affected by LF morbidity also suffer from ill health, such as depression, anxiety, pain, stigma and social isolation due to disfigurement, as well as loss of mobility, livelihood and income. Mental health is often overlooked as a component of morbidity management and disability prevention (MMDP) services, despite the high prevalence of depression and anxiety among people affected by LF. To address this gap, Christian Blind Mission (CBM) piloted a comprehensive approach providing morbidity management and disability prevention by integrating mental health as part of the MMDP care package. The participatory evaluation of the project reviewed the project documents and a review meeting, small group discussions and in-depth interviews with project stakeholders. Findings suggest that project training and service delivery targets were exceeded in most cases. In addition, the disability and gender disaggregated data highlights the interplay of gender and disability in accessing care and the existence of unmet mental health needs. The financial cost of transportation to utilise referrals or access other MMDP services, such as replenishing treatment supplies, was a major constraint in accessing services for LF morbidity patients and low levels of awareness, fear of hydrocoele surgery and social stigmatisation were reported. The project outcomes demonstrate the feasibility and effectiveness of integrating mental health as part of a comprehensive MMDP package of care. Integration strategies should target training of MMDP providers in basic mental health skills, screening for mental health issues and the provision of mental health services and other MMDP services within the same facilities. Integration is an important step towards comprehensive care for people affected by LF and other NTD morbidities and disabilities.
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Affiliation(s)
- Juliana A Amanyi-Enegela
- Inclusive Eye Health and Neglected Tropical Diseases Initiative, CBM Christoffel-Blindenmission Christian Blind Mission e.V., Wellington House, East Road CB1 1BH, Cambridge, UK
| | - Jacqueline A Badaki
- Department of Zoology, Federal University of Technology, Lokoja, Kogi State, Nigeria
| | - Maureen Pali
- HANDS, 5A Naomi Jugu Drive, Rayfield, Jos, Plateau State, Nigeria
| | - Faizah Okunade
- CBM Christoffel-Blindenmission Christian Blind Mission e.V Nigeria Country Office, 13 Okemesi Crescent, Garki 2, Federal Capital Territory, Abuja, Nigeria
| | - Joseph Kumbur
- CBM Christoffel-Blindenmission Christian Blind Mission e.V Nigeria Country Office, 13 Okemesi Crescent, Garki 2, Federal Capital Territory, Abuja, Nigeria
| | - Samuel Omoi
- CBM Christoffel-Blindenmission Christian Blind Mission e.V Nigeria Country Office, 13 Okemesi Crescent, Garki 2, Federal Capital Territory, Abuja, Nigeria
| | - Rinpan Ishaya
- HANDS, 5A Naomi Jugu Drive, Rayfield, Jos, Plateau State, Nigeria
| | | | | | - Girija Sankar
- Inclusive Eye Health and Neglected Tropical Diseases Initiative, CBM Christoffel-Blindenmission Christian Blind Mission e.V., Wellington House, East Road CB1 1BH, Cambridge, UK
| | - Babar Qureshi
- Inclusive Eye Health and Neglected Tropical Diseases Initiative, CBM Christoffel-Blindenmission Christian Blind Mission e.V., Wellington House, East Road CB1 1BH, Cambridge, UK
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Brown DMY, Lerner I, Cairney J, Kwan MY. Independent and Joint Associations of Physical Activity and Sleep on Mental Health Among a Global Sample of 200,743 Adults. Int J Behav Med 2024:10.1007/s12529-024-10280-8. [PMID: 38532194 DOI: 10.1007/s12529-024-10280-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Previous research has demonstrated that both sleep and physical activity (PA) are independently associated with various indicators of mental health among adults. However, their joint contribution to mental health has received limited attention. The present study used cross-sectional data from the Mental Health Million Project to examine the independent and joint effects of sleep and PA on mental health among a global sample of adults, and whether these effects differ among individuals receiving mental health treatment. METHOD The sample included 200,743 participants (33.1% young adults, 45.6% middle-aged adults, 21.3% older adults; 57.6% females, 0.9% other) from 213 countries, territories, and archipelagos worldwide that completed a comprehensive 47-item assessment of mental health including both problems (i.e., ill-being) and assets (i.e., well-being): the Mental Health Quotient. Participants also reported their weekly frequency of PA and adequate sleep, and mental health treatment status. A series of generalized linear mixed models were computed. RESULTS Independent dose-response associations were observed, whereby greater amounts of PA and adequate sleep were each associated with better mental health. In addition, a synergistic interaction was observed in which the positive correlation of PA with mental health was strengthened with greater frequency of adequate sleep. These benefits were less pronounced among adults receiving mental health treatment. CONCLUSION While findings suggest sleep can help to offset the negative influence of a physically inactive lifestyle (and vice versa), our results point to a "more is better" approach for both behaviors when it comes to promoting mental health.
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Affiliation(s)
- Denver M Y Brown
- Department of Psychology, The University of Texas at San Antonio, 1 UTSA Circle, San Antonio, TX, USA.
| | - Itamar Lerner
- Department of Psychology, The University of Texas at San Antonio, 1 UTSA Circle, San Antonio, TX, USA
| | - John Cairney
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Matthew Y Kwan
- Department of Child and Youth Studies, Brock University, St. Catherines, Canada
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Dülsen P, Baumeister H. Internet- and mobile-based anxiety and depression interventions for children and adolescents: efficacy and negative effects - a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02404-y. [PMID: 38430237 DOI: 10.1007/s00787-024-02404-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 02/19/2024] [Indexed: 03/03/2024]
Abstract
Mental disorders, most commonly anxiety disorders and fourth most common depression, are prevalent in children and adolescents. Internet- and mobile-based interventions might represent a scalable approach to improve mental health care, however, evidence so far is inconclusive and systematic reports on negative effects are missing. Four data-bases were searched for randomized controlled trials evaluating internet- and mobile-based interventions (IMIs) targeting anxiety disorders or depression in children and adolescents up to 18 years exhibiting clinically relevant symptoms. Meta-analytic evaluations were conducted in comparison to active and passive control groups, furthermore, pre-defined sub-groups were explored and reported negative effects examined. Pooled estimates showed a moderate positive effect for IMIs targeting anxiety disorders compared to passive control groups (g = -0.69; CI -0.94 to -0.45; k = 8; n = 559; p ≤ 0,001), but not for depression. Pooled estimates compared to active control groups remained non-significant. Subgroup analyses were largely omitted due to an insufficient number of trials or were non-significant. Negative effects were mainly reported as drop-out rates and (non)-response rates, while additional negative effects, such as deterioration rates or the development of additional symptoms, were reported by only one third of included studies. The focus on children and adolescents with clinically relevant symptoms allowed the present findings to complement previous work, however, the limited amount of trials hindered many planned comparisons. The overview of reported negative effects highlighted that negative effects are being neglected in the majority of RCTs. Hence, in the future RCTs should include more information about potential negative effects, at best a combination of quantitative and qualitative information. Open Science Framework (osf.io/ch5nj).
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Affiliation(s)
- Patrick Dülsen
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Lise-Meitner-Straße 16, 89081, Ulm, Germany.
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Lise-Meitner-Straße 16, 89081, Ulm, Germany
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Giusto A, Jack HE, Magidson JF, Ayuku D, Johnson S, Lovero K, Hankerson SH, Sweetland AC, Myers B, Fortunato Dos Santos P, Puffer ES, Wainberg ML. Global Is Local: Leveraging Global Mental-Health Methods to Promote Equity and Address Disparities in the United States. Clin Psychol Sci 2024; 12:270-289. [PMID: 38529071 PMCID: PMC10962902 DOI: 10.1177/21677026221125715] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Structural barriers perpetuate mental health disparities for minoritized US populations; global mental health (GMH) takes an interdisciplinary approach to increasing mental health care access and relevance. Mutual capacity building partnerships between low and middle-income countries and high-income countries are beginning to use GMH strategies to address disparities across contexts. We highlight these partnerships and shared GMH strategies through a case series of said partnerships between Kenya-North Carolina, South Africa-Maryland, and Mozambique-New York. We analyzed case materials and narrative descriptions using document review. Shared strategies across cases included: qualitative formative work and partnership-building; selecting and adapting evidence-based interventions; prioritizing accessible, feasible delivery; task-sharing; tailoring training and supervision; and mixed-method, hybrid designs. Bidirectional learning between partners improved the use of strategies in both settings. Integrating GMH strategies into clinical science-and facilitating learning across settings-can improve efforts to expand care in ways that consider culture, context, and systems in low-resource settings.
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Affiliation(s)
- Ali Giusto
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY 10032, USA
| | - Helen E Jack
- Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, WA
| | - Jessica F Magidson
- Department of Psychology, University of Maryland, College Park, 1147B Biology-Psychology Building College Park, MD 20742
| | - David Ayuku
- Department of Mental Health and Behavioural Sciences, College of Health Sciences Moi University, P. O. Box 4606-30100, Eldoret, Kenya
| | - Savannah Johnson
- Department of Neuroscience and Psychology, Duke University. Duke Global Health Institute, Durham, NC, USA
| | - Kathryn Lovero
- Department of Clinical Sociomedical Sciences in Psychiatry, Columbia Mailman School of Public Health, New York, NY, USA
| | - Sidney H Hankerson
- Department of Population Health Sciences & Policy, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029
| | - Annika C Sweetland
- Department of Psychiatry, Columbia Vagelos College of Physicians & Surgeons/New York State Psychiatric Institute, New York, NY 10032
| | - Bronwyn Myers
- Curtin enAble Institute, Faculty of Health Science, Curtin University, Perth, Australia; Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, South Africa
| | - Palmira Fortunato Dos Santos
- Department of Mental Health, Ministry of Health, Av. Eduardo Mondlane/Av. Salvador Allende P.O. Box 1613, Maputo, Mozambique
| | - Eve S Puffer
- Department of Neuroscience and Psychology, Duke University. Duke Global Health Institute, Durham, NC, USA
| | - Milton L Wainberg
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY 10032, USA
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Pereira-Payo D, Mendoza-Muñoz M, Denche-Zamorano A, Rubio-de la Osa A, Moreno-Quintanilla M, Pastor-Cisneros R. Physical Activity Is Associated with the Incidence of Depression in United States Adults from the NHANES 2013-18: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:552. [PMID: 38470663 PMCID: PMC10931288 DOI: 10.3390/healthcare12050552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/05/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
The number of depression sufferers is rising globally. In the United States, 8% of adults over 20 years of age suffer from it, making it the most prevalent mental disorder in the country. Some lifestyle habits have been shown to favor or prevent the onset of depression; for instance, physical inactivity is associated with an increased likelihood of suffering depression, whilst multiple benefits have been attributed to performing physical activity (PA). This study aims to test whether there is a dependence between the prevalence of depression and PA, age, gender and educational level. The secondary objective was to identify the differentiating variables for depression and non-depression. This cross-sectional study is based on data from the NHANES 2013-2014, 2015-2016 and 2017-2018 editions. Some of the items in this survey were taken from preexisting questionnaires: the Patient Health Questionnaire-9 for depression screening and the Global Physical Activity Questionnaire (GPAQ) for the PA groups. The final sample was formed of 15,574 United States residents over 18 years old. After testing the data normality (p < 0.001), a descriptive analysis and the non-parametric chi-square test was conducted, as well as discriminant analysis. The results showed that there was an association between depression prevalence and PA (p < 0.001) in the general population and for both genders. Inactive participants had the highest prevalence of major depression and other depressive disorders. The discriminant analysis identified PA group (0.527), education level (0.761) and gender (-0.505) as significant variables that differentiate between participants with and without depression. The results of this research confirmed that a dependency relationship between PA group according to the GPAQ and depression prevalence according to the PHQ-9 existed in the United States adult population, and that PA group is a relevant variable to differentiate between depression sufferers and non-sufferers.
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Affiliation(s)
- Damián Pereira-Payo
- Health, Economy, Motricity and Education (HEME) Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (D.P.-P.); (M.M.-Q.)
| | - María Mendoza-Muñoz
- Physical and Health Literacy and Health-Related Quality of Life (PHYQoL), Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, 7000-645 Évora, Portugal
| | - Angel Denche-Zamorano
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (A.D.-Z.); (R.P.-C.)
| | | | - Miranda Moreno-Quintanilla
- Health, Economy, Motricity and Education (HEME) Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (D.P.-P.); (M.M.-Q.)
| | - Raquel Pastor-Cisneros
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (A.D.-Z.); (R.P.-C.)
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Karadzhov D, Lee J, Hatton G, White RG, Sharp L, Jalloh A, Langan Martin J. Identifying core global mental health professional competencies: A multi-sectoral perspective. Glob Ment Health (Camb) 2024; 11:e24. [PMID: 38572254 PMCID: PMC10988164 DOI: 10.1017/gmh.2024.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/21/2024] [Accepted: 02/11/2024] [Indexed: 04/05/2024] Open
Abstract
Concerned with sustainably alleviating mental distress and promoting the right to health worldwide, global mental health (GMH) is practised across various contexts spanning the humanitarian-development-peace nexus. The inherently intersectoral and multidisciplinary nature of GMH calls for competency frameworks and training programmes that embody diversity, decolonisation and multiprofessionalism. Existing competency frameworks have failed to capture the multi-sectoral, inter-professional nature of contemporary GMH practice. In response to these needs, a qualitative content analysis of relevant job advertisements was conducted to distil a comprehensive set of professional competencies in contemporary GMH practice. Approximately 200 distinct skills and competencies were extracted from 70 job advertisements and organised into four meta-dimensions: 'skills', 'sector', 'self' and 'subject'. The first known systematic attempt at a multi-sectoral GMH competency framework, it offers a springboard for exploring vital yet overlooked professional competencies such as resilience, self-reflection, political skills and entrepreneurialism. On this basis, recommendations for building a competent, agile and effective GMH workforce with diversified and future-proof skillsets are proposed. The framework can also inform inter-professional training and curriculum design, and capacity-building initiatives aimed at early-career professional development, particularly in low- and middle-income settings.
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Affiliation(s)
- Dimitar Karadzhov
- School of Health & Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Joanne Lee
- UNICEF, Eastern and Southern Africa Regional Office, Nairobi, Kenya
| | - George Hatton
- School of Health & Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Ross G. White
- School of Psychology, Queen’s University Belfast, Belfast, UK
| | - Laura Sharp
- School of Health & Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Abdul Jalloh
- School of Health & Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Julie Langan Martin
- School of Health & Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Santre S. Mental Disorders and Mental Health Promotion in Police Officers. Health Psychol Res 2024; 12:93904. [PMID: 38375073 PMCID: PMC10875161 DOI: 10.52965/001c.93904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/05/2023] [Indexed: 02/21/2024] Open
Abstract
The number of police officers suffering from mental illnesses is becoming a significant public health concern. Police officers are more likely to experience mental health problems than the general population. The use of effective mental health promotion programs can assist in reducing police officers' psychological problems. In this paper author reviews existing literature on mental disorders and mental health promotion among police officers. This review emphasizes the importance of mental health promotion and programs in improving police officers' well-being and decreasing mental disorders. The prevalence of mental disorders, risk factors, and negative consequences are explained. Furthermore, examples of programs or interventions to promote mental health, and recommendations for further study are presented. Therefore, this review could be useful in developing intervention program to support police officers' health.
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Affiliation(s)
- Siriporn Santre
- Faculty of Public Health, Department of Health Education and Behavioral Sciences Mahidol University
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Barr HK, Guggenbickler AM, Hoch JS, Dewa CS. Examining evidence for a relationship between human-animal interactions and common mental disorders during the COVID-19 pandemic: a systematic literature review. FRONTIERS IN HEALTH SERVICES 2024; 4:1321293. [PMID: 38385049 PMCID: PMC10879592 DOI: 10.3389/frhs.2024.1321293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/24/2024] [Indexed: 02/23/2024]
Abstract
Introduction COVID-19 lockdowns, shelter in place, closures of transportation and mental health services, and dearth of mental health providers created new barriers to obtaining support for mental health needs at a time of increased rates of anxiety and depression. During the pandemic, a record number of households owned and adopted pets, opening a potential avenue to investigate the relationship between pets and mental health. This systematic literature review examined the question: What is the evidence for a relationship between human-animal interaction and/or animal ownership and common mental disorders among adults who interacted with pets compared to adults who did not during the COVID-19 pandemic? Methods To address this question, four databases were searched: Medline, PsycINFO, Web of Science, and SCOPUS for peer-reviewed literature published between 2020 and July 2023. Of the 1,746 articles identified by the searches, 21 studies were included in this review. Results Results suggest that there exists a relationship between animal ownership and strong pet attachment and pet interaction, though the directionality of the relationship was not investigated by the included studies. There was an association between having a stronger relationship with a pet and lower feelings of depression and other mental health symptoms. There was also evidence of an association between anxiety and higher levels of animal attachment. Conclusion Understanding the association between human-animal interaction and common mental disorders may be helpful to clinicians assessing the mental health of clients. Clinicians may glean additional insight about stressors, risk factors, social supports, and lifestyle of clients based on the client's status as a pet owner. Future research could further explore the direction of the causal relationship of human-animal interaction and/or animal ownership on common mental disorders; this could further inform how the HAI relationship can be used to support clients with mental health struggles.
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Affiliation(s)
- H. K. Barr
- Graduate Group in Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, United States
| | - A. M. Guggenbickler
- Graduate Group in Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, United States
| | - J. S. Hoch
- Division of Health Policy and Management, Department of Public Health Sciences, University of California, Davis, Davis, CA, United States
- Center for Healthcare Policy and Research, University of California, Davis, Davis, CA, United States
| | - C. S. Dewa
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis, CA, United States
- Department of Public Health Sciences, University of California, Davis, Davis, CA, United States
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Mee N, Abera M, Kerac M. Acceptability and Feasibility of Maternal Mental Health Assessment When Managing Small, Nutritionally At-Risk Infants Aged < 6 Months: A Key Informant Interview Study. CHILDREN (BASEL, SWITZERLAND) 2024; 11:209. [PMID: 38397321 PMCID: PMC10887604 DOI: 10.3390/children11020209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/25/2024]
Abstract
Maternal mental health (MMH) conditions and infant malnutrition are both major global public health concerns. Despite a well-established link between the two, many nutrition programmes do not routinely consider MMH. New World Health Organization (WHO) malnutrition guidelines do, however, emphasise MMH. To inform guideline rollout, we aimed to assess the feasibility and acceptability of MMH assessments in nutrition programmes in low-resource settings. Ten semi-structured interviews were conducted with international key informants who work on nutrition programmes or MMH research. Interview transcripts were coded using subthemes derived from the key points discussed. The benefits and risks were highlighted. These included ethical dilemmas of asking about MMH if local treatment services are suboptimal. Commonly reported challenges included governance, staff training and finance. Community and programme staff perceptions of MMH were primarily negative across the different settings. Many points were raised for improvements and innovations in practice, but fundamental developments were related to governance, care pathways, advocacy, training, funding and using existing community networks. Future implementation research is needed to understand whether assessment is safe/beneficial (as it is in other settings) to promote MMH screening. Current service providers in low-resource settings can undertake several steps, as recommended in this paper, to improve the care offered to mothers and infants.
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Affiliation(s)
- Natalie Mee
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK;
| | - Mubarek Abera
- Department of Psychiatry, Faculty of Medical Sciences, Institute of Health, Jimma University, Jimma P.O. Box 378, Ethiopia;
| | - Marko Kerac
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK;
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Freeman JA, Desrosiers A, Schafer C, Kamara P, Farrar J, Akinsulure-Smith AM, Betancourt TS. The adaptation of a youth mental health intervention to a peer-delivery model utilizing CBPR methods and the ADAPT-ITT framework in Sierra Leone. Transcult Psychiatry 2024; 61:3-14. [PMID: 37822245 DOI: 10.1177/13634615231202091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Low- and middle-income countries (LMICs) carry a significant proportion of the global burden of untreated mental health disorders. Peer-delivered programs offer LMICs with limited mental health professionals an opportunity to increase mental health service access. This study describes the process of adapting a lay-worker-delivered evidence-based youth mental health intervention to a peer-delivery model in Sierra Leone using participatory methods. We convened Youth Community Advisory Boards (YCABs) as partners to develop a peer-delivery model for an evidence-based intervention. In collaboration with YCABs, the Assessment, Decision, Administration, Production, Topical experts, Integration, Training, Testing (ADAPT-ITT) framework was applied to guide the adaptation. The ADAPT-ITT framework is an eight-step process to adapt evidence-based interventions. The ADAPT-ITT framework facilitated the adaptation of the Youth Readiness Intervention (YRI), an evidence-based mental health program intervention that has been delivered by adult lay-workers to the youth peer-delivery platform in Sierra Leone. The YCABs identified program modifications, including the incorporation of storytelling, refinement of metaphors, and alterations to make delivery more accessible to low-literacy youth with particular attention to gender. YCABs also provided recommendations on how to support youth facilitators in providing psychosocial support, emphasizing self-care and boundary setting to ensure high-quality intervention delivery and do-no-harm principles. Study findings suggest that the ADAPT-ITT framework can be feasibly applied to guide the intervention adaptation process in LMICs. The use of participatory methods generated modifications that reflected youth experiences, needs, and concerns as facilitators and participants. Next steps include refinement and pilot testing of the adapted intervention.
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Affiliation(s)
- Jordan A Freeman
- School of Social Work Research Program on Children and Adversity, Boston College, USA
| | | | - Carolyn Schafer
- School of Social Work Research Program on Children and Adversity, Boston College, USA
| | | | - Jordan Farrar
- School of Social Work Research Program on Children and Adversity, Boston College, USA
| | | | - Theresa S Betancourt
- School of Social Work Research Program on Children and Adversity, Boston College, USA
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Ali AA, Aqeel AA, Shami MO, Khodari BH, Alqassim AY, Alessa AM, Alhazm FI, Alhazmi YA, Sumayli AY, Arishi FH, Muaddi MA, Alharbi AA, Almaghrabi HA, Alhazmi AH. Relationship Between Depression, Anxiety, Stress, and Weight Self-Stigma Among Youths in Saudi Arabia: A Nationwide Study. Cureus 2024; 16:e54125. [PMID: 38487156 PMCID: PMC10939164 DOI: 10.7759/cureus.54125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2024] [Indexed: 03/17/2024] Open
Abstract
Background and objectives Many research studies show that self-stigma related to weight can exacerbate mental health issues. There is also evidence suggesting that depression, anxiety, and stress could be predictors of weight stigma. However, these connections have not been thoroughly investigated among young people in Saudi Arabia, where there is a high prevalence of obesity. This study aimed to explore the relationships between depression, anxiety, stress, and weight self-stigma in Saudi Arabian adolescents and young adults. Materials and methods This cross-sectional study was conducted between January and March 2022 and utilized online surveys, including the Weight Self-Stigma Questionnaire (WSSQ) and Depression, Anxiety, and Stress Scale 21 (DASS-21). We conducted descriptive analysis, independent samples t-tests, analysis of variance (ANOVA), and linear regression for the statistical analysis using SPSS version 25 (IBM Corp., Armonk, NY). Results A total of 1624 participants were enrolled in this survey. Most participants (889, 54.7%) were females. The mean age was 20.73 years (SD: 2.63). Males were more likely to report self-stigma compared to females (p = 0.018). Weight self-stigma demonstrated significant positive associations with body mass index (BMI) (p = 0.0001) and depression, anxiety, and stress (p = 0.0001) scores. Further analysis revealed weight self-stigma was positively correlated with psychological distress levels in the study population (p = 0.0001). The results demonstrated a statistically significant difference between different regions of Saudi Arabia with weight self-stigma being more prevalent in the Al-Baha region and least prevalent in the Al-Madinah region. Conclusions The results of this study indicate robust positive correlations between weight self-stigma scores and depression, anxiety, and stress scale scores among adolescents and young adults in Saudi Arabia. Further epidemiological and clinical studies on the national level are warranted.
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Affiliation(s)
- Abdullah A Ali
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Abdulrahman A Aqeel
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Mohammed O Shami
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan, SAU
| | | | - Ahmad Y Alqassim
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Abdulrahman M Alessa
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Feras I Alhazm
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Yahya Alhasan Alhazmi
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Abdulrrahman Y Sumayli
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Fatimah H Arishi
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Mohammed A Muaddi
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Abdullah A Alharbi
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Hatim A Almaghrabi
- Department of Medicine and Surgery, College of Medicine, Umm Al-Qura University, Makkah, SAU
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Saha A, Mandal B, Muhammad T, Ali W. Decomposing the rural-urban differences in depression among multimorbid older patients in India: evidence from a cross-sectional study. BMC Psychiatry 2024; 24:60. [PMID: 38254089 PMCID: PMC10804604 DOI: 10.1186/s12888-023-05480-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 12/25/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND In India, the prevalence of depression among older adults dealing with multiple health conditions varies between rural and urban areas due to disparities in healthcare access and cultural factors. The distinct patterns observed underscore the necessity for tailored research and interventions to address mental health inequalities among multimorbid older patients in diverse geographic contexts. METHODS This study used data from the Longitudinal Ageing Study in India (LASI) wave 1 (2017-18). A total of 7,608 adults aged ≥ 60 years who were diagnosed with two or more chronic conditions (such as hypertension, diabetes, cancer, chronic lung disease, chronic heart diseases, stroke, bone/joint disease, any neurological or psychiatric diseases, and high cholesterol) were included in this study. Descriptive statistics, bivariate analysis, logistic regression estimates, and Fairlie decomposition method were used to accomplish the study's objectives. RESULTS The prevalence of depression among older adults with multimorbidity was 9.48% higher in rural areas (38.33%) than in urban areas (28.85%).. Older adults with multimorbidity belonging to the scheduled caste group were 40% more likely to experience depression. Moreover, those with multimorbidity and any form of disability in activities of daily living (ADL) were 93% more likely to experience depression than those without disability, whereas those with multimorbidity and perceived good general health were 65% less likely to suffer from depression than those with poor self-perceived health. Additionally, decomposition analysis revealed that education (35.99%), caste status (10.30%), IADL disability (19.30%), and perceived discrimination (24.25%) were the primary factors contributing to the differences in depression prevalence among older adults with multimorbidity between rural and urban areas. CONCLUSIONS We found significant rural-urban differences in depression among older Indians with multimorbidity. The findings underscore the need for targeted interventions that address the unique challenges faced by older patients in rural areas, including lack of social capital, discrimination, and limited resources that enable access to healthcare services. Policymakers and healthcare professionals must collaboratively design and implement effective strategies to improve the mental health and overall well-being of rural older adults, particularly those with multiple comorbidities.
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Affiliation(s)
- Amiya Saha
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, 400088, India.
| | - Bittu Mandal
- School of Humanities and Social Sciences, Indian Institute of Technology, Indore, 453552, India
| | - T Muhammad
- Center for Healthy Aging, The Pennsylvania State University, University park, 16802, USA
| | - Waad Ali
- Department of Geography, Sultan Qaboos University, Muscat, 123, Oman
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45
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Golden TL, Ordway RW, Magsamen S, Mohanty A, Chen Y, Ng TWC. Supporting youth mental health with arts-based strategies: a global perspective. BMC Med 2024; 22:7. [PMID: 38166923 PMCID: PMC10763059 DOI: 10.1186/s12916-023-03226-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024] Open
Abstract
The devastating impact of youth mental health concerns is increasingly evident on a global scale. This crisis calls for innovative solutions that are sufficiently accessible, scalable, and cost-effective to support diverse communities around the world. One such solution involves engagement in the arts: incorporating and building upon existing local resources and cultural practices to bolster youth mental health. In this article, we describe the global youth mental health crisis and note major gaps in the knowledge and resources needed to address it. We then discuss the potential for arts- and culture-based strategies to help meet this challenge, review the mounting evidence regarding art's ability to support mental health, and call for action to undertake critical research and its translation into accessible community practices. Four steps are suggested: (1) elevate and prioritize youth voice, (2) develop core outcome measures, (3) identify and analyze successful models around the globe, and (4) generate clear funding pathways for research and translational efforts. Worldwide implementation of arts- and culture-based strategies to address youth mental health will provide critical resources to support the health, wellbeing and flourishing of countless youth across the globe.
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Affiliation(s)
- Tasha L Golden
- International Arts + Mind Lab, Johns Hopkins University School of Medicine, 5801 Smith Ave, Ste #110, Baltimore, MD, 21209, USA.
| | - Richard W Ordway
- Department of Biology and Doctors, Kienle Center for Humanistic Medicine, Penn State University, University Park, PA, 16802, USA
| | - Susan Magsamen
- International Arts + Mind Lab, Johns Hopkins University School of Medicine, 5801 Smith Ave, Ste #110, Baltimore, MD, 21209, USA
| | - Aanchal Mohanty
- International Arts + Mind Lab, Johns Hopkins University School of Medicine, 5801 Smith Ave, Ste #110, Baltimore, MD, 21209, USA
| | - Yifan Chen
- International Arts + Mind Lab, Johns Hopkins University School of Medicine, 5801 Smith Ave, Ste #110, Baltimore, MD, 21209, USA
| | - T W Cherry Ng
- International Arts + Mind Lab, Johns Hopkins University School of Medicine, 5801 Smith Ave, Ste #110, Baltimore, MD, 21209, USA
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Madden E, Prior K, Guckel T, Garlick Bock S, Bryant Z, O'Dean S, Nepal S, Ward C, Thornton L. "What Do I Say? How Do I Say it?" Twitter as a Knowledge Dissemination Tool for Mental Health Research. JOURNAL OF HEALTH COMMUNICATION 2024; 29:20-33. [PMID: 37955053 DOI: 10.1080/10810730.2023.2278617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
This study aims to generate evidence-based guidelines for researchers regarding how to effectively disseminate mental health research via Twitter. Three hundred mental health research Tweets posted from September 2018 to September 2019 were sampled from two large Australian organizations. Twenty-seven predictor variables were coded for each Tweet across five thematic categories: messaging; research area; mental health area; external networks; and media features. Regression analyses were conducted to determine associations with engagement outcomes of Favourites, Retweets, and Comments. Less than half (n = 10) of predictor variables passed validity tests. Notably, conclusions could not reliably be drawn on whether a Tweet featured evidence-based information. Tweets were significantly more likely to be Retweeted if they contained a hyperlink or multimedia. Tweets were significantly more likely to receive comments if they focused on a specific population group. These associations remain significant when controlling for organization. These findings indicate that researchers may be able to maximize engagement on Twitter by highlighting the population groups that the research applies to and enriching Tweets with multimedia content. In addition, care should be taken to ensure users can infer which messages are evidence-based. Guidelines and an accompanying resource are proposed.
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Affiliation(s)
- Erin Madden
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Katrina Prior
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Tara Guckel
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Sophia Garlick Bock
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- ReachOut Australia, Pyrmont, NSW, Australia
| | - Zachary Bryant
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Siobhan O'Dean
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Smriti Nepal
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Sax Institute, Haymarket, NSW, Australia
| | - Caitlin Ward
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Louise Thornton
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- School of Public Health and Community Medicine, The University of New South Wales, Sydney, NSW, Australia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
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Mundt AP, Delhey S, Martínez P, Irarrázaval M, Grasso L, Rivera-Arroyo G, Capistrano A, Trujillo N, Golcher F, Benavides Salcedo A, Dedik C, Cordero M, Torales J, Malpartida C, Almánzar Á. Types of Psychiatric Beds and Mental Health Services in 16 Latin American Countries, 1990-2020. Psychiatr Serv 2024; 75:48-54. [PMID: 37644830 DOI: 10.1176/appi.ps.20220590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
OBJECTIVE Latin America has undergone major changes in psychiatric services over the past three decades. The authors aimed to assess the availability of service data and changes in psychiatric services in this region during the 1990-2020 period. METHODS The authors formed a research network to collect data on psychiatric service indicators gathered between 1990 and 2020 from national registries in Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Dominican Republic, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Panama, Paraguay, Peru, and Uruguay. Indicators included psychiatric beds in psychiatric and general hospitals overall, for children and adolescents, and for forensic populations; residential beds for substance use treatment; treatment slots in residential facilities and day hospitals; and outpatient facilities. RESULTS Data availability varied among countries, service indicators, and time points. The median prevalence of psychiatric beds decreased in psychiatric hospitals from 5.1 to 3.0 per 100,000 people (-42%) and in general hospitals from 1.0 to 0.8 (-24%). The median prevalence estimates of specialized psychiatric beds for children and adolescents (0.18) and for forensic populations (0.04) remained unchanged. Increases in prevalence were observed for residential beds for substance use treatment (from 0.40 to 0.57, 43% increase), available treatment slots in residential facilities (0.67 to 0.79, 17%), treatment slots in day hospitals (0.41 to 0.54, 32%), and outpatient facilities (0.39 to 0.93, 138%). CONCLUSIONS The findings indicate that treatment capacity shifted from inpatient to outpatient and community care. Most countries had a bed shortage for acute psychiatric care, especially for children and adolescents and forensic patients. More comprehensive and standardized mental health service registries are needed.
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Affiliation(s)
- Adrian P Mundt
- School of Medicine, Universidad Diego Portales, Santiago, Chile (Mundt, Delhey); Clínica Alemana, Universidad del Desarrollo School of Medicine, Santiago, Chile (Mundt); School of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada (Martínez); Charles-Le Moyne Research Center on Health Innovations, Longueuil, Québec, Canada (Martínez); Pan American Health Organization, Washington, D.C. (Irarrázaval); Department of Mental Health and Addiction, Ministry of Public Health, Buenos Aires (Grasso); Department of Psychology, Universidad Privada de Santa Cruz de la Sierra, Santa Cruz de la Sierra, Bolivia (Rivera-Arroyo); General Coordination of Mental Health, Alcohol, and Other Drugs, Ministry of Health, São Paulo, Brazil (Capistrano); Mental Health Group, National Faculty of Public Health, Universidad de Antioquia, Medellín, Colombia (Trujillo); Department of Psychiatry and Mental Health, Ministry of Public Health, San José, Costa Rica (Golcher); Ministry of Public Health, Quito, Ecuador (Benavides Salcedo); National Economic Research Center, Guatemala City (Dedik); Center for Global Mental Health Research, Ramón de la Fuente Muńiz National Institute of Psychiatry, Mexico City (Cordero); Department of Psychiatry, Universidad Nacional de Asunción, San Lorenzo, Paraguay (Torales); Regional Institute for Health Research, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay (Torales); Ministry of Health, Lima, Peru (Malpartida); Department of Psychiatry and Mental Health, Ministry of Public Health, Santo Domingo, Dominican Republic (Almánzar)
| | - Sabine Delhey
- School of Medicine, Universidad Diego Portales, Santiago, Chile (Mundt, Delhey); Clínica Alemana, Universidad del Desarrollo School of Medicine, Santiago, Chile (Mundt); School of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada (Martínez); Charles-Le Moyne Research Center on Health Innovations, Longueuil, Québec, Canada (Martínez); Pan American Health Organization, Washington, D.C. (Irarrázaval); Department of Mental Health and Addiction, Ministry of Public Health, Buenos Aires (Grasso); Department of Psychology, Universidad Privada de Santa Cruz de la Sierra, Santa Cruz de la Sierra, Bolivia (Rivera-Arroyo); General Coordination of Mental Health, Alcohol, and Other Drugs, Ministry of Health, São Paulo, Brazil (Capistrano); Mental Health Group, National Faculty of Public Health, Universidad de Antioquia, Medellín, Colombia (Trujillo); Department of Psychiatry and Mental Health, Ministry of Public Health, San José, Costa Rica (Golcher); Ministry of Public Health, Quito, Ecuador (Benavides Salcedo); National Economic Research Center, Guatemala City (Dedik); Center for Global Mental Health Research, Ramón de la Fuente Muńiz National Institute of Psychiatry, Mexico City (Cordero); Department of Psychiatry, Universidad Nacional de Asunción, San Lorenzo, Paraguay (Torales); Regional Institute for Health Research, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay (Torales); Ministry of Health, Lima, Peru (Malpartida); Department of Psychiatry and Mental Health, Ministry of Public Health, Santo Domingo, Dominican Republic (Almánzar)
| | - Pablo Martínez
- School of Medicine, Universidad Diego Portales, Santiago, Chile (Mundt, Delhey); Clínica Alemana, Universidad del Desarrollo School of Medicine, Santiago, Chile (Mundt); School of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada (Martínez); Charles-Le Moyne Research Center on Health Innovations, Longueuil, Québec, Canada (Martínez); Pan American Health Organization, Washington, D.C. (Irarrázaval); Department of Mental Health and Addiction, Ministry of Public Health, Buenos Aires (Grasso); Department of Psychology, Universidad Privada de Santa Cruz de la Sierra, Santa Cruz de la Sierra, Bolivia (Rivera-Arroyo); General Coordination of Mental Health, Alcohol, and Other Drugs, Ministry of Health, São Paulo, Brazil (Capistrano); Mental Health Group, National Faculty of Public Health, Universidad de Antioquia, Medellín, Colombia (Trujillo); Department of Psychiatry and Mental Health, Ministry of Public Health, San José, Costa Rica (Golcher); Ministry of Public Health, Quito, Ecuador (Benavides Salcedo); National Economic Research Center, Guatemala City (Dedik); Center for Global Mental Health Research, Ramón de la Fuente Muńiz National Institute of Psychiatry, Mexico City (Cordero); Department of Psychiatry, Universidad Nacional de Asunción, San Lorenzo, Paraguay (Torales); Regional Institute for Health Research, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay (Torales); Ministry of Health, Lima, Peru (Malpartida); Department of Psychiatry and Mental Health, Ministry of Public Health, Santo Domingo, Dominican Republic (Almánzar)
| | - Matías Irarrázaval
- School of Medicine, Universidad Diego Portales, Santiago, Chile (Mundt, Delhey); Clínica Alemana, Universidad del Desarrollo School of Medicine, Santiago, Chile (Mundt); School of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada (Martínez); Charles-Le Moyne Research Center on Health Innovations, Longueuil, Québec, Canada (Martínez); Pan American Health Organization, Washington, D.C. (Irarrázaval); Department of Mental Health and Addiction, Ministry of Public Health, Buenos Aires (Grasso); Department of Psychology, Universidad Privada de Santa Cruz de la Sierra, Santa Cruz de la Sierra, Bolivia (Rivera-Arroyo); General Coordination of Mental Health, Alcohol, and Other Drugs, Ministry of Health, São Paulo, Brazil (Capistrano); Mental Health Group, National Faculty of Public Health, Universidad de Antioquia, Medellín, Colombia (Trujillo); Department of Psychiatry and Mental Health, Ministry of Public Health, San José, Costa Rica (Golcher); Ministry of Public Health, Quito, Ecuador (Benavides Salcedo); National Economic Research Center, Guatemala City (Dedik); Center for Global Mental Health Research, Ramón de la Fuente Muńiz National Institute of Psychiatry, Mexico City (Cordero); Department of Psychiatry, Universidad Nacional de Asunción, San Lorenzo, Paraguay (Torales); Regional Institute for Health Research, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay (Torales); Ministry of Health, Lima, Peru (Malpartida); Department of Psychiatry and Mental Health, Ministry of Public Health, Santo Domingo, Dominican Republic (Almánzar)
| | - Luciano Grasso
- School of Medicine, Universidad Diego Portales, Santiago, Chile (Mundt, Delhey); Clínica Alemana, Universidad del Desarrollo School of Medicine, Santiago, Chile (Mundt); School of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada (Martínez); Charles-Le Moyne Research Center on Health Innovations, Longueuil, Québec, Canada (Martínez); Pan American Health Organization, Washington, D.C. (Irarrázaval); Department of Mental Health and Addiction, Ministry of Public Health, Buenos Aires (Grasso); Department of Psychology, Universidad Privada de Santa Cruz de la Sierra, Santa Cruz de la Sierra, Bolivia (Rivera-Arroyo); General Coordination of Mental Health, Alcohol, and Other Drugs, Ministry of Health, São Paulo, Brazil (Capistrano); Mental Health Group, National Faculty of Public Health, Universidad de Antioquia, Medellín, Colombia (Trujillo); Department of Psychiatry and Mental Health, Ministry of Public Health, San José, Costa Rica (Golcher); Ministry of Public Health, Quito, Ecuador (Benavides Salcedo); National Economic Research Center, Guatemala City (Dedik); Center for Global Mental Health Research, Ramón de la Fuente Muńiz National Institute of Psychiatry, Mexico City (Cordero); Department of Psychiatry, Universidad Nacional de Asunción, San Lorenzo, Paraguay (Torales); Regional Institute for Health Research, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay (Torales); Ministry of Health, Lima, Peru (Malpartida); Department of Psychiatry and Mental Health, Ministry of Public Health, Santo Domingo, Dominican Republic (Almánzar)
| | - Guillermo Rivera-Arroyo
- School of Medicine, Universidad Diego Portales, Santiago, Chile (Mundt, Delhey); Clínica Alemana, Universidad del Desarrollo School of Medicine, Santiago, Chile (Mundt); School of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada (Martínez); Charles-Le Moyne Research Center on Health Innovations, Longueuil, Québec, Canada (Martínez); Pan American Health Organization, Washington, D.C. (Irarrázaval); Department of Mental Health and Addiction, Ministry of Public Health, Buenos Aires (Grasso); Department of Psychology, Universidad Privada de Santa Cruz de la Sierra, Santa Cruz de la Sierra, Bolivia (Rivera-Arroyo); General Coordination of Mental Health, Alcohol, and Other Drugs, Ministry of Health, São Paulo, Brazil (Capistrano); Mental Health Group, National Faculty of Public Health, Universidad de Antioquia, Medellín, Colombia (Trujillo); Department of Psychiatry and Mental Health, Ministry of Public Health, San José, Costa Rica (Golcher); Ministry of Public Health, Quito, Ecuador (Benavides Salcedo); National Economic Research Center, Guatemala City (Dedik); Center for Global Mental Health Research, Ramón de la Fuente Muńiz National Institute of Psychiatry, Mexico City (Cordero); Department of Psychiatry, Universidad Nacional de Asunción, San Lorenzo, Paraguay (Torales); Regional Institute for Health Research, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay (Torales); Ministry of Health, Lima, Peru (Malpartida); Department of Psychiatry and Mental Health, Ministry of Public Health, Santo Domingo, Dominican Republic (Almánzar)
| | - Adelia Capistrano
- School of Medicine, Universidad Diego Portales, Santiago, Chile (Mundt, Delhey); Clínica Alemana, Universidad del Desarrollo School of Medicine, Santiago, Chile (Mundt); School of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada (Martínez); Charles-Le Moyne Research Center on Health Innovations, Longueuil, Québec, Canada (Martínez); Pan American Health Organization, Washington, D.C. (Irarrázaval); Department of Mental Health and Addiction, Ministry of Public Health, Buenos Aires (Grasso); Department of Psychology, Universidad Privada de Santa Cruz de la Sierra, Santa Cruz de la Sierra, Bolivia (Rivera-Arroyo); General Coordination of Mental Health, Alcohol, and Other Drugs, Ministry of Health, São Paulo, Brazil (Capistrano); Mental Health Group, National Faculty of Public Health, Universidad de Antioquia, Medellín, Colombia (Trujillo); Department of Psychiatry and Mental Health, Ministry of Public Health, San José, Costa Rica (Golcher); Ministry of Public Health, Quito, Ecuador (Benavides Salcedo); National Economic Research Center, Guatemala City (Dedik); Center for Global Mental Health Research, Ramón de la Fuente Muńiz National Institute of Psychiatry, Mexico City (Cordero); Department of Psychiatry, Universidad Nacional de Asunción, San Lorenzo, Paraguay (Torales); Regional Institute for Health Research, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay (Torales); Ministry of Health, Lima, Peru (Malpartida); Department of Psychiatry and Mental Health, Ministry of Public Health, Santo Domingo, Dominican Republic (Almánzar)
| | - Natalia Trujillo
- School of Medicine, Universidad Diego Portales, Santiago, Chile (Mundt, Delhey); Clínica Alemana, Universidad del Desarrollo School of Medicine, Santiago, Chile (Mundt); School of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada (Martínez); Charles-Le Moyne Research Center on Health Innovations, Longueuil, Québec, Canada (Martínez); Pan American Health Organization, Washington, D.C. (Irarrázaval); Department of Mental Health and Addiction, Ministry of Public Health, Buenos Aires (Grasso); Department of Psychology, Universidad Privada de Santa Cruz de la Sierra, Santa Cruz de la Sierra, Bolivia (Rivera-Arroyo); General Coordination of Mental Health, Alcohol, and Other Drugs, Ministry of Health, São Paulo, Brazil (Capistrano); Mental Health Group, National Faculty of Public Health, Universidad de Antioquia, Medellín, Colombia (Trujillo); Department of Psychiatry and Mental Health, Ministry of Public Health, San José, Costa Rica (Golcher); Ministry of Public Health, Quito, Ecuador (Benavides Salcedo); National Economic Research Center, Guatemala City (Dedik); Center for Global Mental Health Research, Ramón de la Fuente Muńiz National Institute of Psychiatry, Mexico City (Cordero); Department of Psychiatry, Universidad Nacional de Asunción, San Lorenzo, Paraguay (Torales); Regional Institute for Health Research, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay (Torales); Ministry of Health, Lima, Peru (Malpartida); Department of Psychiatry and Mental Health, Ministry of Public Health, Santo Domingo, Dominican Republic (Almánzar)
| | - Francisco Golcher
- School of Medicine, Universidad Diego Portales, Santiago, Chile (Mundt, Delhey); Clínica Alemana, Universidad del Desarrollo School of Medicine, Santiago, Chile (Mundt); School of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada (Martínez); Charles-Le Moyne Research Center on Health Innovations, Longueuil, Québec, Canada (Martínez); Pan American Health Organization, Washington, D.C. (Irarrázaval); Department of Mental Health and Addiction, Ministry of Public Health, Buenos Aires (Grasso); Department of Psychology, Universidad Privada de Santa Cruz de la Sierra, Santa Cruz de la Sierra, Bolivia (Rivera-Arroyo); General Coordination of Mental Health, Alcohol, and Other Drugs, Ministry of Health, São Paulo, Brazil (Capistrano); Mental Health Group, National Faculty of Public Health, Universidad de Antioquia, Medellín, Colombia (Trujillo); Department of Psychiatry and Mental Health, Ministry of Public Health, San José, Costa Rica (Golcher); Ministry of Public Health, Quito, Ecuador (Benavides Salcedo); National Economic Research Center, Guatemala City (Dedik); Center for Global Mental Health Research, Ramón de la Fuente Muńiz National Institute of Psychiatry, Mexico City (Cordero); Department of Psychiatry, Universidad Nacional de Asunción, San Lorenzo, Paraguay (Torales); Regional Institute for Health Research, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay (Torales); Ministry of Health, Lima, Peru (Malpartida); Department of Psychiatry and Mental Health, Ministry of Public Health, Santo Domingo, Dominican Republic (Almánzar)
| | - Andrés Benavides Salcedo
- School of Medicine, Universidad Diego Portales, Santiago, Chile (Mundt, Delhey); Clínica Alemana, Universidad del Desarrollo School of Medicine, Santiago, Chile (Mundt); School of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada (Martínez); Charles-Le Moyne Research Center on Health Innovations, Longueuil, Québec, Canada (Martínez); Pan American Health Organization, Washington, D.C. (Irarrázaval); Department of Mental Health and Addiction, Ministry of Public Health, Buenos Aires (Grasso); Department of Psychology, Universidad Privada de Santa Cruz de la Sierra, Santa Cruz de la Sierra, Bolivia (Rivera-Arroyo); General Coordination of Mental Health, Alcohol, and Other Drugs, Ministry of Health, São Paulo, Brazil (Capistrano); Mental Health Group, National Faculty of Public Health, Universidad de Antioquia, Medellín, Colombia (Trujillo); Department of Psychiatry and Mental Health, Ministry of Public Health, San José, Costa Rica (Golcher); Ministry of Public Health, Quito, Ecuador (Benavides Salcedo); National Economic Research Center, Guatemala City (Dedik); Center for Global Mental Health Research, Ramón de la Fuente Muńiz National Institute of Psychiatry, Mexico City (Cordero); Department of Psychiatry, Universidad Nacional de Asunción, San Lorenzo, Paraguay (Torales); Regional Institute for Health Research, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay (Torales); Ministry of Health, Lima, Peru (Malpartida); Department of Psychiatry and Mental Health, Ministry of Public Health, Santo Domingo, Dominican Republic (Almánzar)
| | - Corinne Dedik
- School of Medicine, Universidad Diego Portales, Santiago, Chile (Mundt, Delhey); Clínica Alemana, Universidad del Desarrollo School of Medicine, Santiago, Chile (Mundt); School of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada (Martínez); Charles-Le Moyne Research Center on Health Innovations, Longueuil, Québec, Canada (Martínez); Pan American Health Organization, Washington, D.C. (Irarrázaval); Department of Mental Health and Addiction, Ministry of Public Health, Buenos Aires (Grasso); Department of Psychology, Universidad Privada de Santa Cruz de la Sierra, Santa Cruz de la Sierra, Bolivia (Rivera-Arroyo); General Coordination of Mental Health, Alcohol, and Other Drugs, Ministry of Health, São Paulo, Brazil (Capistrano); Mental Health Group, National Faculty of Public Health, Universidad de Antioquia, Medellín, Colombia (Trujillo); Department of Psychiatry and Mental Health, Ministry of Public Health, San José, Costa Rica (Golcher); Ministry of Public Health, Quito, Ecuador (Benavides Salcedo); National Economic Research Center, Guatemala City (Dedik); Center for Global Mental Health Research, Ramón de la Fuente Muńiz National Institute of Psychiatry, Mexico City (Cordero); Department of Psychiatry, Universidad Nacional de Asunción, San Lorenzo, Paraguay (Torales); Regional Institute for Health Research, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay (Torales); Ministry of Health, Lima, Peru (Malpartida); Department of Psychiatry and Mental Health, Ministry of Public Health, Santo Domingo, Dominican Republic (Almánzar)
| | - Martha Cordero
- School of Medicine, Universidad Diego Portales, Santiago, Chile (Mundt, Delhey); Clínica Alemana, Universidad del Desarrollo School of Medicine, Santiago, Chile (Mundt); School of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada (Martínez); Charles-Le Moyne Research Center on Health Innovations, Longueuil, Québec, Canada (Martínez); Pan American Health Organization, Washington, D.C. (Irarrázaval); Department of Mental Health and Addiction, Ministry of Public Health, Buenos Aires (Grasso); Department of Psychology, Universidad Privada de Santa Cruz de la Sierra, Santa Cruz de la Sierra, Bolivia (Rivera-Arroyo); General Coordination of Mental Health, Alcohol, and Other Drugs, Ministry of Health, São Paulo, Brazil (Capistrano); Mental Health Group, National Faculty of Public Health, Universidad de Antioquia, Medellín, Colombia (Trujillo); Department of Psychiatry and Mental Health, Ministry of Public Health, San José, Costa Rica (Golcher); Ministry of Public Health, Quito, Ecuador (Benavides Salcedo); National Economic Research Center, Guatemala City (Dedik); Center for Global Mental Health Research, Ramón de la Fuente Muńiz National Institute of Psychiatry, Mexico City (Cordero); Department of Psychiatry, Universidad Nacional de Asunción, San Lorenzo, Paraguay (Torales); Regional Institute for Health Research, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay (Torales); Ministry of Health, Lima, Peru (Malpartida); Department of Psychiatry and Mental Health, Ministry of Public Health, Santo Domingo, Dominican Republic (Almánzar)
| | - Julio Torales
- School of Medicine, Universidad Diego Portales, Santiago, Chile (Mundt, Delhey); Clínica Alemana, Universidad del Desarrollo School of Medicine, Santiago, Chile (Mundt); School of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada (Martínez); Charles-Le Moyne Research Center on Health Innovations, Longueuil, Québec, Canada (Martínez); Pan American Health Organization, Washington, D.C. (Irarrázaval); Department of Mental Health and Addiction, Ministry of Public Health, Buenos Aires (Grasso); Department of Psychology, Universidad Privada de Santa Cruz de la Sierra, Santa Cruz de la Sierra, Bolivia (Rivera-Arroyo); General Coordination of Mental Health, Alcohol, and Other Drugs, Ministry of Health, São Paulo, Brazil (Capistrano); Mental Health Group, National Faculty of Public Health, Universidad de Antioquia, Medellín, Colombia (Trujillo); Department of Psychiatry and Mental Health, Ministry of Public Health, San José, Costa Rica (Golcher); Ministry of Public Health, Quito, Ecuador (Benavides Salcedo); National Economic Research Center, Guatemala City (Dedik); Center for Global Mental Health Research, Ramón de la Fuente Muńiz National Institute of Psychiatry, Mexico City (Cordero); Department of Psychiatry, Universidad Nacional de Asunción, San Lorenzo, Paraguay (Torales); Regional Institute for Health Research, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay (Torales); Ministry of Health, Lima, Peru (Malpartida); Department of Psychiatry and Mental Health, Ministry of Public Health, Santo Domingo, Dominican Republic (Almánzar)
| | - César Malpartida
- School of Medicine, Universidad Diego Portales, Santiago, Chile (Mundt, Delhey); Clínica Alemana, Universidad del Desarrollo School of Medicine, Santiago, Chile (Mundt); School of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada (Martínez); Charles-Le Moyne Research Center on Health Innovations, Longueuil, Québec, Canada (Martínez); Pan American Health Organization, Washington, D.C. (Irarrázaval); Department of Mental Health and Addiction, Ministry of Public Health, Buenos Aires (Grasso); Department of Psychology, Universidad Privada de Santa Cruz de la Sierra, Santa Cruz de la Sierra, Bolivia (Rivera-Arroyo); General Coordination of Mental Health, Alcohol, and Other Drugs, Ministry of Health, São Paulo, Brazil (Capistrano); Mental Health Group, National Faculty of Public Health, Universidad de Antioquia, Medellín, Colombia (Trujillo); Department of Psychiatry and Mental Health, Ministry of Public Health, San José, Costa Rica (Golcher); Ministry of Public Health, Quito, Ecuador (Benavides Salcedo); National Economic Research Center, Guatemala City (Dedik); Center for Global Mental Health Research, Ramón de la Fuente Muńiz National Institute of Psychiatry, Mexico City (Cordero); Department of Psychiatry, Universidad Nacional de Asunción, San Lorenzo, Paraguay (Torales); Regional Institute for Health Research, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay (Torales); Ministry of Health, Lima, Peru (Malpartida); Department of Psychiatry and Mental Health, Ministry of Public Health, Santo Domingo, Dominican Republic (Almánzar)
| | - Ángel Almánzar
- School of Medicine, Universidad Diego Portales, Santiago, Chile (Mundt, Delhey); Clínica Alemana, Universidad del Desarrollo School of Medicine, Santiago, Chile (Mundt); School of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada (Martínez); Charles-Le Moyne Research Center on Health Innovations, Longueuil, Québec, Canada (Martínez); Pan American Health Organization, Washington, D.C. (Irarrázaval); Department of Mental Health and Addiction, Ministry of Public Health, Buenos Aires (Grasso); Department of Psychology, Universidad Privada de Santa Cruz de la Sierra, Santa Cruz de la Sierra, Bolivia (Rivera-Arroyo); General Coordination of Mental Health, Alcohol, and Other Drugs, Ministry of Health, São Paulo, Brazil (Capistrano); Mental Health Group, National Faculty of Public Health, Universidad de Antioquia, Medellín, Colombia (Trujillo); Department of Psychiatry and Mental Health, Ministry of Public Health, San José, Costa Rica (Golcher); Ministry of Public Health, Quito, Ecuador (Benavides Salcedo); National Economic Research Center, Guatemala City (Dedik); Center for Global Mental Health Research, Ramón de la Fuente Muńiz National Institute of Psychiatry, Mexico City (Cordero); Department of Psychiatry, Universidad Nacional de Asunción, San Lorenzo, Paraguay (Torales); Regional Institute for Health Research, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay (Torales); Ministry of Health, Lima, Peru (Malpartida); Department of Psychiatry and Mental Health, Ministry of Public Health, Santo Domingo, Dominican Republic (Almánzar)
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48
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Kruk ME, Kapoor NR, Lewis TP, Arsenault C, Boutsikari EC, Breda J, Carai S, Croke K, Dayalu R, Fink G, Garcia PJ, Kassa M, Mohan S, Moshabela M, Nzinga J, Oh J, Okiro EA, Prabhakaran D, SteelFisher GK, Tarricone R, Garcia-Elorrio E. Population confidence in the health system in 15 countries: results from the first round of the People's Voice Survey. Lancet Glob Health 2024; 12:e100-e111. [PMID: 38096882 PMCID: PMC10716625 DOI: 10.1016/s2214-109x(23)00499-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/11/2023] [Accepted: 10/18/2023] [Indexed: 12/17/2023]
Abstract
Population confidence is essential to a well functioning health system. Using data from the People's Voice Survey-a novel population survey conducted in 15 low-income, middle-income, and high-income countries-we report health system confidence among the general population and analyse its associated factors. Across the 15 countries, fewer than half of respondents were health secure and reported being somewhat or very confident that they could get and afford good-quality care if very sick. Only a quarter of respondents endorsed their current health system, deeming it to work well with no need for major reform. The lowest support was in Peru, the UK, and Greece-countries experiencing substantial health system challenges. Wealthy, more educated, young, and female respondents were less likely to endorse the health system in many countries, portending future challenges for maintaining social solidarity for publicly financed health systems. In pooled analyses, the perceived quality of the public health system and government responsiveness to public input were strongly associated with all confidence measures. These results provide a post-COVID-19 pandemic baseline of public confidence in the health system. The survey should be repeated regularly to inform policy and improve health system accountability.
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Affiliation(s)
- Margaret E Kruk
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA.
| | - Neena R Kapoor
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Todd P Lewis
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Catherine Arsenault
- Department of Global Health, George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Eleni C Boutsikari
- Division of Country Health Policies and Systems, WHO Athens Quality of Care Office, WHO Regional Office for Europe, Athens, Greece
| | - João Breda
- Division of Country Health Policies and Systems, WHO Athens Quality of Care Office, WHO Regional Office for Europe, Athens, Greece
| | - Susanne Carai
- Division of Country Health Policies and Systems, WHO Athens Quality of Care Office, WHO Regional Office for Europe, Athens, Greece
| | - Kevin Croke
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Rashmi Dayalu
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Günther Fink
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute and University of Basel, Basel, Switzerland
| | - Patricia J Garcia
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Munir Kassa
- Minister's Office, Ministry of Health, Addis Ababa, Ethiopia
| | | | - Mosa Moshabela
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Jacinta Nzinga
- Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Juhwan Oh
- Seoul National University College of Medicine, Seoul, South Korea
| | - Emelda A Okiro
- Population and Health Impact Surveillance Group, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Gillian K SteelFisher
- Department of Health Policy and Management, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Rosanna Tarricone
- Department of Social and Political Science, Bocconi University, Milan, Italy
| | - Ezequiel Garcia-Elorrio
- School of Public Health, Universidad Peruana Cayetano Heredia, Lima, Peru; Health Care Quality and Patient Safety, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
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49
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Aryal R, Rajbanshi M, Pokhrel S, Regmi S, Mali P, Baskota S. Help-seeking behaviour towards anxiety among undergraduate students of Nepal: a web-based cross-sectional study. Ann Med Surg (Lond) 2024; 86:146-152. [PMID: 38222717 PMCID: PMC10783325 DOI: 10.1097/ms9.0000000000001568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 11/21/2023] [Indexed: 01/16/2024] Open
Abstract
Background Stigma among mental disorders like anxiety has been identified as an important barrier in help-seeking by national policymakers. Anxiety disorders are quite common among college students, and their severity and prevalence are growing. This study aimed to assess help-seeking behavior (HSB) towards anxiety among undergraduate students of Kathmandu University (KU). Methodology A web-based cross-sectional study was conducted among 422 undergraduate students. General Help-Seeking Questionnaire (GHSQ) tool was used to assess HSB. Frequencies, percentages, mean, and Standard Deviation were calculated to assess the characteristics of the participants. Factors associated with HSB were examined using Chi-Square test. Pearson correlation was determined to find out the association between professional and informal sources for seeking help. All the tests were carried out at the statistically significant level at a P-value of 0.05. Results The mean (±SD) age was 20.3±1.1 years in this study. This study demonstrated that 36.5 and 17.5% of the participants were extremely likely to seek help from parents and psychiatrists towards anxiety, respectively. Sex (OR=1.5, 95% CI: 1.0-1.3) was significantly associated with parents, education was significantly associated with parents (OR=0.4, 95% CI: 0.2-0.6), and friends (OR=0.5, 95% CI: 0.3-0.9), meanwhile, ethnicity (OR=0.6, 95% CI: 0.4-0.9), and residence (OR=0.5, 95% CI: 0.3-0.8) were significantly associated with psychiatrists and psychologists for help-seeking behavior, respectively. Fear of criticism (34.1%) and stigma (20.3%) were the main reasons for not seeking help among the participants. The maximum number of participants (41.5%) preferred to seek help immediately if they ever experienced anxiety. This study showed professional and informal sources were positively correlated with anxiety (rpi=0.3) at a P-value <0.05. Conclusion This study showed that students preferred to seek help from informal sources rather than professional sources. In addition, there is still stigma and fear among students regarding mental health. This study suggests that there is a need to have psychosocial intervention at colleges and educational institutions in order to promote professional help-seeking for any mental disorders including anxiety.
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Affiliation(s)
- Richa Aryal
- Department of Public Health, Om Health Campus, Purbanchal University, Nepal
| | - Manish Rajbanshi
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Nepal
| | - Sushma Pokhrel
- Department of Public Health, Om Health Campus, Purbanchal University, Nepal
| | - Sushama Regmi
- Central Department of Psychology, Tribhuvan University, Nepal
| | - Prajita Mali
- Kathmandu University- School of Medical Sciences, Nepal
| | - Swechhya Baskota
- Department of Public Health, Om Health Campus, Purbanchal University, Nepal
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50
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Bassi E, Bright K, Norman L, Pintson K, Daniel S, Sidhu S, Gondziola J, Bradley J, Fersovitch M, Stamp L, Moskovic K, LaMonica H, Iorfino F, Gaskell T, Tomlinson S, Johnson D, Dimitropoulos G. Perceptions of mental health providers of the barriers and facilitators of using and engaging youth in digital mental-health-enabled measurement based care. Digit Health 2024; 10:20552076241253093. [PMID: 38726214 PMCID: PMC11080807 DOI: 10.1177/20552076241253093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2024] [Indexed: 05/12/2024] Open
Abstract
Objectives Increased rates of mental health disorders and substance use among youth and young adults have increased globally, furthering the strain on an already burdened mental health system. Digital solutions have been proposed as a potential option for the provision of timely mental health services for youth, with little research exploring mental health professional views about using such innovative tools. In Alberta, Canada, we are evaluating the implementation and integration of a digital mental health (dMH) platform into existing service pathways. Within this paper we seek to explore mental health professionals' perceptions of the barriers and facilitators that may influence their utilization of digital MH-enabled measurement-based care (MBC) with the youth who access their services. Methods A qualitative, descriptive methodology was used to inductively generate themes from focus groups conducted with mental health professionals from specialized mental health services and primary care networks in Alberta. Results As mental health professionals considered the barriers and facilitators of using dMH with youth, they referenced individual and family barriers and facilitators to consider. Providers highlighted perceived barriers, including: first, cultural stigma, family apprehension about mental health care, and parental access to dMH and MBC as deterrents to providers adopting digital platforms in routine care; second, perceptions of increased responsibility and liability for youth in crisis; third, perception that some psychiatric and neurodevelopmental disorders in youth are not amenable to dMH; fourth, professionals contemplated youth readiness to engage with dMH-enabled MBC. Participants also highlighted pertinent facilitators to dMH use, noting: first, the suitability of dMH for youth with mild mental health concerns; second, youth motivated to report their changes in mental health symptoms; and lastly, youth proficiency and preference for dMH options. Conclusions By identifying professionals' perceptions of barriers and facilitators for youth users, we may better understand how to address misconceptions about who is eligible and appropriate for dMH through training and education.
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Affiliation(s)
- E.M. Bassi
- Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
| | - K.S. Bright
- School of Nursing and Midwifery, Faculty of Health, Community, and Education, Mount Royal University, Calgary, Alberta, Canada
- Heroes in Mind, Advocacy, and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, College of Health Science, University of Alberta, Edmonton, Alberta, Canada
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
- Provincial Addiction and Mental Health, Alberta Health Services, Calgary, Alberta, Canada
| | - L.G. Norman
- Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
| | - K. Pintson
- Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
| | - S. Daniel
- Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
| | - S. Sidhu
- Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
| | - J. Gondziola
- Provincial Addiction and Mental Health, Alberta Health Services, Calgary, Alberta, Canada
| | - J. Bradley
- Provincial Addiction and Mental Health, Alberta Health Services, Calgary, Alberta, Canada
| | - M. Fersovitch
- Provincial Addiction and Mental Health, Alberta Health Services, Calgary, Alberta, Canada
| | - L. Stamp
- Provincial Addiction and Mental Health, Alberta Health Services, Calgary, Alberta, Canada
| | - K. Moskovic
- Provincial Addiction and Mental Health, Alberta Health Services, Calgary, Alberta, Canada
| | - H.M. LaMonica
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - F. Iorfino
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - T. Gaskell
- Provincial Addiction and Mental Health, Alberta Health Services, Calgary, Alberta, Canada
| | - S. Tomlinson
- Provincial Addiction and Mental Health, Alberta Health Services, Calgary, Alberta, Canada
| | - D.W. Johnson
- Departments of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Maternal Newborn Child and Youth Strategic Clinical Network, Alberta Health Services, Calgary, Alberta, Canada
| | - G. Dimitropoulos
- Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
- Calgary Eating Disorders Program, Alberta Health Services, Calgary, Alberta, Canada
- Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
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