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Walker SC, Wissow L, Gubner NR, Ngo S, Szatmari P, Servili C. Scale-up of Global Child and Youth Mental Health Services: A Scoping Review. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024:10.1007/s10488-024-01400-3. [PMID: 39105972 DOI: 10.1007/s10488-024-01400-3] [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: 07/14/2024] [Indexed: 08/07/2024]
Abstract
Numerous influential policy and scientific bodies are calling for more rapid advances in the scale-up of child and youth mental health services (CYMHS). A number of CYMHS innovations hold promise for advancing scale-up but little is known about how real-world efforts are progressing. We conducted a scoping review to identify promising approaches to CYMHS scale-up across the globe. Searches were completed in six databases (Academic Search Complete, CINAHL, MEDLINE, PsychInfo, PubMed, and Web of Science). Article selection and synthesis were conducted in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) checklist. A second search focused on low-and-middle-income countries (LMIC) was conducted based on the Cochrane Library recommended search filters of the World Bank listed LMIC countries. Authors used a double coding strategy during the title/abstract and full-text review. Twenty-eight articles meeting the eligibility criteria were identified that described 22 initiatives (in 11 different countries). Our review found the majority of published scale-up studies in CYMHS were not informed by scale-up frameworks in design or reporting. The methods and outcomes used in the identified articles were highly variable and limited our ability to draw conclusions about comparative effectiveness although promising approaches emerged. Successes and failures identified in our review largely reflect consensus in the broader literature regarding the need for strategies to better navigate the complexities of system and policy implementation while ensuring CYMHS interventions fit local contexts.
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Affiliation(s)
- Sarah Cusworth Walker
- University of Washington, 4333 Brooklyn Ave NE, Box 359457, Seattle, WA, 98195-9457, USA.
| | - Lawrence Wissow
- University of Washington, 4800 Sand Point Way NE, MS OA.5.154, Seattle, WA, 98105, USA
| | - Noah R Gubner
- University of Washington, 4333 Brooklyn Ave NE, Box 359457, Seattle, WA, 98195-9457, USA
| | - Sally Ngo
- University of Washington, 4333 Brooklyn Ave NE, Box 359457, Seattle, WA, 98195-9457, USA
| | - Peter Szatmari
- University of Toronto, 80 Workman Way, Toronto, ON, M6J 1H4, Canada
| | - Chiara Servili
- World Health Organization, Avenue Appia 20, 1201, Geneva, Switzerland
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Joshi PT, Cullins LM, Cookson C. Global Mental Health and Immigrant Families. Child Adolesc Psychiatr Clin N Am 2024; 33:499-509. [PMID: 38823820 PMCID: PMC11149908 DOI: 10.1016/j.chc.2024.03.011] [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: 06/03/2024]
Abstract
There are few human tragedies that stir sympathy and concern more deeply than seeing children suffer secondary to war, displacement, and increasingly frequent epidemics of violence around the world. Falling witness or victim to acts of war and terrorism and subsequent fleeing of millions of children across the world stirs an array of powerful human emotions. Such circumstances by definition involve destruction, pain, and death. It is, paramount that we all work collaboratively, to provide psychological assistance, training, and education and work with various stakeholders to decrease the psychological impact of displacement secondary to war, terrorism, and other social factors.
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Affiliation(s)
- Paramjit T Joshi
- Department of Psychiatry & Human Behavior, University of California - Irvine, 3800 West Chapman Avenue Suite 500, Orange CA 92868, USA.
| | - Lisa M Cullins
- PGY4 Psychiatry Residency & Clinical Fellowship Program, Intramural Research Program, Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Building 10 6-5342, Bethesda, MD 20892, USA
| | - Carolyn Cookson
- Department of Psychiatry & Human Behavior, University of California - Irvine, 3800 West Chapman Avenue Suite 500, Orange CA 92868, USA
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Jansen E, Frantz I, Hutchings J, Lachman J, Williams M, Taut D, Baban A, Raleva M, Lesco G, Ward C, Gardner F, Fang X, Heinrichs N, Foran HM. Preventing child mental health problems in southeastern Europe: Feasibility study (phase 1 of MOST framework). FAMILY PROCESS 2022; 61:1162-1179. [PMID: 34494263 DOI: 10.1111/famp.12720] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 07/14/2021] [Accepted: 07/27/2021] [Indexed: 06/13/2023]
Abstract
The prevalence of child emotional and behavioral problems is an international problem but is higher in low- and middle-income countries (LMIC) where there are often less mental health supports for families. Parenting programs can be an effective means of prevention, but must be low-cost, scalable, and suitable for the local context. The RISE project aims to systematically adapt, implement, and evaluate a low-cost parenting program for preventing/reducing child mental health problems in three middle-income countries in Southeastern Europe. This small pre-post pilot study is informed by the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework and tested the feasibility of the intervention, the implementation, and evaluation procedures: Phase 1 of the three-phase Multiphase Optimization Strategy (MOST) for program adaptation. Local facilitators delivered the Parenting for Lifelong Health (PLH) for Young Children program to parents of children aged 2-9 in North Macedonia, the Republic of Moldova and Romania in 2018. Parents completed assessments pre- and post-program. Results demonstrated positive pre-post change for participating families (N = 140) on various outcomes including child externalizing and internalizing symptoms and parenting behavior, in all three countries, all in the expected direction. Program participation was associated with positive outcomes in participating families. Based on the experiences of this pilot study, we outline the practical implications for the successful implementation of parenting programs in the three countries that will inform our next study phases, factorial experiment, and RCT.
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Affiliation(s)
- Elena Jansen
- Institute of Psychology, University of Klagenfurt, Klagenfurt, Austria
| | - Inga Frantz
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Bremen, Bremen, Germany
| | - Judy Hutchings
- Centre for Evidence Based Early Intervention, School of Psychology, Bangor University, Bangor, UK
| | - Jamie Lachman
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Margiad Williams
- Centre for Evidence Based Early Intervention, School of Psychology, Bangor University, Bangor, UK
| | - Diana Taut
- Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Adriana Baban
- Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Marija Raleva
- Institute for Marriage, Family and Systemic Practice-ALTERNATIVA, Skopje, Macedonia
| | - Galina Lesco
- Health for Youth Association, Chișinău, Republic of Moldova
| | - Cathy Ward
- Department of Psychology, University of Cape Town, Rondebosch, South Africa
| | - Frances Gardner
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Xiangming Fang
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Nina Heinrichs
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Bremen, Bremen, Germany
| | - Heather M Foran
- Institute of Psychology, University of Klagenfurt, Klagenfurt, Austria
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Kretchy IA, Blewuada EK, Debrah AB. A qualitative study exploring community pharmacists’ perspectives of child and adolescent mental healthcare. SCIENTIFIC AFRICAN 2021. [DOI: 10.1016/j.sciaf.2021.e00969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Raballo A, Schultze-Lutter F, Armando M. Editorial: Children, Adolescents and Families With Severe Mental Illness: Toward a Comprehensive Early Identification of Risk. Front Psychiatry 2021; 12:812229. [PMID: 34992558 PMCID: PMC8724427 DOI: 10.3389/fpsyt.2021.812229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/03/2021] [Indexed: 12/20/2022] Open
Affiliation(s)
- Andrea Raballo
- Section of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Perugia, Italy.,Center for Translational, Phenomenological and Developmental Psychopathology (CTPDP), Perugia University Hospital, Perugia, Italy
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.,Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia.,University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Marco Armando
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
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Weiss B, Dang HM, Lam TT, Nguyen MC. Urbanization, and child mental health and life functioning in Vietnam: implications for global health disparities. Soc Psychiatry Psychiatr Epidemiol 2020; 55:673-683. [PMID: 32055892 PMCID: PMC7276283 DOI: 10.1007/s00127-020-01838-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 02/03/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Urbanization is linked to increased health risks, including mental health. However, the large majority of this research has been conducted in high-income countries, and little is known about effects in low-and-middle-income countries (LMIC) where urbanization is occurring most frequently and most rapidly. Within global mental health, children and adolescents are a critical but understudied population. The present study assessed relations between urbanization factors, and child mental health in Vietnam, a Southeast Asian LMIC. METHODS Most studies investigating urbanization and mental health have used geographically based dichotomous urban vs. rural variables. Because of significant limitations with this approach, the present study assessed parent-reported urbanization factors (e.g., pollution, crime). In Sub-study #1 (cross-sectional), 1314 parents from 10 Vietnam provinces completed the Urbanization Factors Questionnaire, Child Behavior Checklist (mental health), and Brief Impairment Scale (life functioning). In Sub-study #2 (longitudinal), 256 parents from one highly urban and one highly rural province completed the same measures, at three timepoints across 12 months. RESULTS Cross-sectional canonical correlations identified relatively small (e.g., R2 = 0.08) but significant relations between urbanization factors, and child functioning. Parallel analyses using a geographically defined urban vs. rural variable did not produce significant results. The large majority of longitudinal relations between the different urbanization factors and child functioning were non-significant. CONCLUSIONS This study, among the first to assess urbanization as a multi-dimensional continuous construct in relation to child psychopathology, highlights the value of the use of an urbanization factors approach. A new "urbanization factors differentials" theory is proposed to suggest how effects of urbanization factors might result in global health disparities.
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Affiliation(s)
- Bahr Weiss
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA.
| | - Hoang-Minh Dang
- University of Education, Vietnam National University, Hanoi, Vietnam
| | | | - Minh C. Nguyen
- University of Education, Vietnam National University, Hanoi, Vietnam
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Ortega F, Müller MR. Global Mental Health and Pharmacology: The Case of Attention Deficit and Hyperactivity Disorders in Brazil. FRONTIERS IN SOCIOLOGY 2020; 5:535125. [PMID: 33869481 PMCID: PMC8022440 DOI: 10.3389/fsoc.2020.535125] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 08/20/2020] [Indexed: 05/08/2023]
Abstract
Global Mental Health (GMH) is the field of study, research, and intervention, which aims at improving access to mental health worldwide. It is based on the global burden of disease research program and on the existence of a large "treatment gap" between the need and availability of mental health services, displaying individual and social costs of undiagnosed and untreated mental disorders, especially in low- and middle-income countries (LMIC). Few academic publications in Brazil dialogue directly with the field of GMH, although several issues drawn from its agenda have been the subject of mental health policies in the country. Brazil can be classified as a middle-income country with a well-structured national health system. This system is oriented toward primary health care, which integrates both community mental health services and the broader health care network. The debate between GMH advocates and critics has unearthed old controversies in psychiatry such as universality or cultural specificity of mental disorders, their expressions, and their relationship with social and economic factors. We intend to examine how these controversies reverberate in the Brazilian mental health scenario, taking as an illustration the debates around Attention Deficit Hyperactivity Disorder (ADHD) in the country. ADHD discussions oppose those who argue that the condition is underdiagnosed and undertreated, and those who claim that there is overdiagnosis and overtreatment and thus, medicalization of childhood. This article presents the current status of the Brazilian mental health literature on ADHD, with emphasis on tensions around diagnosis, prevalence and interventions. Our aim is to highlight how the differential in discourse shapes the debate on ADHD in Brazil and how this may contribute to the GMH agenda. This goal will be undertaken in three steps. First, we will briefly examine studies around GMH and ADHD. Secondly, we address Brazilian studies on this theme, considering the specificities regarding the constitution of the mental health field. Finally, we will examine the debate of treatment gap vs. medicalization in the country in order to underscore the potentials and limitations of each perspective.
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Hazo JB, Brunn M, Wykes T, McDaid D, Dorsey M, Demotes-Mainard J, van der Feltz-Cornelis CM, Wahlbeck K, Knappe S, Meyer-Lindenberg A, Obradors-Tarragó C, Haro JM, Leboyer M, Chevreul K. European mental health research resources: Picture and recommendations of the ROAMER project. Eur Neuropsychopharmacol 2019; 29:179-194. [PMID: 30579654 DOI: 10.1016/j.euroneuro.2018.11.1111] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 11/13/2018] [Accepted: 11/15/2018] [Indexed: 11/29/2022]
Abstract
As part of the Roamer project, we sought to have a picture of the available mental health research (MHR) funding, capacity-building and infrastructures resources and to establish consensus-based recommendations that would allow an increase of European MHR resources and enable better use and accessibility to them. The methods fell into three sections (i) a review of the literature, (ii) a mental health-related keywords search within the Cordis®, On-Course® and Meril® databases which contain information on European research funding, training and infrastructures. These reviews provided an overview that was presented to (iii) two experts workshops with 28 participants drawn from academic which identified gaps and produced recommendations. The literature review illustrates the debates in the scientific community on funding, training and infrastructures. The database searches estimated the fraction of health research resources available for mental health. Eight overarching goals for MHR resources were identified by the workshops; each of them was carried out with several practical recommendations. Resources for MHR are scarce considering the burden of mental disorders, the high rate of return of MHR and the under-investment of the field. The recommendations are urgently warranted to increase resources and their optimal access and use.
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Affiliation(s)
- Jean-Baptiste Hazo
- ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France; AP-HP, URC-Eco, DHU PePSY, F-75 004 Paris, France; Fondation FondaMental, French Scientific Foundation, Créteil, France; World Health Organization Collaborating Centre for Research and Training in Mental Health, CCOMS, Lille 59260, Hellemmes, France.
| | - Matthias Brunn
- ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France; AP-HP, URC-Eco, DHU PePSY, F-75 004 Paris, France; Fondation FondaMental, French Scientific Foundation, Créteil, France
| | - Til Wykes
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, South London and Maudsley NHS Foundation Trust, UK
| | - David McDaid
- PSSRU, London School of Economics and Political Science, London, UK
| | - Maya Dorsey
- ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France; AP-HP, URC-Eco, DHU PePSY, F-75 004 Paris, France; Fondation FondaMental, French Scientific Foundation, Créteil, France
| | | | - Christina M van der Feltz-Cornelis
- Department of Health Sciences, MHARG, University of York, York, United Kingdom; Tranzo Department, Tilburg University, Tilburg, The Netherlands
| | | | - Susanne Knappe
- Institut für Klinische Psychologie und Psychotherapie, Behaviorale Epidemiologie & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
| | - Andreas Meyer-Lindenberg
- Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, 68159 Mannheim, Germany
| | | | - Josep Maria Haro
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Institut de Recerca Sant Joan de Déu, Sant Boi de llobregat, Universitat de Barcelona, Barcelona, Spain
| | - Marion Leboyer
- Fondation FondaMental, French Scientific Foundation, Créteil, France; AP-HP, Department of Psychiatry of Mondor Hospital, DHU PePSY, Paris-Est-Créteil University (UPEC), Créteil, France; INSERM, U955, Translational Psychiatry, Créteil, France
| | - Karine Chevreul
- ECEVE, UMRS 1123, Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France; AP-HP, URC-Eco, DHU PePSY, F-75 004 Paris, France
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Palinkas LA. Commentary: Equity and Exchange in Global Research-Practice Partnerships. GLOBAL SOCIAL WELFARE : RESEARCH, POLICY & PRACTICE 2019; 6:209-213. [PMID: 31828003 PMCID: PMC6905463 DOI: 10.1007/s40609-018-0118-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Lawrence A Palinkas
- Suzanne Dworak-Peck School of Social Work, University of Southern California
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Berry C, Othman E, Tan JC, Gee B, Byrne RE, Hodgekins J, Michelson D, Ng ALO, Marsh NV, Coker S, Fowler D. Assessing social recovery of vulnerable youth in global mental health settings: a pilot study of clinical research tools in Malaysia. BMC Psychiatry 2019; 19:188. [PMID: 31221136 PMCID: PMC6585120 DOI: 10.1186/s12888-019-2164-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 05/28/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A social recovery approach to youth mental health focuses on increasing the time spent in valuable and meaningful structured activities, with a view to preventing enduring mental health problems and social disability. In Malaysia, access to mental health care is particularly limited and little research has focused on identifying young people at risk of serious socially disabling mental health problems such as psychosis. We provide preliminary evidence for the feasibility and acceptability of core social recovery assessment tools in a Malaysian context, comparing the experiential process of engaging young Malaysian participants in social recovery assessments with prior accounts from a UK sample. METHODS Nine vulnerable young people from low-income backgrounds were recruited from a non-government social enterprise and partner organisations in Peninsular Malaysia. Participants completed a battery of social recovery assessment tools (including time use, unusual experiences, self-schematic beliefs and values). Time for completion and completion rates were used as indices of feasibility. Acceptability was examined using qualitative interviews in which participants were asked to reflect on the experience of completing the assessment tools. Following a deductive approach, the themes were examined for fit with previous UK qualitative accounts of social recovery assessments. RESULTS Feasibility was indicated by relatively efficient completion time and high completion rates. Qualitative interviews highlighted the perceived benefits of social recovery assessments, such as providing psychoeducation, aiding in self-reflection and stimulating goal setting, in line with findings from UK youth samples. CONCLUSIONS We provide preliminary evidence for the feasibility and acceptability of social recovery assessment tools in a low-resource context, comparing the experiential process of engaging young Malaysian participants in social recovery assessments with prior accounts from a UK sample. We also suggest that respondents may derive some personal and psychoeducational benefits from participating in assessments (e.g. of their time use and mental health) within a social recovery framework.
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Affiliation(s)
- Clio Berry
- School of Psychology, Pevensey I, University of Sussex, Falmer, Brighton, East Sussex, BN1 9QH, UK. .,Research & Development, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Millview Hospital, Nevill Avenue, Hove, BN3 7HY, UK.
| | - Ellisha Othman
- SOLS HEALTH, SOLS 24/7, 1Petaling Commerz and Residential Condos, #G-8, Jalan, 1C/149, Off Jalan Sungai Besi, Sungai Besi, 57100 Kuala Lumpur, Malaysia
| | - Jun Chuen Tan
- SOLS HEALTH, SOLS 24/7, 1Petaling Commerz and Residential Condos, #G-8, Jalan, 1C/149, Off Jalan Sungai Besi, Sungai Besi, 57100 Kuala Lumpur, Malaysia
| | - Brioney Gee
- 0000 0001 1092 7967grid.8273.eClinical Psychology, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, Norfolk NR4 7TJ UK ,grid.451148.dResearch & Development, Norfolk & Suffolk NHS Foundation Trust, 80 St Stephens Road, Norwich, NR1 3RE UK
| | - Rory Edward Byrne
- 0000 0004 0430 6955grid.450837.dPsychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Psychosis Research UnitHarrop House, Prestwich Hospital, Bury New Road, Manchester, M25 3BL UK
| | - Joanne Hodgekins
- 0000 0001 1092 7967grid.8273.eClinical Psychology, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, Norfolk NR4 7TJ UK ,grid.451148.dResearch & Development, Norfolk & Suffolk NHS Foundation Trust, 80 St Stephens Road, Norwich, NR1 3RE UK
| | - Daniel Michelson
- 0000 0004 1936 7590grid.12082.39School of Psychology, Pevensey I, University of Sussex, Falmer, Brighton, East Sussex BN1 9QH UK
| | - Alvin Lai Oon Ng
- SOLS HEALTH, SOLS 24/7, 1Petaling Commerz and Residential Condos, #G-8, Jalan, 1C/149, Off Jalan Sungai Besi, Sungai Besi, 57100 Kuala Lumpur, Malaysia ,grid.430718.9Department of Psychology, Faculty of Science and Technology, Sunway University, No. 5, Jalan Universiti, Bandar Sunway, Petaling Jaya, Selangor Malaysia
| | - Nigel V. Marsh
- grid.456586.cDepartment of Psychology, James Cook University, 149 Sims Drive, Singapore, 387380 Singapore
| | - Sian Coker
- SOLS HEALTH, SOLS 24/7, 1Petaling Commerz and Residential Condos, #G-8, Jalan, 1C/149, Off Jalan Sungai Besi, Sungai Besi, 57100 Kuala Lumpur, Malaysia ,0000 0001 1092 7967grid.8273.eClinical Psychology, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, Norfolk NR4 7TJ UK ,grid.430718.9Department of Psychology, Faculty of Science and Technology, Sunway University, No. 5, Jalan Universiti, Bandar Sunway, Petaling Jaya, Selangor Malaysia
| | - David Fowler
- 0000 0004 1936 7590grid.12082.39School of Psychology, Pevensey I, University of Sussex, Falmer, Brighton, East Sussex BN1 9QH UK
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Psychological Distress among Adolescents in Laos, Mongolia, Nepal, and Sri Lanka. Asian Nurs Res (Korean Soc Nurs Sci) 2019; 13:147-153. [PMID: 31003005 DOI: 10.1016/j.anr.2019.04.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 04/10/2019] [Accepted: 04/10/2019] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The purpose of this study was to explore psychological distress and examine the relationship between this distress and individual, family, and school factors among adolescents in four low- and middle-income countries (LAMICs) in Asia (i.e., Laos, Mongolia, Nepal, and Sri Lanka). METHODS A total of 4,098 adolescents attending public schools in the four LAMICs were surveyed as part of the Healthy School Development Project, which aimed to develop school capacity for improving (1) health among all school members and (2) the school environment through tailored school health programs. Psychological distress, family factors (i.e., parental understanding and monitoring, and parental tobacco and alcohol use), and school factors (i.e., having close friends, not bullied, school attendance, and health education) were assessed using self-report questionnaires. Data were collected from September to November in 2012 and 2013. Data analysis comprised descriptive statistics, Chi-squared testing, and logistic regression. RESULTS Over half of the participants were women (53.2%-64.1%), and 33.7% (in Sri Lanka) to 53.8% (in Laos) were aged older than 15 years. Approximately 32.9% reported the presence of psychological distress; moreover, 7.9%-13.2% reported suicidal ideation. Parental monitoring and being bullied were associated with psychological distress in all four countries. CONCLUSION One-third of adolescents experience psychological distress across these four LAMICs, which poses a substantial public health issue. Adolescents can benefit from family and school-based approaches for screening, ameliorating, and preventing psychological distress.
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Frantz I, Foran HM, Lachman JM, Jansen E, Hutchings J, Băban A, Fang X, Gardner F, Lesco G, Raleva M, Ward CL, Williams ME, Heinrichs N. Prevention of child mental health problems in Southeastern Europe: a multicentre sequential study to adapt, optimise and test the parenting programme 'Parenting for Lifelong Health for Young Children', protocol for stage 1, the feasibility study. BMJ Open 2019; 9:e026684. [PMID: 30782760 PMCID: PMC6352775 DOI: 10.1136/bmjopen-2018-026684] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Families in low-income and middle-income countries (LMICs) face multiple challenges (eg, poverty and adverse childhood experiences) that increase the risk for child mental health problems, while the context may provide them with few resources. Existing prevention-oriented parenting programmes have been shown to be effective in reducing child behaviour problems and associated risk factors. This project has the overall goal of adapting, implementing and testing a parenting intervention in three Southeastern European LMIC and uses the Multiphase Optimisation Strategy and dimensions of the Reach, Effectiveness, Adoption, Implementation and Maintenance framework. It is implemented over three phases: (1) preparation, (2) optimisation and (3) evaluation. The preparation phase, the subject of this paper, involves the adaptation and feasibility piloting of the parenting programme. METHODS AND ANALYSIS This protocol describes the assessment of an evidence-informed indicated prevention programme for families with children aged 2-9 years (Parenting for Lifelong Health for Young Children) for implementation in FYR of Macedonia, Republic of Moldova and Romania. In this phase, officials, experts, parents and practitioners are interviewed to explore their views of suitability and needs for further adaptation. In addition, a small pre-post pilot study will test the feasibility of the programme and its implementation as well as the evaluation measures in the three countries with 40 families per country site (n=120). Quantitative data analysis will comprise a psychometric analysis of measures, testing pre-post differences using ANCOVA, χ2 tests and regression analysis. For qualitative data analysis, a thematic approach within an experiential framework will be applied. ETHICS AND DISSEMINATION The ethics review board of the Alpen-Adria University Klagenfurt and ethical review boards in the three LMIC sites have approved the study. TRIAL REGISTRATION NUMBER NCT03552250.
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Affiliation(s)
- Inga Frantz
- Institute for Psychology, Technische Universität Braunschweig, Braunschweig, Germany
| | - Heather M Foran
- Institute for Psychology, Alpen-Adria-University Klagenfurt, Klagenfurt, Austria
| | - Jamie M Lachman
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Elena Jansen
- Institute for Psychology, Alpen-Adria-University Klagenfurt, Klagenfurt, Austria
| | | | - Adriana Băban
- Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Xiangming Fang
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Frances Gardner
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Galina Lesco
- Health for Youth Association, Chișinău, Republic of Moldova
| | - Marija Raleva
- Institute for Marriage, Family and Systemic Practice – ALTERNATIVA, Skopje, Macedonia
| | - Catherine L Ward
- Department of Psychology, University of Cape Town, Rondebosch, South Africa
| | | | - Nina Heinrichs
- Institute for Psychology, Technische Universität Braunschweig, Braunschweig, Germany
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Abstract
There are few human tragedies that stir sympathy and concern more deeply than to see the suffering of children from around the world, often giving rise to spontaneous feelings and impulses of wanting to help. However, such impulses need to be harnessed in a productive manner. Knowledge and training in the psychopathology and phenomenology of mental illness is not enough. New, innovative, evidence-based treatments and interventions are equally important if we are to adequately address the needs of our youth who carry the burden of a psychiatric and/or behavioral condition. This edition of CAMH includes papers that address both the challenges and opportunities in terms of the way in which interventions underpinned by research can work to improve global mental health and how we can better understand the environmental, familial, cultural and societal underpinnings of global child mental health problems.
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Affiliation(s)
- Paramjit T Joshi
- Department of Psychiatry & Human Behavior, University of California Irivine School of Medicine, Irivine, CA, USA
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Maselko J. Social Epidemiology and Global Mental Health: Expanding the Evidence from High-Income to Low- and Middle-Income Countries. CURR EPIDEMIOL REP 2017; 4:166-173. [PMID: 28680795 PMCID: PMC5488107 DOI: 10.1007/s40471-017-0107-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE OF THE REVIEW The vast majority of research on the social determinants of mental health has been generated from high-income country (HIC) populations, even as the greatest health disparities, and greatest disease burden, is observed in lower- and middle-income countries (LMICs). The goal of this review is to examine the evidence base on how key social epidemiology constructs relate to mental health in LMIC contexts. A special focus is on points of departure from the HIC knowledge base, gaps in overall understanding, and opportunities for social epidemiology to make a significant contribution. RECENT FINDINGS A growing body of literature suggests that there is significant heterogeneity, both in the direction and magnitude, of association between factors such as socioeconomic status, income inequality, gender, and social networks/supports and mental health in LMIC. For example, higher levels of education and being married can be risk factors for worse mental health among women in certain contexts. However, many studies have methodological limitations that make causal inference difficult. Poverty alleviation interventions offer a unique opportunity to examine the impact of improving economic resources and mental health. SUMMARY Much remains unknown about the impact of key social factors on mental health in LMIC. Findings from HICs may not apply to LMIC populations, since the meaning and distribution of a given social variable may differ significantly from what is commonly observed in HICs. These points of departure point to opportunities for social epidemiology to make a contribution to the field of global mental health.
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Affiliation(s)
- Joanna Maselko
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 2105e McGavran-Greenberg Hall, Campus Box 7435, Chapel Hill, NC 27599-7435 USA
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Woollett N, Cluver L, Bandeira M, Brahmbhatt H. Identifying risks for mental health problems in HIV positive adolescents accessing HIV treatment in Johannesburg. J Child Adolesc Ment Health 2017; 29:11-26. [PMID: 28287023 DOI: 10.2989/17280583.2017.1283320] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Mental health problems of adolescents are underserved in low and middle-income countries where they account for a significant proportion of disease burden. Perinatally infected HIV-positive adolescents have a high prevalence of mental health disorders; however, little is known about those retained in care in South Africa. METHODS HIV-positive adolescents aged 13-19 years (n = 343) accessing five paediatric antiretroviral clinics in Johannesburg were assessed using standardized measures for depression, anxiety, post-traumatic stress disorder (PTSD), and suicidality. Descriptive and bivariate analyses were conducted on all variables using Statistica v13. RESULTS Twenty-seven percent were symptomatic for depression, anxiety, or PTSD; 24% reported suicidality. Peer violence was significantly correlated to all mental health problems, as was hunger, being inappropriately touched, being hit, and being female. Those reporting sickness in the past year were more symptomatic. High exposure to violence was evident. Additionally, not feeling safe at home or in the community increased risk for all mental health disorders. Knowing one's HIV status was protective as was having dreams for the future. CONCLUSION HIV-positive adolescents accessing care demonstrated high levels of mental health problems that are largely unrecognized and could potentially be addressed within health systems. Mental health difficulties are driven by social challenges that require attention.
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Affiliation(s)
- Nataly Woollett
- a Wits School of Clinical Medicine , University of the Witwatersrand , Johannesburg , South Africa.,b Wits Reproductive Health and HIV Institute, University of the Witwatersrand , Johannesburg , South Africa.,c Wits School of Public Health , University of the Witwatersrand , Johannesburg , South Africa
| | - Lucie Cluver
- d Centre for Evidence-Based Intervention, Department of Social Policy and Intervention , University of Oxford , Oxford , United Kingdom
| | | | - Heena Brahmbhatt
- b Wits Reproductive Health and HIV Institute, University of the Witwatersrand , Johannesburg , South Africa.,f Department of Population, Reproductive and Family Health, Bloomberg School of Public Health , Johns Hopkins University , Baltimore , USA
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