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Al-Hussaini M, Abdel-Razeq H, Shamieh O, Al-Ani A, Hammouri M, Mansour A. Assessment of psycho-oncology in the Middle East and North Africa region: a systematic review and meta-analysis. Oncologist 2024:oyae193. [PMID: 39137150 DOI: 10.1093/oncolo/oyae193] [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: 02/05/2024] [Accepted: 05/23/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND The Middle East and North Africa (MENA) region is expected to witness a significant increase in the burden of cancer. Contrary to Western literature, the burden of psycho-oncology is yet to be established within the MENA region. This study reviews all available evidence characterizing the psychological burden among patients with cancer across the MENA region. METHODS We systematically explored the PubMed/MEDLINE, Cochrane/CENTRAL, and Web of Science (WoS) databases for reports on the psychiatric burden among patients with cancer residing within the MENA region from January 2000 until January 2023. Raw proportion were extracted and analyzed using a random-effects model. FINDINGS Eighty-three studies comprised of 16 810 participants, representing 14 countries, met our inclusion criteria. Across the MENA region, the prevalence of depression, anxiety, and distress were 44% (95% CI, 39%-50%), 47% (95% CI, 40%-54%), and 43% (95% CI, 30%-56%), respectively. Prevalence of depression was significantly different across countries, with Palestine (73%; 95% CI, 42%-91%) reporting the highest rate while Morocco (23%; 95% CI, 7%-56%) reported the lowest. Similarly, anxiety significantly differed across MENA nations ranging from 64% (95% CI, 3%-99%) in Morocco to 28% (95% CI, 18%-42%) in Tunisia. Rates of depression and anxiety were significantly different across measurement tools but not between Arabic-speaking versus Persian/Farsi-speaking countries. Meta-regression models showed that neither publication year nor age affected the prevalence of both anxiety and depression (P = .374 and .091 for depression and P = .627, and .546 for anxiety, respectively). INTERPRETATION We report an abnormally high rate of psychiatric burden among patients with cancer in the MENA region. Thus, establishing appropriate psycho-oncologic interventions within the MENA region is of utmost importance.
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Affiliation(s)
- Maysa Al-Hussaini
- Department of Cell Therapy and Applied Genomics, King Hussein Cancer Center, Amman 11941, Jordan
- Department of Pathology and Laboratory Medicine, King Hussein Cancer Center, Amman 11941, Jordan
| | - Hikmat Abdel-Razeq
- Department of Internal Medicine, King Hussein Cancer Center, Amman 11941, Jordan
| | - Omar Shamieh
- Centre for Palliative and Cancer Care in Conflict, Department of Palliative Care, King Hussein Cancer Center, Amman 11941, Jordan
| | - Abdallah Al-Ani
- Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11941, Jordan
| | | | - Asem Mansour
- Office of Director General, King Hussein Cancer Center, Amman 11941, Jordan
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El-Haj-Mohamad R, Böttche M, Vöhringer M, Specht F, Stammel N, Nesterko Y, Knaevelsrud C, Wagner B. An internet-based cognitive behavioural intervention for adults with depression in Arabic-speaking countries: A randomized controlled trial. Stress Health 2024:e3432. [PMID: 38806256 DOI: 10.1002/smi.3432] [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: 01/29/2024] [Revised: 05/12/2024] [Accepted: 05/15/2024] [Indexed: 05/30/2024]
Abstract
Internet-based interventions have proven to be effective for the treatment of depression in different samples, but evidence from the Middle East and North Africa (MENA) region is scarce. The aim of this study was to investigate the acceptance and efficacy of an internet-based cognitive behavioural writing intervention for Arabic-speaking participants with depression living in the MENA region. A total of 259 participants (167 female, age in years: M = 25.58, SD = 6.39) with depressive symptoms indicative of clinical relevance were randomly allocated to a treatment group (TG; nTG = 128) or a waitlist control group (WG; nWG = 131). The TG received an internet-based intervention over a 6-week period. The primary outcome was depressive symptoms, and secondary outcomes were anxiety and quality of life (QoL). T-tests with change scores from pre- to post-treatment were used for data analyses. Intention-to-treat (ITT) as well as completer analyses were calculated. The ITT analysis revealed significant differences between the TG and WG in depression (T257 = -4.89, p < 0.001, d = 0.70) and QoL (T257 = 3.39, p < 0.001, d = 0.47). Significant differences regarding anxiety symptoms (T257 = 3.25, p < 0.05, d = 0.53) were identified for the completer sample. The general dropout rate was 39.9%. The results indicate the feasibility and efficacy of an internet-based cognitive behavioural writing intervention in adults from Arabic-speaking countries. The development and implementation of such interventions can be used to improve access to psychological help and adequate treatment.
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Affiliation(s)
- Rayan El-Haj-Mohamad
- Department for Transcultural and Traumatic Stress Studies, Center ÜBERLEBEN, Berlin, Germany
- Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Maria Böttche
- Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Max Vöhringer
- Department for Transcultural and Traumatic Stress Studies, Center ÜBERLEBEN, Berlin, Germany
| | - Freya Specht
- Department for Transcultural and Traumatic Stress Studies, Center ÜBERLEBEN, Berlin, Germany
| | - Nadine Stammel
- Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Yuriy Nesterko
- Department for Transcultural and Traumatic Stress Studies, Center ÜBERLEBEN, Berlin, Germany
- Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
- Department for Medical Psychology and Medical Sociology, University of Leipzig Medical Center, Leipzig, Germany
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Naal H, Alaeddine R, Brome D, Daou T, Hudroj L, el Sayed I, Soubra R, Hokayem J, Ghalayini M, Slim W, Saleh S. Capacity building and community of practice for women community health workers in low-resource settings: long-term evaluation of the Mobile University For Health (MUH). Front Glob Womens Health 2024; 5:1304954. [PMID: 38832109 PMCID: PMC11144904 DOI: 10.3389/fgwh.2024.1304954] [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] [Received: 09/30/2023] [Accepted: 05/01/2024] [Indexed: 06/05/2024] Open
Abstract
Background Lebanon has been facing a series of crises, significantly increasing health challenges, and straining its healthcare infrastructure. This caused deficiencies in the system's ability to attend to population health needs, and it profoundly impacted vulnerable and refugee communities who face additional challenges accessing healthcare services. In response, the Global Health Institute at the American University of Beirut designed and implemented the Mobile University for Health (MUH), which promotes task-shifting through capacity building complemented by communities of practice (CoP). The program aimed to prepare vulnerable women to assume the role of community health workers (CHW) within their communities, and to promote positive health knowledge and behaviours. Methods A mixed-methods approach was used to evaluate MUHs' three certificates (women's health, mental health and psychosocial support, and non-communicable diseases). Implementation took place between 2019 and 2022, with 83 CHWs graduating from the program. Short-term data including knowledge assessments, course evaluations, and community member feedback surveys were collected. 93 semi-structured interviews with CHWs and 14 focus group discussions with community members were conducted to evaluate the long-term impact of the capacity building and CoP components. Results Data revealed multiple strengths of the initiative, including increased access to education for the community, effectiveness of blended learning modality, successful planning and delivery of CoP sessions, and improved knowledge, skills, and health behaviours over time. The supplementary CoP sessions fostered trust in CHWs, increased community empowerment, and increased leadership skills among CHWs. However, some challenges persisted, including limited access to healthcare services, implementation logistical issues, difficulties with some aspects of the learning modality, and some resistance within the communities. Conclusion MUH promoted and improved positive health knowledge and behaviours within targeted vulnerable populations in Lebanon. The supplementary CoP component proved instrumental in empowering CHWs and enhancing their impact within their communities. The study highlights the need for ongoing training and support for CHWs and underscores the importance of continued investment and adaptation of such initiatives through a gendered lens. This evaluation provides evidence on the successes of a capacity building model that has strong potential for scale and replication across health topics in conflict-affected contexts.
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Affiliation(s)
- Hady Naal
- Global Health Institute at the American University of Beirut, Beirut, Lebanon
| | - Reem Alaeddine
- Global Health Institute at the American University of Beirut, Beirut, Lebanon
| | - Dayana Brome
- Global Health Institute at the American University of Beirut, Beirut, Lebanon
| | - Tracy Daou
- Global Health Institute at the American University of Beirut, Beirut, Lebanon
| | - Laura Hudroj
- Global Health Institute at the American University of Beirut, Beirut, Lebanon
| | - Israa el Sayed
- Global Health Institute at the American University of Beirut, Beirut, Lebanon
| | - Racha Soubra
- Department of Health Management, Evaluation and Policy, University of Montreal, Montreal, QC, Canada
| | - Joanne Hokayem
- School of Public Health, Harvard University, Cambridge, MA, United States
| | - Mohamad Ghalayini
- Global Health Institute at the American University of Beirut, Beirut, Lebanon
| | - Waed Slim
- Global Health Institute at the American University of Beirut, Beirut, Lebanon
| | - Shadi Saleh
- Global Health Institute at the American University of Beirut, Beirut, Lebanon
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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Khaled SM, Alhussaini NWZ, Alabdulla M, Sampson NA, Kessler RC, Woodruff PW, Al‐Thani SM. Lifetime prevalence, risk, and treatment of mood and anxiety disorders in Qatar's national mental health study. Int J Methods Psychiatr Res 2024; 33:e2011. [PMID: 38726890 PMCID: PMC11323770 DOI: 10.1002/mpr.2011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 12/17/2023] [Accepted: 01/30/2024] [Indexed: 08/16/2024] Open
Abstract
OBJECTIVES To estimate lifetime prevalence, risk, and treatment for mental disorders and their correlates in Qatar's general population for the first time. METHODS We conducted a national phone survey of 5,195 Qatari and Arab residents in Qatar (2019-2022) using the Composite International Diagnostic Interview Version 3.3 and estimated lifetime mood and anxiety defined diagnoses. Survival-based discrete time models, lifetime morbid risk, and treatment projections were estimated. RESULTS Lifetime prevalence of any disorder was 28.0% and was associated with younger cohorts, females, and migrants, but lower formal education. Treatment contact in the year of disorder onset were 13.5%. The median delay in receiving treatment was 5 years (IQR = 2-13). Lifetime treatment among those with a lifetime disorder were 59.9% for non-healthcare and 63.5% for healthcare; it was 68.1% for any anxiety and 80.1% for any mood disorder after 50 years of onset. Younger cohorts and later age of onset were significantly predictors of treatment. CONCLUSIONS Lifetime prevalence of mental disorders in Qatar is comparable to other countries. Treatment is significantly delayed and delivered largely in non-healthcare sectors thus the need for increased literacy of mental illness to reduce stigma and improve earlier help-seeking in healthcare settings.
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Affiliation(s)
- Salma Mawfek Khaled
- Department of Population MedicineCollege of MedicineQatar UniversityDohaQatar
| | | | - Majid Alabdulla
- Department of PsychiatryHamad Medical CorporationDohaQatar
- College of MedicineQatar UniversityDohaQatarQatar
| | - Nancy A. Sampson
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
| | - Ronald C. Kessler
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
| | - Peter W. Woodruff
- School of Medicine and Population HealthUniversity of SheffieldSheffieldUK
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Nehme A, Moussa S, Fekih-Romdhane F, Hallit S, Obeid S, Haddad G. The mediating role of depression in the association between perceived financial wellbeing and somatization: a study in the context of Lebanon's financial crisis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-15. [PMID: 38598249 DOI: 10.1080/09603123.2024.2341132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 04/05/2024] [Indexed: 04/11/2024]
Abstract
The objectives of this study were to examine the association between financial wellbeing and somatization, in addition to the mediating effect of anxiety, depression and stress. To test such hypotheses, a cross-sectional study was carried out between September and October 2021; 403 participants (264 females; age = 32.76 ± 13.24 years) were recruited. Depression mediated the association between financial wellbeing and somatization. A worse financial wellbeing was significantly associated with more depression, which was associated with more somatization. Moreover, a worse financial wellbeing was significantly and directly associated with more somatization. Our study adds to the narrow body of research revolving around the relationship between financial wellbeing and somatization in Lebanese adults. Understanding that the effects of, depression are aggravated in a country such as Lebanon would help establish more preventative guidelines and mental health awareness campaigns. Identifying the correlates of somatization can also be translated into improved interventions.
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Affiliation(s)
- Antonio Nehme
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Sara Moussa
- Faculty of Medicine, University of Balamand, Koura, Lebanon
| | - Feten Fekih-Romdhane
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi Hospital, Manouba, Tunisia
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Georges Haddad
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
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Nehme A, Moussa S, Fekih-Romdhane F, Yakın E, Hallit S, Obeid S, Haddad G. Expressive suppression moderates the relationship between PTSD from COVID-19 and somatization and validation of the Arabic version of Patient Health Questionnaire-15 (PHQ-15). PLoS One 2024; 19:e0293081. [PMID: 38271356 PMCID: PMC10810523 DOI: 10.1371/journal.pone.0293081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 10/01/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Lebanese adults have been crippled for years by several crises, including the lately COVID-19 pandemic. These massive civilian traumas have increased the risk of post-traumatic stress disorder (PTSD) in this population. Extensive literature pointed to the association between PTSD and somatization; however, the nature of this relationship remains unknown. We sought to contribute further to work in this area by testing the moderating role of emotion regulation in the relationship between COVID-19- related PTSD and somatization. As a secondary objective, we aimed to examine the psychometric properties of an Arabic translation of the somatization measure Patient Health Questionnaire-15 (PHQ-15) in terms of factorial validity and internal consistency before its use in the present study. METHODS This cross-sectional study was conducted between September and October 2021. A total of 403 Lebanese adults residing in Lebanon were recruited. Eligible participants received an online link to the survey. The Patient Health Questionnaire-15 was used to assess somatization, PTSD Checklist-Civilian Version for PTSD and Emotion Regulation Questionnaire for emotion regulation. RESULTS The results of the exploratory factor analysis (EFA) revealed a three-factor solution explaining 48.79% of the common variance. Confirmatory Factor Analysis results of the three-factor model obtained in the EFA indicated a good fit with a significant CFI of 0.98, TLI 0.98 and a GFI of .97, a RMSEA of .04 [90% CI .01, .06]. Higher PTSD symptoms were associated with somatization. In addition, we found that one specific ER component, i.e. expressive suppression, significantly moderated the relationship between PTSD from the COVID pandemic and somatization. In particular, the interaction PTSD from the COVID-19 pandemic by expressive suppression was significantly associated with somatization; at low, medium and high levels of expressive suppression, higher PTSD from the COVID-19 pandemic was significantly associated with higher somatization scores. As for our secondary objective, findings revealed that the Arabic version of the PHQ-15 exhibited good psychometric properties. In particular, the scale yielded a three-factor structure, and good internal consistency (Cronbach's alpha = 0.87). CONCLUSION The moderating role of expressive suppression on the link between PTSD and somatization presents a novel finding in the field of trauma. Additionally, making a psychometrically sound Arabic version of the PHQ-15 available is a valuable addition to the literature.
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Affiliation(s)
- Antonio Nehme
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Sara Moussa
- Faculty of Medicine, University of Balamand, Koura, Lebanon
| | - Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi Hospital, Manouba, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Ecem Yakın
- Centre d’Études et de Recherches en Psychopathologie et Psychologie de la Santé, Université de Toulouse-Jean Jaurès, UT2J, Toulouse, France
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Georges Haddad
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
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Alzubaidi H, Saidawi W, Alzoubi KH, Franson KL, Samorinha C, Goldstone LW. Mental Health Care Education and Training in Pharmacy Programs in Arabic-Speaking Countries. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2023; 87:100039. [PMID: 37534929 DOI: 10.1016/j.ajpe.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/13/2022] [Accepted: 12/02/2022] [Indexed: 08/04/2023]
Abstract
OBJECTIVE This study aimed to assess how entry-level pharmacy programs in Arab countries prepare graduates to provide mental health care, specifically examining the didactic curricula and experiential training in psychiatry in bachelor and PharmD programs. METHODS An electronic survey was sent to all entry-level pharmacy programs in the 22 Arab countries asking to report on the 2021-2022 academic year. The survey assessed teaching and learning (eg, psychiatric diseases taught and extent of the coverage; contact hours dedicated to psychiatric therapeutics, pharmacology, and medicinal chemistry), experiential training in psychiatry and its challenges, and graduates' preparedness to provide mental health. A descriptive analysis of the data was undertaken, and data were reported for bachelor and PharmD programs separately. RESULTS Overall, 35 pharmacy programs completed the survey. All PharmD programs and 80% of bachelor programs covered psychiatric therapeutics, and most contact hours were dedicated to pharmacology, followed by psychiatric therapeutics and medicinal chemistry. Over half of the faculty considered that depression and anxiety disorders were covered sufficiently, and 56.2% of programs did not offer experiential training in psychiatry. Common challenges in psychiatry experiential training included a lack of sites and qualified preceptors. Overall, 26.4% of faculty positively rated graduates' preparedness to provide mental health care. Graduates who completed experiential training in psychiatry and PharmD graduates were rated higher. CONCLUSION Pharmaceutical education in Arab countries could be improved by enhancing the teaching and assessment of mental health topics and expanding psychiatry experiential training. Such changes would improve entry-level pharmacists' competencies in mental health care provision.
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Affiliation(s)
- Hamzah Alzubaidi
- University of Sharjah, College of Pharmacy, Sharjah, United Arab Emirates; University of Sharjah, Research Institute for Health and Medical Sciences, Sharjah, United Arab Emirates; Deakin University, Faculty of Health, School of Medicine, Deakin Rural Health, Victoria, Australia.
| | - Ward Saidawi
- University of Sharjah, Research Institute for Health and Medical Sciences, Sharjah, United Arab Emirates
| | - Karem H Alzoubi
- University of Sharjah, College of Pharmacy, Sharjah, United Arab Emirates; University of Sharjah, Research Institute for Health and Medical Sciences, Sharjah, United Arab Emirates
| | - Kari L Franson
- University of Southern California, School of Pharmacy, Los Angeles, CA, USA
| | - Catarina Samorinha
- University of Sharjah, Research Institute for Health and Medical Sciences, Sharjah, United Arab Emirates
| | - Lisa W Goldstone
- University of Southern California, School of Pharmacy, Los Angeles, CA, USA
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Khatib HE, Alyafei A, Shaikh M. Understanding experiences of mental health help-seeking in Arab populations around the world: a systematic review and narrative synthesis. BMC Psychiatry 2023; 23:324. [PMID: 37161342 PMCID: PMC10170733 DOI: 10.1186/s12888-023-04827-4] [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: 11/24/2022] [Accepted: 04/28/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Racial and ethnic disparities in mental health service utilisation and access is well established. Mental illness is common among Arab populations globally, but most individuals display negative attitudes towards mental health and do not seek professional help. The aim of this systematic review was to determine 1) help-seeking behaviours 2) help-seeking attitudes and 3) help-seeking barriers and facilitators, related to mental health services among Arab adults. METHOD A pre-defined search strategy and eligibility criteria allowed for database searching using terms related to: mental health, Arabs, help-seeking, as well as experiences and behaviours. Seventy-four articles were included and analysed through narrative synthesis. Results were reported using the PRISMA guidelines. The review protocol was registered prospectively on PROSPERO (CRD42022319889). RESULTS Arabs across the world have negative attitudes towards formal help-seeking and are reluctant to seek help, despite the presence of psychological distress. There is little information on factors that influence help-seeking behaviours and rates of service use. Preference for informal help sources such as family and friends were expressed and considered more acceptable. Low mental health literacy, stigma, gender, age, education, religion, acculturation, and immigrant status were the most common factors influencing help-seeking attitudes. Barriers to help-seeking included stigma, privacy and confidentiality, trust, mental health literacy, language, logistics, and culture related barriers. Increasing societal and family awareness, external support and encouragement, shared culture between the client and therapist, quality of doctor patient relationship, and feelings of connectedness with the host country among refugees were mentioned facilitators. Mixed findings for the role of religion, and family and community, in relation to facilitating or hindering help-seeking were reported. CONCLUSIONS There is an increased likelihood and preference to seek informal sources of psychological support among Arabs. Contextual and cultural factors impeding help-seeking for Arabs are common across the world. Future research should address actual utilisation rates of services to better understand factors that influence help-seeking behaviours and facilitators to help-seeking. Increasing mental health literacy and developing anti stigma campaigns is necessary. Developing culturally informed interventions should inform future efforts to promote help-seeking among this population.
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Affiliation(s)
- Hania El Khatib
- Division of Psychiatry, University College London, London, UK
| | - Aisha Alyafei
- Division of Psychiatry, University College London, London, UK
| | - Madiha Shaikh
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
- North East London NHS Foundation Trust, London, UK.
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Bizri M, Ibrahim N, El Hayek S, Saliba A, Ehlers SL, Ostroff JS, Maalouf F, Taher A. Challenges in implementing psycho-oncology services in Arab low- and middle-income countries: Lessons learned from Lebanon. Psychooncology 2023; 32:174-178. [PMID: 35861229 DOI: 10.1002/pon.6004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/24/2022] [Accepted: 07/12/2022] [Indexed: 01/14/2023]
Affiliation(s)
- Maya Bizri
- Department of Psychiatry, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Nour Ibrahim
- Department of Psychiatry, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Samer El Hayek
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Antoine Saliba
- Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota, USA.,Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
| | - Shawna L Ehlers
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Jamie S Ostroff
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Fadi Maalouf
- Department of Psychiatry, American University of Beirut Medical Centre, Beirut, Lebanon
| | - Ali Taher
- Division of Hematology and Oncology, Department of Internal Medicine, American University of Beirut Medical Centre, Beirut, Lebanon
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Nehme A, Barakat M, Malaeb D, Obeid S, Hallit S, Haddad G. Association between COVID-19 symptoms, COVID-19 vaccine, and somatization among a sample of the Lebanese adults. Pharm Pract (Granada) 2023; 21:2763. [PMID: 37090451 PMCID: PMC10117341 DOI: 10.18549/pharmpract.2023.1.2763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 11/03/2022] [Indexed: 04/25/2023] Open
Abstract
Objectives Long COVID syndrome, the poorly defined illness, has been increasingly mentioned in recent studies yet is still poorly understood especially when it comes to precipitating and modulating factors, the high prevalence of mental health problems associated with the COVID-19 pandemic has brought to light the hypothesis of the existence of a psychological component associated with the persistence of symptoms and if vaccination may serve as a modulating factor. This study aims to examine the prevalence of somatization disorders and association between persistent COVID-19 symptoms and COVID-19 vaccine with somatization among a sample of the Lebanese general population. Methods A cross-sectional study was carried out between September and October 2021. The snowball sampling technique was picked to choose a sample that addressed all Lebanese Mohafazat. Patient Health Questionnaire-15 (PHQ-15) was used to assess somatization. Results A total of 403 participants was enrolled in this study, with a mean age of 32.76 ± 13.24 years, 108 (26.8%) had medium somatization symptoms (PHQ-15 scores ≥10). Having persistent COVID symptoms (β=2.15) was significantly associated with more somatization, whereas the intake of COVID vaccine (β=-1.17) was significantly associated with less somatization. Conclusion Long lasting COVID-19 symptoms were closely related to somatization, although the administration of the COVID-19 vaccine was associated with less somatization. However, further studies are needed to provide a better understanding of the relationship between long COVID and somatization, on one hand, and the modulating factors on the other hand.
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Affiliation(s)
- Antonio Nehme
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
| | - Muna Barakat
- Department of Clinical Pharmacy and therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, 11931, Jordan.
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates.
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon.
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
| | - Georges Haddad
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Psychiatry Departments, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
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Kovess-Masfety V, Karam E, Keyes K, Sabawoon A, Sarwari BA. Access to Care for Mental Health Problems in Afghanistan: A National Challenge. Int J Health Policy Manag 2022; 11:1442-1450. [PMID: 34124868 PMCID: PMC9808366 DOI: 10.34172/ijhpm.2021.46] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 04/18/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND This paper describes the access to care for mental health problems in Afghanistan, according to the nature of the mental health problems and the service provider. Following the Andersen model, it evaluates the respective roles in access to care of "predisposing," "needs," "enabling" factors, and other "environmental" factors such as exposure to traumatic events and level of danger of the place of residence. METHODS Trans-sectional probability survey in general population by multistage sampling in 16 provinces, nationally representative: N=4445 (15 years or older), participation rate of 81%. Face to face interviews using standardized measures of mental health (CIDI, Composite International Diagnostic Interview). Different logistic regression models are presented. RESULTS The 12-month rate of mental health help-seeking was 6.56% with substantial regional variation (2.35% to 12.65%). Providers were mainly from the health sector; the non-health sector (religious and healers) was also prevalent. Most consultations were held in private clinics (non-governmental organisation, NGO). The severity of mental health disorders as well as the perceived impairment due to mental health were independently very important: odds ratio (OR) = 6.04 for severe disorder, OR=3.79 for perceived impairment. Living in a dangerous area decreased access to care: for high level of danger and for very high level: OR=0.22. Gender, education and ethnicity were not associated with mental health help-seeking after controlling for exposure to trauma. CONCLUSION Access to care for mental health problems depended mainly on the needs as defined as disorder severity level and impairment, and on environmental factors such as exposure to traumatic events. The system seems equitable; however, this is counterbalanced by a very challenging environment. This survey is a testimony to the hardship experienced by the Afghan population and by health professionals, and to the efforts to deliver organized mental healthcare in a challenging situation. This research may inform and support policy-makers and NGOs in other countries undergoing similar challenges.
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Affiliation(s)
- Viviane Kovess-Masfety
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Conseil Santé, Clichy, France
- Laboratoire de Psychopathologie et Processus de Santé (LPPS), Université de Paris, Boulogne-Billancourt, France
| | - Elie Karam
- Department of Psychiatry & Clinical Psychology, St. George Hospital University Medical, Beirut, Lebanon
- Faculty of Medicine, University of Balamand Medical Center, University of Balamand, Beirut, Lebanon
- Institute for Development, Research, Advocacy & Applied Care (IDRAAC), Beirut, Lebanon
| | - Katherine Keyes
- Mailman School of Public Health, Columbia University, New York City, NY, USA
| | - Ajmal Sabawoon
- Governance Institute of Afghanistan (GI-A), Kabul, Afghanistan
| | - Bashir Ahmad Sarwari
- Department of Mental Health & Substance Abuse, Primary Health Care Directorate, Ministry of Public Health, Kabul, Afghanistan
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12
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Abi Hana R, Arnous M, Heim E, Aeschlimann A, Koschorke M, Hamadeh RS, Thornicroft G, Kohrt BA, Sijbrandij M, Cuijpers P, El-Chammay R. Mental health stigma at primary health care centres in Lebanon: qualitative study. Int J Ment Health Syst 2022; 16:23. [PMID: 35525972 PMCID: PMC9077642 DOI: 10.1186/s13033-022-00533-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 03/29/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Mental health-related stigma is a global public health concern and a major barrier to seeking care. In this study, we explored the role of stigma as a barrier to scaling up mental health services in primary health care (PHC) centres in Lebanon. We focused on the experiences of Healthcare Providers (HCPs) providing services to patients with mental health conditions (MHCs), the views of policy makers, and the perceptions of stigma or discrimination among individuals with MHCs. This study was conducted as part of INDIGO-PRIMARY, a larger multinational stigma reduction programme. METHODS Semi-structured qualitative interviews (n = 45) were carried out with policy makers (n = 3), PHC management (n = 4), PHC staff (n = 24), and service users (SUs) (n = 14) between August 2018 and September 2019. These interviews explored mental health knowledge, attitudes and behaviour of staff, challenges of providing treatment, and patient outcomes. All interviews were coded using NVivo and a thematic coding framework. RESULTS The results of this study are presented under three themes: (1) stigma at PHC level, (2) stigma outside PHC centres, and (3) structural stigma. SUs did not testify to discrimination from HCPs but did describe stigmatising behaviour from their families. Interestingly, at the PHC level, stigma reporting differed among staff according to a power gradient. Nurses and social workers did not explicitly report incidents of stigma but described patients with MHCs as uncooperative, underscoring their internalized negative views on mental health. General practitioners and directors were more outspoken than nurses regarding the challenges faced with mental health patients. Mental health professionals revealed that HCPs still hold implicitly negative views towards patients with MHCs however their attitude has improved recently. Our analysis highlights five layers of stigma affecting SUs. CONCLUSION This qualitative study reveals that stigma was still a key concern that affects patients with MHC. SUs reported experiencing overt stigmatising behaviour in the community but less explicit discrimination in a PHC setting. Our findings emphasise the importance of (1) combatting structural stigma through legal reform, (2) addressing interpersonal stigma, (3) committing PHC management to deliver high quality mental health integrated services, and (4) reducing intrapersonal stigma by building public empathy.
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Affiliation(s)
- Racha Abi Hana
- Ministry of Public Health, National Mental Health Programme, Beirut, Lebanon.
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit, Amsterdam, The Netherlands.
| | - Maguy Arnous
- Ministry of Public Health, National Mental Health Programme, Beirut, Lebanon
| | - Eva Heim
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | | | - Mirja Koschorke
- Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Randa S Hamadeh
- Primary Healthcare Department at Ministry of Public Health, Beirut, Lebanon
- Global Health Team of Experts (GHTE), Beirut, Lebanon
| | - Graham Thornicroft
- Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Brandon A Kohrt
- Department of Psychiatry and Behavioral Sciences, Division of Global Mental Health George Washington University, Washington, DC, USA
| | - Marit Sijbrandij
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Rabih El-Chammay
- Ministry of Public Health, National Mental Health Programme, Beirut, Lebanon
- Department of Psychiatry, Saint Joseph University, Beirut, Lebanon
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13
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Treatment Gap of Mental Disorders in São Paulo Metropolitan Area, Brazil: Failure and Delay in Initiating Treatment Contact After First Onset of Mental and Substance Use Disorders. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00814-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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14
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Harris MG, Kazdin AE, Munthali RJ, Vigo DV, Hwang I, Sampson NA, Al-Hamzawi A, Alonso J, Andrade LH, Borges G, Bunting B, Florescu S, Gureje O, Karam EG, Lee S, Navarro-Mateu F, Nishi D, Rapsey C, Scott KM, Stagnaro JC, Viana MC, Wojtyniak B, Xavier M, Kessler RC. Perceived helpfulness of service sectors used for mental and substance use disorders: Findings from the WHO World Mental Health Surveys. Int J Ment Health Syst 2022; 16:6. [PMID: 35093131 PMCID: PMC8800240 DOI: 10.1186/s13033-022-00516-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/12/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Mental healthcare is delivered across service sectors that differ in level of specialization and intervention modalities typically offered. Little is known about the perceived helpfulness of the combinations of service sectors that patients use. METHODS Respondents 18 + years with 12-month DSM-IV mental or substance use disorders who saw a provider for mental health problems in the year before interview were identified from WHO World Mental Health surveys in 17 countries. Based upon the types of providers seen, patients were grouped into nine mutually exclusive single-sector or multi-sector 'treatment profiles'. Perceived helpfulness was defined as the patient's maximum rating of being helped ('a lot', 'some', 'a little' or 'not at all') of any type of provider seen in the profile. Logistic regression analysis was used to examine the joint associations of sociodemographics, disorder types, and treatment profiles with being helped 'a lot'. RESULTS Across all surveys combined, 29.4% (S.E. 0.6) of respondents with a 12-month disorder saw a provider in the past year (N = 3221). Of these patients, 58.2% (S.E. 1.0) reported being helped 'a lot'. Odds of being helped 'a lot' were significantly higher (odds ratios [ORs] = 1.50-1.89) among the 12.9% of patients who used specialized multi-sector profiles involving both psychiatrists and other mental health specialists, compared to other patients, despite their high comorbidities. Lower odds of being helped 'a lot' were found among patients who were seen only in the general medical, psychiatrist, or other mental health specialty sectors (ORs = 0.46-0.71). Female gender and older age were associated with increased odds of being helped 'a lot'. In models stratified by country income group, having 3 or more disorders (high-income countries only) and state-funded health insurance (low/middle-income countries only) were associated with increased odds of being helped 'a lot'. CONCLUSIONS Patients who received specialized, multi-sector care were more likely than other patients to report being helped 'a lot'. This result is consistent with previous research suggesting that persistence in help-seeking is associated with receiving helpful treatment. Given the nonrandom sorting of patients by types of providers seen and persistence in help-seeking, we cannot discount that selection bias may play some role in this pattern.
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Affiliation(s)
- Meredith G Harris
- School of Public Health, The University of Queensland, Level 2, Public Health Building (887), 288 Herston Road, Herston, QLD, 4006, Australia.
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wolston Park Rd, Wacol, QLD, 4076, Australia.
| | - Alan E Kazdin
- Department of Psychology, Yale University, 2 Hillhouse Avenue- 208205, New Haven, CT, 06520, USA
| | - Richard J Munthali
- Department of Psychiatry, University of British Columbia, UBC Hospital-Detwiller Pavilion, UBC Vancouver Campus, Room 2813, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada
| | - Daniel V Vigo
- Department of Psychiatry, University of British Columbia, UBC Hospital-Detwiller Pavilion, UBC Vancouver Campus, Room 2813, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA
| | - Irving Hwang
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115, USA
| | - Nancy A Sampson
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115, USA
| | - Ali Al-Hamzawi
- College of Medicine, Al-Qadisiya University, Al-Diwaniyah, P.O.Box 88, Al-Qadisiyah, Iraq
| | - Jordi Alonso
- IMIM-Hospital del Mar Medical Research Institute, PRBB Building, Doctor Aiguader, 88, 08003, Barcelona, Spain
- CIBER en Epidemiología Y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain
- Pompeu Fabra University (UPF), Plaça de la Mercè, 10-12, 08002, Barcelona, Spain
| | - Laura Helena Andrade
- University of São Paulo Medical School, Núcleo de Epidemiologia Psiquiátrica - LIM 23, Rua Dr. Ovidio Pires de Campos, 785, São Paulo, CEP 05403-010, Brazil
| | - Guilherme Borges
- National Institute of Psychiatry Ramón de La Fuente Muñiz, Calzada México-Xochimilco, 101, Colonia San Lorenzo Huipulco, DF 14370, México City, Mexico
| | - Brendan Bunting
- School of Psychology, Ulster University, College Avenue, Londonderry, BT48 7JL, UK
| | - Silvia Florescu
- National School of Public Health, Management and Development, 31 Vaselor Str, 21253, Bucharest, Romania
| | - Oye Gureje
- Department of Psychiatry, University of Ibadan, University College Hospital, Ibadan, 5116, PMB, Nigeria
| | - Elie G Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Achrafieh, St. George Hospital Street, Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Ashrafieh, Beirut, 166378, Lebanon
- Faculty of Medicine, Balamand University, Rond Point Saloumeh, Sin el Fil, Beirut, Lebanon
| | - Sing Lee
- Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
- G/F Multicentre, Tai Po Hospital, 9 Chuen On Road, Tai Po, Hong Kong
| | - Fernando Navarro-Mateu
- Unidad de Docencia, Investigacion Y Formación en Salud Mental, Servicio Murciano de Salud, Murcia Health Service, C/ Lorca, nº 58. -El Palmar, 30120, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria Virgen de La Arrixaca, El Palmar, 30120, Murcia, Spain
- Centro de Investigación Biomédica en ERed en Epidemíologia Y Salud Pública, El Palmar, 30120, Murcia, Spain
| | - Daisuke Nishi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Charlene Rapsey
- Department of Psychological Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand
| | - Kate M Scott
- Department of Psychological Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand
| | - Juan Carlos Stagnaro
- Departamento de Psiquiatría Y Salud Mental, Facultad de Medicina, Universidad de Buenos Aires, 2155, C1121ABG CABA, Paraguay, Argentina
| | - Maria Carmen Viana
- Department of Social Medicine, Postgraduate Program in Public Health, Federal University of Espírito Santo, Rua Dr. Euríco de Águiar, 888/705, Vitoria, Espirito Santo-ES, 29052-600, Brazil
| | - Bogdan Wojtyniak
- National Institute of Public Health, National Research Institute, 24 Chocimska St., 00-791, Warsaw, Poland
| | - Miguel Xavier
- Lisbon Institute of Global Mental Health and Chronic Diseases Research Center (CEDOC), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056, Lisbon, Portugal
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA, 02115, USA
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15
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Jaspal R, Assi M, Maatouk I. Coping styles in heterosexual and non-heterosexual students in Lebanon: a cross-sectional study (Estilo de afrontamiento en estudiantes heterosexuales y no heterosexuales en Líbano: un estudio transversal). INTERNATIONAL JOURNAL OF SOCIAL PSYCHOLOGY 2022. [DOI: 10.1080/02134748.2021.1993117] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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16
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Hu J, Zheng Q, Zhang Y, Liu C, Tian X, Liu X, Wang D, Ma J. Help-seeking behavior of individuals with schizophrenia in the general population of Hunan, China. Sci Rep 2021; 11:23012. [PMID: 34836983 PMCID: PMC8626485 DOI: 10.1038/s41598-021-01819-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 11/01/2021] [Indexed: 12/14/2022] Open
Abstract
This study aims to know the seeking help behavior of individuals with SZ (Schizophrenia) in Hunan province of China. Individuals (age > 15) with schizophrenia were recruited in the study after a two-stage diagnosis procedure (including questionnaire screening and face-to-face SCID interview by psychiatrists) in Hunan province. A self-designed questionnaire was used to investigate their help-seeking behavior. (1) Of the 367 participants, 68.9% (253/367) sought help; of those, 64.6% (n = 163) pursued professional psychiatric services and 30.8% (n = 78) pursued non-medical options (i.e., relatives, praying to Buddha) as the most common first choices. (2) Family history of mental disorders is significantly related to whether or not the individual with SZ seeks help, and the first choice of help is significantly related to education level. (P < 0.05). (3) Frequent reasons behind not seeking help include fear of stigmatization (72.9%), poor mental health literacy (64.5%), concerns over cost (50.6%), and limited access to medical services (47.0%). About one-third of the individuals do not seek help. Individuals with SZ tend to choose psychiatric hospitals and relatives as their first choice. Among the factors we investigated, family history of mental disorders is the most influential factor associated with help-seeking behavior. Individuals with more education tend to seek professional help first. The primary reasons for not seeking help include fear of stigmatization, lack of awareness about mental illness, concerns over cost, etc.
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Affiliation(s)
- Jiawen Hu
- School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, China.,Econd People's Hospital of Hunan Province(Brain Hospital of Hunan Province), Changsha, China
| | - Qiongjuan Zheng
- Econd People's Hospital of Hunan Province(Brain Hospital of Hunan Province), Changsha, China
| | - Yun Zhang
- Northwest Minzu University, Lanzhou, China
| | - Chunyu Liu
- Department of Psychiatry, Department of Neuroscience & Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Xuefei Tian
- School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Xuejun Liu
- Econd People's Hospital of Hunan Province(Brain Hospital of Hunan Province), Changsha, China
| | - Dongxin Wang
- Econd People's Hospital of Hunan Province(Brain Hospital of Hunan Province), Changsha, China.
| | - Jing Ma
- School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, China.
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17
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Farran N. Mental health in Lebanon: Tomorrow's silent epidemic. MENTAL HEALTH & PREVENTION 2021; 24:200218. [PMID: 34660191 PMCID: PMC8503814 DOI: 10.1016/j.mhp.2021.200218] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 09/05/2021] [Indexed: 12/14/2022]
Abstract
Lebanon is a middle-income country that has been recently crippled by several tragedies including the economic collapse, COVID-19, and the fourth of August Beirut port explosion, the world’s most powerful non-nuclear explosion of the twenty-first century. Recent data on mental health from Lebanon is summarised, and other topics such as the psychological impact of cumulative adversities and the role of international support in Lebanon are examined. Data from Lebanon shows severe levels of distress among the people, in a country with minimal resources. Given current adversities in Lebanon, recent data in the country, and the literature on adversity and mental health outcomes of man-made disasters, Lebanon is most likely going to face an epidemic in poor mental health. A call is made for the wider scientific community and international organizations to support the mental health field in the country and help prevent further negative mental health outcomes. Understanding how to better navigate mental health in places with extreme adversity and emergencies can be beneficial to other communities which might face similar challenges.
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Affiliation(s)
- Natali Farran
- Institute of Psychiatry, Psychology, and Neuroscience. King's College London, 16 De Crespigny Park, Camberwell, London SE5 8AB, UK
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18
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Khaled SM, Petcu C, Bader L, Amro I, Al‐Assi M, Le Trung K, Mneimneh ZN, Sampson NA, Kessler RC, Woodruff PW. Conducting a state-of-the-art mental health survey in a traditional setting: Challenges and lessons from piloting the World Mental Health Survey in Qatar. Int J Methods Psychiatr Res 2021; 30:e1885. [PMID: 34224172 PMCID: PMC8412229 DOI: 10.1002/mpr.1885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/03/2021] [Accepted: 06/23/2021] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES A small country in the Arabian Peninsula, Qatar experienced rapid economic growth in the last 3 decades accompanied by major socio-demographic shifts towards a younger and more highly educated population. To date, no national epidemiological study has examined the prevalence, associated factors, or sequelae of mental disorders in Qatar's general population. METHODS The World Mental Health Qatar (WMHQ) is a national mental health needs assessment survey and is the first carried out in collaboration with the World Mental Health Survey initiative to assess the prevalence and burden of psychiatric illnesses among the full Arabic speaking population (nationals and non-nationals) within the same country. RESULTS Standard translation and harmonization procedures were used to develop the WMHQ instrument. A survey quality control system with standard performance indicators was developed to ensure interviewer adherence to standard practices. A pilot study was then carried out just prior to the COVID-19 pandemic. Endorsement from public health authorities and sequential revision of the interview schedule led to full survey completion (as opposed to partial completion) and good overall response rate. CONCLUSIONS The WMHQ survey will provide timely and actionable information based on quality enhancement procedures put in place during the development and piloting of the study.
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Affiliation(s)
- Salma M. Khaled
- Social and Economic Survey Research InstituteQatar UniversityDohaQatar
| | - Catalina Petcu
- Social and Economic Survey Research InstituteQatar UniversityDohaQatar
| | - Lina Bader
- Social and Economic Survey Research InstituteQatar UniversityDohaQatar
| | - Iman Amro
- Social and Economic Survey Research InstituteQatar UniversityDohaQatar
| | - Marwa Al‐Assi
- Social and Economic Survey Research InstituteQatar UniversityDohaQatar
| | - Kien Le Trung
- Social and Economic Survey Research InstituteQatar UniversityDohaQatar
| | - Zeina N. Mneimneh
- Survey Research CenterInstitute for Social ResearchUniversity of MichiganAnn ArborMichiganUSA
| | - Nancy A. Sampson
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
| | - Ronald C. Kessler
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
| | - Peter W. Woodruff
- Department of Neuroscience, Faculty of Medicine Dentistry and HealthThe University of SheffieldSheffieldUK
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19
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Zant MA, Nazzal Z, Qaddoumi L, Abdallah R, Maraqa B, Najjar K. Psychological morbidity among primary health care attendees in Palestine: A study in a stressful environment. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02107-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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20
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Roche GC, Fung P, Ransing R, Noor IM, Shalbafan M, El Hayek S, Koh EBY, Gupta AK, Kudva KG. The state of psychiatric research in the Asia Pacific region. Asia Pac Psychiatry 2021; 13:e12432. [PMID: 33145988 DOI: 10.1111/appy.12432] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 10/10/2020] [Indexed: 12/18/2022]
Abstract
INTRODUCTION This study aims to review recent scientific publications and research output in the field of psychiatry, from a series of countries in the Asia-Pacific region (Australia, India, Indonesia, Iran, Lebanon, Malaysia, and Nepal), with a view to identify themes and similarities across regions, as well as to examine the barriers and challenges in mental health research faced by countries in the region. METHODS Seven psychiatrists from seven countries reviewed recent published and ongoing research in psychiatry in their respective nations, with respect to themes, as well as any barriers or challenges faced by mental health researchers. RESULTS While the seven nations included in this review vary in terms of research capabilities and economic development level, they share many similarities both in terms of research direction, and with regards to challenges faced. Limitations in the form of sociocultural differences from the West, and a lack of funding were some of the barriers identified. DISCUSSION Mental health research in the region has been progressing well. However, more varied research in the form of qualitative or economic studies are lacking, as are multi-center studies. The similar issues that nations face with regards to research could perhaps benefit from collaborative efforts and initiatives for the furtherance of research in the region.
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Affiliation(s)
- Glen Cedric Roche
- Department of Psychological Medicine, Changi General Hospital, Singapore
| | - Paul Fung
- Paramatta Mission, Parramatta, New South Wales, Australia.,Health Education and Training Institute Higher Education, North Paramatta, New South Wales, Australia
| | - Ramdas Ransing
- Department of Psychiatry, BKL Walawalkar Rural Medical College, Ratnagiri, Maharashtra, India
| | - Isa Multazam Noor
- Department of Psychiatry, Dr. Soeharto Heerdjan Mental Hospital, Jakarta, Indonesia
| | - Mohammadreza Shalbafan
- Mental Health Research Center, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Samer El Hayek
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon
| | - Eugene Boon Yau Koh
- Department of Psychiatry, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | | | - Kundadak Ganesh Kudva
- Early Psychosis Intervention Programme and East Region, Institute of Mental Health, Singapore
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21
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Naal H, Whaibeh E, Mahmoud H. Guidelines for primary health care-based telemental health in a low-to middle-income country: the case of Lebanon. Int Rev Psychiatry 2021; 33:170-178. [PMID: 32462955 DOI: 10.1080/09540261.2020.1766867] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Significant efforts have been conducted to improve access to Mental Health Services (MHS) and reduce the burden of Mental Health Disorders (MHD) in Low-to Middle-Income Countries (LMIC). However, important challenges to accessing MHS still exist and limit improvements. Telemental Health (TMH), a modality that delivers remote MHS provides an ideal solution to complement existing efforts; however, there are limited reports on its implementation in developing countries such as Lebanon. This study presents the first roadmap for TMH applicability in Lebanon, with a focus on the Primary Health Care (PHC) setting, which has international relevance. We review existing guidelines and contextualise them to the Lebanese setting by addressing essential components for implementation. In specific, we shed light on 6 aspects: (1) patient population, (2) technological guidelines, (3) clinical guidelines, (4) administrative guidelines, (5) workforce, and (6) monitoring and evaluation. In addition, we acknowledge the important role of governmental efforts in setting the infrastructural and regulatory aspects for TMH practice. We provide guidance for public health professionals, government officials, and clinicians looking to adopt TMH practice in Lebanon or other countries with similar development and cultural landscapes.
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Affiliation(s)
- Hady Naal
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Emile Whaibeh
- Department of Public Health, Faculty of Health Sciences, University of Balamand, Beirut, Lebanon
| | - Hossam Mahmoud
- Department of Psychiatry, Tufts University School of Medicine, Boston, MA, USA
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van 't Hof E, Heim E, Abi Ramia J, Burchert S, Cornelisz I, Cuijpers P, El Chammay R, Harper Shehadeh M, Noun P, Smit F, van Klaveren C, van Ommeren M, Zoghbi E, Carswell K. Evaluating the Effectiveness of an E-Mental Health Intervention for People Living in Lebanon: Protocol for Two Randomized Controlled Trials. JMIR Res Protoc 2021; 10:e21585. [PMID: 33507158 PMCID: PMC7878105 DOI: 10.2196/21585] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/31/2020] [Accepted: 11/10/2020] [Indexed: 12/12/2022] Open
Abstract
Background The lack of availability of evidence-based services for people exposed to adversity globally has led to the development of psychological interventions with features that will likely make them more scalable. The evidence for the efficacy of e-mental health from high-income countries is compelling, and the use of these interventions could be a way to increase the coverage of evidence-based psychological interventions in low- and middle-income countries. Step-by-Step is a brief (5-session) intervention proposed by the World Health Organization as an innovative approach to reducing the suffering and disability associated with depression. Objective This study aims to evaluate the effectiveness and cost-effectiveness of a locally adapted version of Step-by-Step with Syrian nationals (trial 1) and Lebanese nationals and other populations residing in Lebanon (trial 2). Methods This Step-by-Step trial involves 2 parallel, two-armed, randomized controlled trials comparing the e-intervention Step-by-Step to enhanced care as usual in participants with depressive symptoms and impaired functioning. The randomized controlled trials are designed and powered to detect effectiveness in 2 populations: Syrians in Lebanon (n=568) and other people residing in Lebanon (n=568; Lebanese nationals and other populations resident in Lebanon). The primary outcomes are depressive symptomatology (measured with the Patient Health Questionnaire-9) and functioning (measured with the World Health Organization Disability Assessment Scale 2.0). Secondary outcomes include anxiety symptoms, posttraumatic stress disorder symptoms, personalized measures of psychosocial problems, subjective well-being, and economic effectiveness. Participants are mainly recruited through online advertising. Additional outreach methods will be used if required, for example through dissemination of information through partner agencies and organizations. They can access the intervention on a computer, tablet, and mobile phone through a hybrid app. Step-by-Step has 5 sessions, and users are guided by trained nonspecialist “e-helpers” providing phone-based or message-based support for around 15 minutes a week. Results The trials were funded in 2018. The study protocol was last verified June 20, 2019 (WHO ERC.0002797) and registered with ClinicalTrials.gov (NCT03720769). The trials started recruitment as of December 9, 2019, and all data collection was completed in December 2020. Conclusions The Step-by-Step trials will provide evidence about the effectiveness of an e-mental health intervention in Lebanon. If the intervention proves to be effective, this will inform future scale-up of this and similar interventions in Lebanon and in other settings across the world. Trial Registration ClinicalTrials.gov NCT03720769; https://clinicaltrials.gov/ct2/show/NCT03720769 International Registered Report Identifier (IRRID) DERR1-10.2196/21585
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Affiliation(s)
- Edith van 't Hof
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Eva Heim
- Department of Psychology Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland
| | - Jinane Abi Ramia
- National Mental Health Programme, Ministry of Public Health of Lebanon, Beirut, Lebanon
| | - Sebastian Burchert
- Department of Education and Psychology, Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Ilja Cornelisz
- Department of Educational and Family Studies, Amsterdam Center for Learning Analytics, Vrije Universiteit, Amsterdam, Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
| | - Rabih El Chammay
- National Mental Health Programme, Ministry of Public Health of Lebanon, Beirut, Lebanon
| | - Melissa Harper Shehadeh
- Department of Digital Health and Innovations, World Health Organization, Geneva, Switzerland
| | - Philip Noun
- National Mental Health Programme, Ministry of Public Health of Lebanon, Beirut, Lebanon
| | - Filip Smit
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
| | - Chris van Klaveren
- Department of Educational and Family Studies, Amsterdam Center for Learning Analytics, Vrije Universiteit, Amsterdam, Netherlands
| | - Mark van Ommeren
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Edwina Zoghbi
- Country Office for Lebanon, World Health Organization, Beirut, Lebanon
| | - Kenneth Carswell
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
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Naal H, Mahmoud H, Whaibeh E. The potential of telemental health in improving access to mental health services in Lebanon: Analysis of barriers, opportunities, and recommendations. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2020. [DOI: 10.1080/00207411.2020.1863743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Hady Naal
- Global Health Institute, American University of Beirut, Beirut, Lebanon
| | - Hossam Mahmoud
- Cambia Health Solutions, Tufts University School of Medicine, Boston, MA, USA
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24
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Mental health literacy of the Lebanese population (MHeLLP): a cross-sectional study. JOURNAL OF PUBLIC MENTAL HEALTH 2020. [DOI: 10.1108/jpmh-04-2020-0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This study primarily aims to evaluate the mental health literacy (MHL) of the Lebanese adult population in an attempt to yield results that can help fill the gap in the literature and support the development of new strategies to counter mental health stigma.
Design/methodology/approach
A cross-sectional survey was composed of the Mental Health Knowledge Schedule and select questions from the Community Attitudes toward the Mentally Ill and MHL Scale. The surveys were collected from a representative population of sample size (n = 386) among the different governorates of Lebanon. The participants, aged 18–65 years and literate, were recruited between July 2018 and September 2018 from supermarkets widely distributed across the country.
Findings
The results showed that the Lebanese population possesses average knowledge and certain stigmatizing attitudes toward mental illnesses. Curricular education and awareness campaigns may help refine the image of mental illness among the population.
Originality/value
To the best of the authors’ knowledge, this paper is one of the first in Lebanon to assess the MHL of its population as a whole. It gives insight into the common misconceptions about mental illness and patterns of the related stigma that are prevalent in the Lebanese society today.
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Abstract
Lebanon is a medium-income country in the Eastern Mediterranean which has seen a surge in interest in mental health over the past two decades following years of stagnation. The mental health needs of the country at primary care level and for severe psychiatric disorders are underserved. Political instability, chronic underfunding and widespread stigma have all contributed to maintaining a traditional model of private clinics affiliated with inpatient and long-stay psychiatric units. A number of initiatives have recently been launched to cater for patients with psychotic disorders and also to offer partial hospitalization for others with mood-related conditions. In parallel, the Ministry of Public Health,with international funding, has been instrumental in its efforts to standardize care at a national level, particularly for early detection and treatment in primary care settings. The priorities of the national mental health programme are consistent with the global trend in shifting services to the community. Hurdles remain, in line with those facing countries with similar socio-demographics and resources. These include limited third-party coverage of mental health,absence of training opportunities in multidisciplinary community settings and some clinicians' reluctance to update their ways of working. Development of a local workforce, familiar with evidence-based models of care and dedicated to providing a patient-centred approach in the least restrictive settings, is essential for consolidating community carein Lebanon. This would be reinforced by (overdue) legislation and implementation of a mental health law.
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Affiliation(s)
- Joseph El-Khoury
- Department of Psychiatry, American University of Beirut Medical Center
| | - Riwa Haidar
- Department of Psychiatry, American University of Beirut Medical Center
| | - Raghid Charara
- Department of Psychiatry, American University of Beirut Medical Center
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26
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Al‐Subaie AS, Altwaijri YA, Al‐Habeeb A, Bilal L, Almeharish A, Sampson NA, Liu H, Kessler RC. Lifetime treatment of DSM-IV mental disorders in the Saudi National Mental Health Survey. Int J Methods Psychiatr Res 2020; 29:e1837. [PMID: 32529763 PMCID: PMC7507506 DOI: 10.1002/mpr.1837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 05/06/2020] [Accepted: 05/11/2020] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES To estimate lifetime treatment rates of mental disorders in the Saudi National Mental Health Survey (SNMHS). METHODS The SNMHS is a face-to-face community epidemiological survey in a nationally representative household sample of citizens ages 15-65 in the Kingdom of Saudi Arabia (KSA) (n = 4,004). The World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) was used to produce estimates of lifetime prevalence and treatment of common DSM-IV mental disorders. RESULTS Lifetime treatment ranged from 52.2% for generalized anxiety disorder to 20.3% for attention deficit/hyperactivity disorder, had a median (interquartile range) of 35.5% (30.6-39.5%) across disorders, and was 28.3% for people with any lifetime DSM-IV/CIDI disorder. Half (49.0%) of patients received treatment in the mental health specialty sector, 35.9% in the general medical sector, 35.2% in the human services sector, and 15.7% in the complementary-alternative medical sector. Median (interquartile range) delays in help-seeking after disorder onset among respondents who already sought treatment were 8 (3-15) years. Odds of seeking treatment are positively related to age-of-onset and comorbidity. CONCLUSIONS Unmet need for treatment of lifetime mental disorders is a major problem in KSA. Interventions to ensure prompt help-seeking are needed to reduce the burdens and hazards of untreated mental disorders.
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Affiliation(s)
- Abdullah S. Al‐Subaie
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of MedicineKing Saud UniversityRiyadhSaudi Arabia
- Edrak Medical CenterRiyadhSaudi Arabia
| | - Yasmin A. Altwaijri
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of MedicineKing Saud UniversityRiyadhSaudi Arabia
- King Salman Center for Disability ResearchRiyadhSaudi Arabia
- Biostatistics, Epidemiology and Scientific Computing DepartmentKing Faisal Specialist Hospital and Research CentreRiyadhSaudi Arabia
| | | | - Lisa Bilal
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of MedicineKing Saud UniversityRiyadhSaudi Arabia
- King Salman Center for Disability ResearchRiyadhSaudi Arabia
- Biostatistics, Epidemiology and Scientific Computing DepartmentKing Faisal Specialist Hospital and Research CentreRiyadhSaudi Arabia
| | - Amani Almeharish
- Biostatistics, Epidemiology and Scientific Computing DepartmentKing Faisal Specialist Hospital and Research CentreRiyadhSaudi Arabia
| | - Nancy A. Sampson
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
| | - Howard Liu
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
| | - Ronald C. Kessler
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
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27
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Al Laham D, Ali E, Mousally K, Nahas N, Alameddine A, Venables E. Perceptions and Health-Seeking Behaviour for Mental Illness Among Syrian Refugees and Lebanese Community Members in Wadi Khaled, North Lebanon: A Qualitative Study. Community Ment Health J 2020; 56:875-884. [PMID: 31965411 PMCID: PMC7250961 DOI: 10.1007/s10597-020-00551-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 01/10/2020] [Indexed: 02/06/2023]
Abstract
This is a qualitative exploration of the perceptions of mental health (MH) and their influence on health-seeking behaviour among Syrian refugees and the Lebanese population in Wadi Khaled, a rural area of Lebanon bordering Syria. Eight focus group discussions and eight key informant interviews were conducted with male and female Syrian refugees and Lebanese community members from March to April 2018. MH illness was associated with stigma, shame and fear among both populations. Beliefs surrounding mental illness were strongly linked to religious beliefs, including Jinn. Religious healers were considered the first line of help for people with mental illnesses, and were perceived as culturally acceptable and less stigmatizing than MH professionals. It is essential for MH professionals to build trust with the communities in which they work. Collaboration with religious healers is key to identifying MH symptoms and creating referral pathways to MH professionals in this context.
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Affiliation(s)
- Dana Al Laham
- Médecins Sans Frontières, Operational Centre Brussels, Lebanon-Beirut-Metn-Awkar, Lebanon Mission, Beirut, Lebanon.
| | - Engy Ali
- Médecins Sans Frontières, Operational Centre Brussels, Luxembourg Operational Research Unit (LuxOR), Luxembourg, Luxembourg
| | - Krystel Mousally
- Médecins Sans Frontières, Operational Centre Brussels, Lebanon Branch Office, Beirut, Lebanon
| | - Nayla Nahas
- Department of Psychology, Balamand University, Tripoli, Lebanon
| | | | - Emilie Venables
- Médecins Sans Frontières, Operational Centre Brussels, Luxembourg Operational Research Unit (LuxOR), Luxembourg, Luxembourg
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28
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da Silva AG, Baldaçara L, Cavalcante DA, Fasanella NA, Palha AP. The Impact of Mental Illness Stigma on Psychiatric Emergencies. Front Psychiatry 2020; 11:573. [PMID: 32636773 PMCID: PMC7319091 DOI: 10.3389/fpsyt.2020.00573] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 06/03/2020] [Indexed: 01/06/2023] Open
Abstract
Psychiatric emergencies are severe behavioral changes secondary to worsening mental illness. Such situations present a risk to the patient and other people, so they need immediate therapeutic intervention. They are associated with feelings of fear, anger, prejudice, and even exclusion. The attitudes of professionals and factors related to the workplace culture in health can help to perpetuate stereotypes and interfere with the quality of care. Stigma has undesirable consequences in patients with mental disorders. Certain measures can reduce stigma and provide a more dignified way for patients to recover from the crisis. This article aims to discuss the causes of stigma, ways of dealing with it, and achievements that have been made in psychiatric emergency care settings.
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Affiliation(s)
- Antônio Geraldo da Silva
- Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,Associação Brasileira de Psiquiatria, Rio de Janeiro, Brazil.,Asociación Psiquiátrica de América Latina
| | - Leonardo Baldaçara
- Associação Brasileira de Psiquiatria, Rio de Janeiro, Brazil.,Asociación Psiquiátrica de América Latina.,Medicine, Universidade Federal do Tocantins, Palmas, Brazil
| | - Daniel A Cavalcante
- Department of Psychiatry, Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,GAPi (Early Psychosis Group), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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29
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Maalouf FT, Alamiri B, Atweh S, Becker AE, Cheour M, Darwish H, Ghandour LA, Ghuloum S, Hamze M, Karam E, Khoury B, Khoury SJ, Mokdad A, Meho LI, Okasha T, Reed GM, Sbaity E, Zeinoun P, Akl EA. Mental health research in the Arab region: challenges and call for action. Lancet Psychiatry 2019; 6:961-966. [PMID: 31327707 DOI: 10.1016/s2215-0366(19)30124-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 03/19/2019] [Accepted: 03/20/2019] [Indexed: 12/16/2022]
Abstract
Although mental disorders are a leading cause of disability in the Arab region, which includes 5·54% of the global population, Arab countries produce only 1·0% of the global output of peer-reviewed publications in mental health research. Various stakeholders, including Arab mental health researchers, institutional and funding agency officials, and international research collaborators, convened to identify challenges faced by Arab mental health researchers and propose an evidence-informed call for action. Challenges identified include prevalent stigma and low awareness, conflict and war, scarce institutional and funding resources, inadequate publishing opportunities, insufficient training in mental health research, and shortage of reliable and valid assessment tools. The proposed action plan includes ways of addressing stigma and spreading awareness, increasing collaborative efforts, building research infrastructure, strengthening the mental health workforce, and translating research findings into a call to action on societal and governmental levels. The proposed action plan could provide a roadmap for Arab mental health researchers and research institutions, which might ultimately increase research productivity in the Arab region and close the gap between Arab countries and the rest of the world.
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Affiliation(s)
- Fadi T Maalouf
- Division of Child and Adolescent Psychiatry, American University of Beirut, Beirut, Lebanon
| | - Bibi Alamiri
- Al-Manara, Kuwait Center for Mental Health, Kuwait
| | - Samir Atweh
- Department of Neurology, American University of Beirut, Beirut, Lebanon
| | - Anne E Becker
- Department of Global Health and Social Medicine, Harvard Medical School Cambridge, MA, USA
| | - Majda Cheour
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
| | - Hala Darwish
- Hariri School of Nursing, Abu-Haidar Neuroscience Institute, American University of Beirut, Beirut, Lebanon
| | - Lilian A Ghandour
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Suhaila Ghuloum
- Hamad Medical Corporation, Weill Cornell Medicine, Doha, Qatar
| | - Mouin Hamze
- National Council for Scientific Research, Beirut, Lebanon
| | - Elie Karam
- Department of Psychiatry and Clinical Psychology, St Georges Hospital University Medical Center, Beirut, Lebanon
| | - Brigitte Khoury
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon
| | - Samia J Khoury
- Hariri School of Nursing, Abu-Haidar Neuroscience Institute, American University of Beirut, Beirut, Lebanon; Department of Neurology, American University of Beirut, Beirut, Lebanon
| | - Ali Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Lokman I Meho
- University Libraries, American University of Beirut, Beirut, Lebanon
| | - Tarek Okasha
- Institute of Psychiatry, Ain Shams University, Cairo, Egypt
| | - Geoffrey M Reed
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Eman Sbaity
- Department of Surgery, American University of Beirut, Beirut, Lebanon
| | - Pia Zeinoun
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon; Department of Psychology, American University of Beirut, Beirut, Lebanon
| | - Elie A Akl
- Department of Internal Medicine, American University of Beirut Medical Center, Riad-El-Solh, Beirut, Lebanon.
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