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Anum A, Washington-Nortey M, Dzokoto V. Strategic planning in LAMIC mental health research: A Ghana case study. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2020. [DOI: 10.1080/00207411.2020.1719621] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Adote Anum
- Department of Psychology, University of Ghana, Accra, Ghana
| | | | - Vivian Dzokoto
- Department of African American Studies, Virginia Commonwealth University, Richmond, Virginia, USA
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Deborah TD, Anthony EK, Badu E, Amy BA, Gyamfi N, Josephine AN, Opoku MP. The burden of caregiving among mental health nurses providing services to consumers with depression in Ghana. Perspect Psychiatr Care 2020; 56:72-80. [PMID: 30920680 DOI: 10.1111/ppc.12377] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 02/05/2019] [Accepted: 03/10/2019] [Indexed: 01/27/2023] Open
Abstract
PURPOSE The study aims to explore the burden of caregiving among mental health nurses providing services to consumers with depression in Ghana. DESIGN AND METHODS Interpretative phenomenological design and qualitative data FINDINGS: The study shows that several health system constraints and individual factors contribute to the burden of caregiving among mental health nurses. Health system challenges are the poor state of the psychiatric facility, while individual factors are stigmatizing attitudes, nonadherence to medication instructions, limited family support, and physical and verbal abuse. The coping strategies used by mental health nurses are self-motivation, emotional boundaries, and the perceived clinical outcomes of treatment. PRACTICE IMPLICATIONS Clinical policies, procedures, and health facility practices should adequately address caregiving challenges, to facilitate effective mental health services.
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Affiliation(s)
- Tetteh Dela Deborah
- Department of Health Promotion and Disability Studies, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Edusei Kwaku Anthony
- Department of Health Promotion and Disability Studies, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eric Badu
- School of Nursing and Midwifery, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Budu-Ainooson Amy
- Department of Health Promotion and Disability Studies, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Naomi Gyamfi
- Department of Health Promotion and Disability Studies, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Adusei-Nkrumah Josephine
- Department of Health Promotion and Disability Studies, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Badu E, Mitchell R, O'Brien AP. Pathways to mental health treatment in Ghana: Challenging biomedical methods from herbal- and faith-healing perspectives. Int J Soc Psychiatry 2019; 65:527-538. [PMID: 31277557 DOI: 10.1177/0020764019862305] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The clinical pathways for treating mental illness have received global attention. Several empirical studies have been undertaken on treatment pathways in Ghana. No study, however, has systematically reviewed the literature related to the pathways of mental health treatment in Ghana. AIM This article aims to identify the pathways used to treat mental illnesses; examine the evidence about the possibility of collaboration between biomedical, faith and traditional healing pathways; and draw attention to the barriers hindering such collaboration. METHODS A search of the published literature was conducted using Medline, Embase, PsycINFO, CINAHL (EBSCO), Web of Science and Scopus databases. The search was limited to the articles that were published in English and released between 2000 and June 2018. The review synthesises both qualitative and quantitative data. RESULTS The findings showed that mental illnesses in Ghana are treated using a mixture of biomedical and faith-based and traditional healing services. Faith and traditional healing pathways are typically used as a preliminary source of cultural assessment before seeking biomedical treatment. There is an increasing desire for collaboration between biomedical, faith and traditional healing pathways. However, several individual factors (attitude or stigma, the perceived efficacy of treatment and differences in the treatment process) and health system factors (a lack of policy and regulation, a limited number of biomedical service providers, limited financial support and geographical isolation of services) jointly contribute to barriers precluding establishing such collaboration. CONCLUSION This review recommends that policies, regulations, educational support and financial incentives should be developed to facilitate collaboration between biomedical, faith and traditional healing service provision.
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Affiliation(s)
- Eric Badu
- 1 School of Nursing and Midwifery, The University of Newcastle, Callaghan, NSW, Australia
| | - Rebecca Mitchell
- 2 Faculty of Business and Economics, Macquarie University, Sydney, NSW, Australia
| | - Anthony Paul O'Brien
- 3 Faculty of Health and Medicine, School of Nursing and Midwifery, The University of Newcastle, Callaghan, NSW, Australia
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Nartey AK, Badu E, Agyei-Baffour P, Gyamfi N, Opoku MP, O'Brien AP, Mitchell R. The predictors of treatment pathways to mental health services among consumers in Ghana. Perspect Psychiatr Care 2019; 55:300-310. [PMID: 30648278 DOI: 10.1111/ppc.12350] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 11/29/2018] [Accepted: 12/24/2018] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To explore factors influencing treatment pathways to mental health services among consumers in Ghana. DESIGN AND METHODS Cross-sectional design using quantitative method. FINDINGS Treatment pathways for mental illness were general hospitals/clinics, psychiatric hospitals, and faith-based practices. The predisposing (age, household size, primary occupation, ethnicity, marital status, religion, and geographic location, as well as attitudes and beliefs), enabling (affordability), and need factors (severity of mental illness) were significant predictors of treatment pathways. PRACTICE IMPLICATIONS Current advocacy and awareness for mental health services in Ghana should consider the predisposing, enabling, and need factors of consumers. Policy initiatives on mental health services should ensure adequate financing mechanisms and further establish collaboration between biomedical and faith-based services.
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Affiliation(s)
- Anna Korley Nartey
- Techiman Municipal Health Directorate/Ghana Health Services, Techiman, Ghana
| | - Eric Badu
- Faculty of Health and Medicine, School of Nursing and Midwifery, The University of Newcastle, Callaghan, Australia
| | - Peter Agyei-Baffour
- Department of Health Policy, Management and Economics/School of Public Health, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Naomi Gyamfi
- Department of Health Promotion and Disability Studies, Centre for Disability and Rehabilitation Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | | | - Rebecca Mitchell
- Faculty of Business and Economics, Macquarie University, Sydney, Australia
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Badu E, O’Brien AP, Mitchell R. An integrative review of potential enablers and barriers to accessing mental health services in Ghana. Health Res Policy Syst 2018; 16:110. [PMID: 30445980 PMCID: PMC6240297 DOI: 10.1186/s12961-018-0382-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 10/14/2018] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION The importance of accessible mental health treatment is a global concern, particularly when one in five people will experience a mental health problem in their lifespan. This is no less important in Ghana; however, no studies have yet attempted to appraise and synthesise the potential enablers and barriers to accessing services in Ghana. The aim of this integrative review is therefore to identify and synthesise existing evidence on the barriers and enablers to accessing mental health services in Ghana. METHODS A search of the published literature was conducted using Medline, EMBASE, PsycINFO, CINAHL (EBSCO), Web of Science, and Scopus electronic databases. The search was limited to papers published in English and within 2000-2018. Using pre-defined inclusion and exclusion criteria, two reviewers independently screened the titles and abstracts of the retrieved papers. A data extraction form and a Critical Appraisal Checklist were used to extract and appraise data, respectively. The integrative review incorporates both qualitative and quantitative data into a single synthesis. RESULTS Out of 42 papers that met the inclusion criteria, 50% used qualitative methods, 33.3% used mixed methods and 16.7% used quantitative methods alone. The potential barriers in accessing mental health services were attitudinal, knowledge about services, treatment cost, transportation and geographical proximity, as well as perceived efficacy of medication. Similarly, the health systems factors contributing to barriers were low priority, limited funding sources, irregular medicine supply, limited services for marginalised groups and poor state of psychiatric facilities, together with poor management of mental health cadres. The potential enablers for service users involved increased decentralisation and integration, task-shifting and existing support services. CONCLUSION The existing evidence on mental health in Ghana is skewed towards weaknesses in the systems and stigma, with rationally little, or no, evidence or emphasis on the effectiveness, or quality of mental health services. These attributes largely neglect the provision of psychiatric services for marginalised mental health service user groups, including children, adolescents, people with disabilities and the elderly.
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Affiliation(s)
- Eric Badu
- Faculty of Health and Medicine, School of Nursing and Midwifery, The University of Newcastle, Newcastle, NSW Australia
| | - Anthony Paul O’Brien
- Faculty Health and Medicine, School of Nursing and Midwifery, The University of Newcastle, Newcastle, 2308 NSW Australia
| | - Rebecca Mitchell
- Health Services Research Centre, Faculty of Business and Economics, The University of Newcastle, Newcastle, NSW Australia
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Wei YY, Lin WF, Zhang TH, Tang YX, Wang JJ, Zhong MF. Effectiveness of Traditional Chinese Medicineas as an Adjunct Therapy for Refractory Schizophrenia: A Systematic Review and Meta Analysis. Sci Rep 2018; 8:6230. [PMID: 29670200 PMCID: PMC5906629 DOI: 10.1038/s41598-018-24547-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 04/04/2018] [Indexed: 11/08/2022] Open
Abstract
Although recent studies focused on traditional Chinese medicine (TCM) for the treatment of refractory schizophrenia have reported that it may be beneficial, there is still lack of convincing evidence and critical meta-analytic work regarding its effectiveness as an adjunctive therapy. Therefore, we performed a meta-analysis to investigate the effectiveness of TCM in combination with antipsychotics for refractory schizophrenia. Fourteen articles involving 1725 patients published as of December 2016 were included which compared antipsychotic therapies to either TCM alone, or TCM as an adjunctive therapy. TCM was observed to have beneficial effects on aspects of the Positive and Negative Syndrome Scale (PANSS) including total score changes and negative score changes, as well as clinical effects estimated with PANSS or the Brief Psychiatric Rating Scale (BPRS). The changes in extrapyramidal side effects (RSESE) scores from baseline to the end of the treatment period were similar in two groups of related trials. TCM was also reported to mitigate some anti-psychotic related side-effects and overall, TCM adjuvant therapy was generally safe and well tolerated. While, the results indicated the potential utility of TCM as an alternative adjunctive therapeutic for refractory schizophrenia treatment, there remains a need for further high-quality studies.
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Affiliation(s)
- Yan-Yan Wei
- Department of EEG Source Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, P. R. China
| | - Wan-Fu Lin
- Department of Traditional Chinese Medicine, Changhai Hospital, Second Military Medical University, Shanghai, 200433, P. R. China
| | - Tian-Hong Zhang
- Department of EEG Source Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, P. R. China
| | - Yun-Xiang Tang
- Department of medical psychology, Faculty of Mental Health, Second Military Medical University, Shanghai, 200433, P. R. China
| | - Ji-Jun Wang
- Department of EEG Source Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, P. R. China.
| | - Mao-Feng Zhong
- Graduate School of Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, P.R. China.
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Christmals CD, Gross J, Aziato L, Armstrong SJ. The State of Nursing Research in Ghana: An Integrative Literature Review. SAGE Open Nurs 2018; 4:2377960818783820. [PMID: 33415196 PMCID: PMC7774359 DOI: 10.1177/2377960818783820] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 03/10/2018] [Accepted: 04/07/2018] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION For nursing practice to be responsive to the needs of patients, it must be driven by contextual research evidence. To guide institutional and national nursing research policy, there is need to determine the quantity and quality of nursing research in Ghana. PURPOSE The purpose of this integrative literature review was to quantify, critically evaluate, and describe nursing research publication in Ghana from January 2007 to December 2016 with regard to the country's research capacity to sustain evidence-based practice. RESULTS Sixty (60) out of 749 articles identified from EBSCOhost, ProQuest, PubMed, Science Direct, Scopus, Wiley Online Library, and Google Scholar using three keywords (nursing, health, and Ghana) were included. A total of 60,778 human subjects were used in these studies. There were more quantitative (28) studies than qualitative (23) studies. These studies recorded 219 authors from 120 institutions, 55 of which were outside Ghana. Forty-five percent of the articles were published in journals with impact factor. There was a steady increase in publication in Ghana over the decade. A majority of the studies published in education were in curriculum implementation and evaluation. CONCLUSIONS The increasing number of peer-reviewed nursing research publications in Ghana and the curriculum implementation and evaluation in Ghana signified an increasing capacity of the country to implement and sustain evidence-based practice. RECOMMENDATIONS It is recommended that regular research be conducted to evaluate the responsiveness to old and new nursing programs in Ghana.
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Affiliation(s)
- Christmal D. Christmals
- Centre for Health Policy, School of Public Health, University of Witwatersrand, Johannesburg, South Africa
- Department of Nursing Education, School of Therapeutic Sciences, University of Witwatersrand, Johannesburg South Africa
| | - Janet Gross
- Morehead State University, KY, USA
- Global Health Services Partnership, US Peace Corps, Liberia
| | - Lydia Aziato
- Department of Adult Health, School of Nursing and Midwifery, University of Ghana, Accra, Ghana
| | - Susan J. Armstrong
- Centre for Health Policy, School of Public Health, University of Witwatersrand, Johannesburg, South Africa
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Kidia K, Machando D, Mangezi W, Hendler R, Crooks M, Abas M, Chibanda D, Thornicroft G, Semrau M, Jack H. Mental health in Zimbabwe: a health systems analysis. Lancet Psychiatry 2017. [PMID: 28625876 DOI: 10.1016/s2215-0366(17)30128-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
There has been little external analysis of Zimbabwe's mental health system. We did a systems analysis to identify bottlenecks and opportunities for mental health service improvement in Zimbabwe and to generate cost-effective, policy-relevant solutions. We combined in-depth interviews with a range of key stakeholders in health and mental health, analysis of mental health laws and policies, and publicly available data about mental health. Five themes are key to mental health service delivery in Zimbabwe: policy and law; financing and resources; criminal justice; workforce, training, and research; and beliefs about mental illness. We identified human resources, rehabilitation facilities, psychotropic medication, and community mental health as funding priorities. Moreover, we found that researchers should prioritise measuring the economic impact of mental health and exploring substance use, forensic care, and mental health integration. Our study highlights forensic services as a central component of the mental health system, which has been a neglected concept. We also describe a tailored process for mental health systems that is transferable to other low-income settings and that garners political will, builds capacity, and raises the profile of mental health.
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Affiliation(s)
- Khameer Kidia
- Kushinga, Harare, Zimbabwe; Arnhold Institute for Global Health, Icahn School of Medicine, New York, NY, USA.
| | | | - Walter Mangezi
- Department of Psychiatry, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - Reuben Hendler
- Kushinga, Harare, Zimbabwe; Arnhold Institute for Global Health, Icahn School of Medicine, New York, NY, USA
| | - Megan Crooks
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Melanie Abas
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Dixon Chibanda
- Department of Psychiatry, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - Graham Thornicroft
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Maya Semrau
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Helen Jack
- Kushinga, Harare, Zimbabwe; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Harvard Medical School, Boston, MA, USA
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