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Oswald TK, Nguyen MT, Mirza L, Lund C, Jones HG, Crowley G, Aslanyan D, Dean K, Schofield P, Hotopf M, Das-Munshi J. Interventions targeting social determinants of mental disorders and the Sustainable Development Goals: a systematic review of reviews. Psychol Med 2024; 54:1475-1499. [PMID: 38523245 DOI: 10.1017/s0033291724000333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
Globally, mental disorders account for almost 20% of disease burden and there is growing evidence that mental disorders are socially determined. Tackling the United Nations Sustainable Development Goals (UN SDGs), which address social determinants of mental disorders, may be an effective way to reduce the global burden of mental disorders. We conducted a systematic review of reviews to examine the evidence base for interventions that map onto the UN SDGs and seek to improve mental health through targeting known social determinants of mental disorders. We included 101 reviews in the final review, covering demographic, economic, environmental events, neighborhood, and sociocultural domains. This review presents interventions with the strongest evidence base for the prevention of mental disorders and highlights synergies where addressing the UN SDGs can be beneficial for mental health.
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Affiliation(s)
- Tassia Kate Oswald
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Minh Thu Nguyen
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Luwaiza Mirza
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
- University Hospitals Sussex, UK
| | - Crick Lund
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Hannah Grace Jones
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Grace Crowley
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Daron Aslanyan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Kimberlie Dean
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
- Justice Health and Forensic Mental Health Network, New South Wales, Australia
| | - Peter Schofield
- School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King's College London, UK
| | - Matthew Hotopf
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Jayati Das-Munshi
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
- ESRC Centre for Society and Mental Health, King's College London, UK
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Lotzin A, Franc de Pommereau A, Laskowsky I. Promoting Recovery from Disasters, Pandemics, and Trauma: A Systematic Review of Brief Psychological Interventions to Reduce Distress in Adults, Children, and Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5339. [PMID: 37047954 PMCID: PMC10094700 DOI: 10.3390/ijerph20075339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 02/28/2023] [Accepted: 03/09/2023] [Indexed: 06/19/2023]
Abstract
A substantial number of survivors of disasters, pandemics, and other severe stressors develop persistent distress that impairs mental health and well-being. However, only a few brief psychological interventions target distress or subclinical symptoms. This systematic review aimed to identify and describe brief psychological interventions to reduce distress or subclinical symptoms in survivors of disasters, pandemics, and other severe stressors. Based on a systematic literature search (MEDLINE, PsycINFO, PSYNDEX, PTSDpubs, and Web of Science), we reviewed published studies and study protocols on self-help, psychosocial support, or brief psychotherapeutic interventions to reduce distress and/or subclinical symptoms following natural hazards and man-made disasters, pandemics, or other traumatic events. We included 27 published studies or study protocols (n = 15 RCTs, n = 3 controlled pre-post studies, and n = 9 uncontrolled pre-post studies) describing 22 interventions. We found evidence for reducing psychological distress and/or subclinical symptoms in 9 out of 15 RCTs, 2 out of 3 controlled pre-post studies, and 9 out of 9 uncontrolled pre-post studies. One RCT provided evidence of increasing well-being. Innovative brief interventions have been developed to reduce distress and/or subclinical symptoms that have an emerging evidence base.
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Affiliation(s)
- Annett Lotzin
- Institute for Clinical Psychology and Psychotherapy, Department of Psychology, MSH Medical School Hamburg, 20457 Hamburg, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Alicia Franc de Pommereau
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Isabelle Laskowsky
- Institute for Clinical Psychology and Psychotherapy, Department of Psychology, MSH Medical School Hamburg, 20457 Hamburg, Germany
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Peng M, Xiao T, Carter B, Chen P, Shearer J. Effectiveness and Cost-Effectiveness of Mental Health Interventions Delivered by Frontline Health Care Workers in Emergency Health Services: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15847. [PMID: 36497923 PMCID: PMC9736335 DOI: 10.3390/ijerph192315847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/03/2022] [Accepted: 11/15/2022] [Indexed: 06/17/2023]
Abstract
This systematic review is to evaluate the effectiveness and cost-effectiveness of mental health interventions delivered by frontline health care workers in disasters and public health emergencies. Six databases and trial registries were searched, and manual searches were conducted. Of the 221 studies identified, 21 were included. Meta-analyses assessed differences between the intervention and control in terms of PTSD outcomes. Eleven studies of 1802 participants were incorporated in the meta-analysis. Interventions delivered or prompted by specialist health care workers showed significant and large effects in improving PTSD-related symptoms with a SMD = 0.99 (95% CI: 0.42-1.57, p = 0.0007). Interventions delivered or prompted by frontline non-specialist health care workers showed significant but small effects in improving PTSD-related symptoms with SMD of 0.25 (95% CI: 0.11-0.39; p = 0.0007). The results showed that most mental health interventions delivered by frontline health care workers effectively supported affected people. Mental health interventions delivered by mental health care professionals are effective in reducing PTSD-related disorders in natural disasters. Future adequately powered RCTs are needed to evaluate the effectiveness of mental health interventions delivered by trained non-specialists. Economic modelling may be useful to estimate cost effectiveness in low- and middle-income countries given the difficulties of conducting studies in disaster and emergency settings.
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Affiliation(s)
- Min Peng
- King’s Health Economics, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Tao Xiao
- Department of Emergency Response and Preparedness, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- Psychological Rescue Branch, China Association for Disaster and Emergency Rescue Medicine, Haidian District, Beijing 100080, China
| | - Ben Carter
- Department of Biostatistics and Health informatics, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
| | - Pan Chen
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410011, China
| | - James Shearer
- King’s Health Economics, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
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Ryan GK, Bauer A, Endale T, Qureshi O, Doukani A, Cerga-Pashoja A, Brar SK, Eaton J, Bass JK. Lay-delivered talk therapies for adults affected by humanitarian crises in low- and middle-income countries. Confl Health 2021; 15:30. [PMID: 33892755 PMCID: PMC8062937 DOI: 10.1186/s13031-021-00363-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 04/01/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Published by the World Health Organization (WHO) and United Nations High Commissioner for Refugees (UNHCR) in 2015, the mental health Gap Action Programme Humanitarian Intervention Guide (mhGAP-HIG) recommends brief versions of structured psychological interventions for people experiencing symptoms of common mental disorders (CMDs). mhGAP-HIG acknowledges a growing body of evidence suggesting these interventions can be delivered by lay workers to people affected by humanitarian crises in low- and middle-income countries (LMICs). However, there has not yet been a systematic review and synthesis of this evidence. This paper reports the results of a systematic review of qualitative, quantitative, and mixed-methods studies assessing the implementation and/or effectiveness of talk therapies for CMDs when provided by lay workers in LMICs to adults who have survived or are currently living in humanitarian situations. METHODS Seven electronic databases were searched: MEDLINE, Embase, PsycINFO, PsycEXTRA, Global Health, Cochrane Library, and ClinicalTrials.gov . We also hand-searched the contents pages of three academic journals, reference lists of 30 systematic reviews, and online resource directories of two mental health networks. A preliminary list of included studies was circulated to topical experts for review, and all included studies were backward and forward searched. All titles, abstracts, and full-texts were independently double-screened. Quality appraisal and data extraction were carried out by a single reviewer and checked by a second reviewer, using standardised tools. Any disagreements were discussed and referred to a third reviewer as needed. RESULTS We identified 23 unique studies and carried out a narrative synthesis of patient and implementation outcome data. Every evaluation of the effectiveness of lay-delivered talk therapies for adults affected by humanitarian crises in LMICs showed some treatment effect for at least one CMD, and often multiple CMDs. Implementation research generally found these interventions to be acceptable, appropriate and feasible to implement, with good fidelity to manualised therapies. CONCLUSION Although results are promising, particularly for individually-delivered talk therapies based on cognitive behavioural therapy techniques, there is a high degree of heterogeneity in this literature. We make several recommendations on how to improve the quality and generalisability of research on this topic, to facilitate further evidence synthesis. TRIAL REGISTRATION PROSPERO registration number: CRD42017058287 .
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Affiliation(s)
- Grace K Ryan
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK. .,Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, Office 142A, Keppel Street, London, WC1E 7HT, UK.
| | - Andreas Bauer
- Department of Psychology, University of Bath, Bath, UK
| | - Tarik Endale
- Department of Counseling and Clinical Psychology, Teachers College of Columbia University, New York City, New York, USA
| | - Onaiza Qureshi
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.,Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, Office 142A, Keppel Street, London, WC1E 7HT, UK
| | - Asmae Doukani
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.,Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, Office 142A, Keppel Street, London, WC1E 7HT, UK
| | - Arlinda Cerga-Pashoja
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.,Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, Office 142A, Keppel Street, London, WC1E 7HT, UK.,Global Health Training, Public Health England, London, UK
| | - Savvy K Brar
- Division of Data, Analytics, Planning and Monitoring, UNICEF, New York City, New York, USA
| | - Julian Eaton
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.,Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, Office 142A, Keppel Street, London, WC1E 7HT, UK.,Mental Health, CBM Global, Laudenbach, Germany
| | - Judith K Bass
- Department of Mental Health, Johns Hopkins University, Baltimore, MD, USA.,Center for Humanitarian Health, Johns Hopkins University, Baltimore, MD, USA
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Kansaki H, Konno R, Fujii K, Nishimura A. Nurses' experience in providing care at shelters following natural hazards and disasters: a qualitative systematic review protocol. JBI Evid Synth 2020; 18:1070-1076. [PMID: 32813361 DOI: 10.11124/jbisrir-d-19-00271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The review will synthesize current evidence regarding the experiences of nurses who care for people living in shelters following natural hazards and disasters. INTRODUCTION Over the last decade, due to climate change and global warming, the damage caused by natural hazards and disasters like hurricanes, floods and heavy rainfall has been steadily growing. Following natural hazards and disasters, many who lose their homes reside in evacuation shelters for prolonged periods. The loss of medical infrastructure in disaster-stricken areas can result in evacuees' health being compromised and the spread of disease and/or infection. Under such circumstances, disaster relief nurses can play a critical role in supporting these victims. This review aims to provide useful information for nurses who are working in disaster shelters. INCLUSION CRITERIA The review will include qualitative studies examining experiences of nurses caring for people living in shelters following natural hazards and disasters, published in either English or Japanese. Studies published from 2000 to the present will be considered. METHODS The review will follow the meta-aggregation approach developed by JBI. Published and unpublished studies will be searched using major international databases and other relevant databases for gray literature in either English or Japanese. Two reviewers will independently appraise studies and extract qualitative data using the JBI standardized critical appraisal and extraction instruments. Findings from the review will be categorized according to their similarity in meaning and their categories subjected to a meta-synthesis to produce a single comprehensive set of synthesized findings. The final synthesized findings will be graded according to the ConQual approach.
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Affiliation(s)
- Hatsumi Kansaki
- School of Nursing, Hyogo University of Health Sciences, Hyogo, Japan
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Lazcano-Ponce E, Oropeza-Abúndez C. Terremotos, salud y sociedad: lecciones aprendidas. SALUD PUBLICA DE MEXICO 2018. [DOI: 10.21149/9417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
La revista Salud Pública de México, atenta a los fenómenos que inciden en la salud de la población, presenta un número monográfico titulado Terremotos, salud y sociedad: lecciones aprendidas. Esta iniciativa reúne, con pertinencia y oportunidad, la respuesta expedita de diversos grupos de investigación intersectorial en el ámbito nacional e internacional, para documentar la experiencia y describir las lecciones aprendidas, desde la perspectiva multidisciplinaria e intersectorial, de los terremotos ocurridos en México en septiembre de 2017.
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Ryan GK, Bauer A, Bass JK, Eaton J. Theory of change for the delivery of talking therapies by lay workers to survivors of humanitarian crises in low-income and middle-income countries: protocol of a systematic review. BMJ Open 2018; 8:e018193. [PMID: 29455163 PMCID: PMC5855449 DOI: 10.1136/bmjopen-2017-018193] [Citation(s) in RCA: 4] [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: 06/13/2017] [Revised: 12/13/2017] [Accepted: 12/14/2017] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION There is a severe shortage of specialist mental healthcare providers in low-income and middle-income countries (LMICs) affected by humanitarian crises. In these settings, talking therapies may be delivered by non-specialists, including lay workers with no tertiary education or formal certification in mental health. This systematic review will synthesise the literature on the implementation and effectiveness of talking therapies delivered by lay workers in LMICs affected by humanitarian crises, in order to develop a Theory of Change (ToC). METHODS AND ANALYSIS Qualitative, quantitative and mixed-methods studies assessing the implementation or effectiveness of lay-delivered talking therapies for common mental disorders provided to adult survivors of humanitarian crises in LMICs will be eligible for inclusion. Studies set in high-income countries will be excluded. No restrictions will be applied to language or year of publication. Unpublished studies will be excluded. Seven electronic databases will be searched: MEDLINE, Embase, PsycINFO, PsycEXTRA, Global Health, Cochrane Library and ClinicalTrials.gov. Contents pages of three peer-reviewed journals will be hand-searched. Sources of grey literature will include resource directories of two online mental health networks (MHPSS.net and MHInnovation.net) and expert consultation. Forward and backward citation searches of included studies will be performed. Two reviewers will independently screen studies for inclusion, extract data and assess study quality. A narrative synthesis will be conducted, following established guidelines. A ToC map will be amended iteratively to take into account the review results and guide the synthesis. ETHICS AND DISSEMINATION Findings will be presented in a manuscript for publication in a peer-reviewed journal and disseminated through a coordinated communications strategy targeting knowledge generators, enablers and users. PROSPERO REGISTRATION NUMBER CRD42017058287.
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Affiliation(s)
- Grace Kathryn Ryan
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Global Mental Health, London, UK
| | - Andreas Bauer
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Global Mental Health, London, UK
| | - Judith K Bass
- Department of Mental Health, Johns Hopkins University, Baltimore, Maryland, USA
- Center for Humanitarian Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Julian Eaton
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Global Mental Health, London, UK
- CBM International, Bensheim, Germany
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