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Coscini N, Heyes P, Bedford H, Cohen E, D'Aprano A, Goldfeld S, Hargreaves D, Loveday S, Nejat S, Roberts G, Sarkadi A, Saunders NR, Woolfenden S, Milner K. Multicountry review: developmental surveillance, assessment and care by outpatient paediatricians. Arch Dis Child 2023; 108:153-159. [PMID: 35764409 DOI: 10.1136/archdischild-2021-322799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 05/13/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Care of young children with neurodevelopmental disorders (NDD) is a major component of paediatric outpatient practice. However, cross-country practice reviews to date have been limited, and available data demonstrate missed opportunities for early identification, particularly in vulnerable population subgroups. METHODS Multicountry review of national paediatric body guidance related to developmental surveillance, early identification and early childhood intervention together with review of outpatient paediatrician practices for developmental assessment of children aged 0-5 years with/at risk of NDDs. Review included five countries with comparable nationalised universal child healthcare systems (ie, Australia, Canada, New Zealand, Sweden and the UK). Data were collected using a combination of published and grey literature review, supplemented by additional local sources with descriptive review of relevant data points. RESULTS Countries had broadly similar systems for early identification of young children with NDDs alongside universal child health surveillance. However, variation existed in national paediatric guidance, paediatric developmental training and practice, including variable roles of paediatricians in developmental surveillance at primary care level. Data on coverage of developmental surveillance, content and quality of paediatric development assessment practices were notably lacking. CONCLUSION Paediatricians play an important role in ensuring equitable access to early identification and intervention for young children with/at risk of NDDs. However, strengthening paediatric outpatient care of children with NDD requires clearer guidance across contexts; training that is responsive to shifting roles within interdisciplinary models of developmental assessment and improved data to enhance equity and quality of developmental assessment for children with/at risk of NDDs.
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Affiliation(s)
- Nadia Coscini
- Centre for Community Child Health, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia .,Health Services Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Priya Heyes
- Department of Child Development Service, Government of Western Australia Child and Adolescent Health Service, Perth, Western Australia, Australia
| | - Helen Bedford
- Population, Policy and Practice Department, University College London Institute of Child Health, London, UK
| | - Eyal Cohen
- Department of Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.,Department of Paediatrics, University of Toronto Institute of Health Policy Management and Evaluation, Toronto, Ontario, Canada
| | - Anita D'Aprano
- Centre for Community Child Health, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne Melbourne Medical School, Melbourne, Victoria, Australia
| | - Sharon Goldfeld
- Centre for Community Child Health, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.,Population Health Theme, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Dougal Hargreaves
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Sarah Loveday
- Health Services Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Sahar Nejat
- Department of Public Health and Caring Sciences, Uppsala Universitet Institutionen for euroasiatiska studier, Uppsala, Sweden
| | - Gehan Roberts
- Centre for Community Child Health, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.,Population Health Theme, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Anna Sarkadi
- Department of Public Health and Caring Sciences, Uppsala Universitet, Uppsala, Sweden
| | - Natasha Ruth Saunders
- Department of Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.,Department of Paediatrics, University of Toronto Institute of Health Policy Management and Evaluation, Toronto, Ontario, Canada
| | - Susan Woolfenden
- School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.,Department of Community Child Health, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
| | - Kate Milner
- Department of Neurodevelopment and Disability, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.,Neurodisability and Rehabilitation Research Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
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2
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Goetz CJ, Mushquash CJ, Maranzan KA. An Integrative Review of Barriers and Facilitators Associated With Mental Health Help Seeking Among Indigenous Populations. Psychiatr Serv 2023; 74:272-281. [PMID: 36065579 DOI: 10.1176/appi.ps.202100503] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Indigenous populations, compared with majority populations, have a reduced likelihood of receiving professional help for mental health, contributing to health disparities. To increase use of and access to mental health services for Indigenous people, specific factors that affect service use need to be examined. An integrative review was undertaken of the barriers to and facilitators of help seeking and service use for Indigenous populations in Canada, the United States, Australia, and the Pacific Islands. METHODS Five databases-PsycINFO, PubMed, Web of Science, Social Services Abstracts, and Bibliography of Native North Americans-and gray literature were searched to identify original studies with data specific to Indigenous people. A qualitative analysis of common themes among the studies was conducted, along with a quality appraisal of included articles. Of the 1,010 records identified, the final synthesis included 41 articles. RESULTS Six main themes emerged: informal supports, which were often used as a first choice for help seeking compared with formal services; structural obstacles and supports; stigma and shame; self-reliance and uncertainty about services; cultural factors and mistrust of mainstream services; and the need for outreach and information regarding mental illness and services. CONCLUSIONS Policy implications include needed structural changes to decrease mistrust of mainstream systems and services and increased funding and resource availability. Along with technology-facilitated treatment, programs for Indigenous people, families, and communities that enhance education and foster positive relationships can serve as a first step toward Indigenous people becoming comfortable with the idea of talking about mental health and with seeking treatment.
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Affiliation(s)
- Christiana J Goetz
- Department of Psychology, Lakehead University, Thunder Bay, Ontario, Canada
| | | | - K Amanda Maranzan
- Department of Psychology, Lakehead University, Thunder Bay, Ontario, Canada
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3
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Panofsky S, Buchanan MJ, Wilat (Susan Alfred) TZ, Madeek (Jeffrey Brown) DZ, Neekupdeh (Daren George) DZ, Smogelgem (Warner Naziel) DZ, Woodman G, Brown T, Lewis R, We’es Tes (Sandra Harris) TZ, Wilawhl (Lorraine Naziel) TZ, Dumont J, Andrew J, Ferguson A, Hare J, John R. The Wet’suwet’en Nation’s Mobilization of Indigenous Focusing Oriented Therapy: An Exploratory Study. COUNSELING PSYCHOLOGIST 2022. [DOI: 10.1177/00110000221146571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Indigenous mental health research is beginning to address colonization, however, Indigenous approaches to wellness have largely been overlooked. There is a paucity of research exploring psychological trauma interventions with Indigenous peoples. The Wet’suwet’en hereditary chiefs recognize the profound impacts of historical trauma among their people and are utilizing Indigenous focusing oriented therapy (IFOT), a trauma model that is collective, land-based, and intergenerational, as a part of their wellness framework. This collaborative research study explored the question: How is IFOT shaped by Wet’suwet’en ways of knowing and mobilized by individuals, families, house groups, and the Nation? Wet’suwet’en IFOT practitioners participated in sharing circles for data collection and interpretation. The exploratory findings revealed that the strategic application of IFOT by Wet’suwet’en hereditary chiefs created a culturally relevant model for land-based healing wherein Wet’suwet’en people were able to experience greater connection with their own yintah (land) and c’idede’ (history).
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Affiliation(s)
- Sarah Panofsky
- Department of Educational and Counselling Psychology and Special Education, The University of British Columbia, Vancouver, BC, Canada
| | - Marla J. Buchanan
- Department of Educational and Counselling Psychology and Special Education, The University of British Columbia, Vancouver, BC, Canada
| | - Ts’akë ze’ Wilat (Susan Alfred)
- Department of Educational and Counselling Psychology and Special Education, Wet’suwet’en Nation (Office of the Wet’suwet’en), Canada
| | - Dinï ze’ Madeek (Jeffrey Brown)
- Department of Educational and Counselling Psychology and Special Education, Wet’suwet’en Nation (Office of the Wet’suwet’en), Canada
| | - Dinï ze’ Neekupdeh (Daren George)
- Department of Educational and Counselling Psychology and Special Education, Wet’suwet’en Nation (Office of the Wet’suwet’en), Canada
| | | | - Gretchen Woodman
- Department of Educational and Counselling Psychology and Special Education, Wet’suwet’en Nation (Office of the Wet’suwet’en), Canada
| | - Tanya Brown
- Department of Educational and Counselling Psychology and Special Education, Wet’suwet’en Nation (Office of the Wet’suwet’en), Canada
| | - Russell Lewis
- Department of Educational and Counselling Psychology and Special Education, Wet’suwet’en Nation (Office of the Wet’suwet’en), Canada
| | | | | | - Jeremy Dumont
- Department of Educational and Counselling Psychology and Special Education, Wet’suwet’en Nation (Office of the Wet’suwet’en), Canada
| | - Jolene Andrew
- Department of Educational and Counselling Psychology and Special Education, Wet’suwet’en Nation (Office of the Wet’suwet’en), Canada
| | - Alanaise Ferguson
- Department of Educational and Counselling Psychology and Special Education, Simon Fraser University, Burnaby, BC, Canada
| | - Jan Hare
- Department of Educational and Counselling Psychology and Special Education, The University of British Columbia, Vancouver, BC, Canada
| | - Roger John
- Department of Educational and Counselling Psychology and Special Education, The University of British Columbia, Vancouver, BC, Canada
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4
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Montesanti S, Fitzpatrick K, Fayant B, Pritchard C. Identifying priorities, directions and a vision for Indigenous mental health using a collaborative and consensus-based facilitation approach. BMC Health Serv Res 2022; 22:406. [PMID: 35346187 PMCID: PMC8958486 DOI: 10.1186/s12913-022-07682-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 02/24/2022] [Indexed: 12/19/2022] Open
Abstract
Background Mental health disparities between Indigenous and non-Indigenous people in Canada are related to underlying economic, social, and political inequities that are legacies of colonization and the oppression of Indigenous cultures. It also widely acknowledged that mental health services currently available may not be culturally appropriate in supporting the health needs of Indigenous Canadians. A two-day Indigenous mental health forum examined mental health needs and gaps among Indigenous communities across the Regional Municipality of Wood Buffalo (RMWB) on Treaty 8 territory, in northern Alberta, Canada. This paper outlines the insights generated by stakeholder engagement at the forum to identify and prioritize directions for Indigenous mental health and build a vision and strategy for improving mental health services and programs for the region’s diverse Indigenous population. Methods We applied a modified nominal group technique (NGT) consensus method embedded within Indigenous knowledge to determine key priorities and directions for Indigenous-focused mental health and synthesize information from discussions that occurred at the forum. Following the NGT, a participatory community visioning exercise was conducted with participants to develop a vision, guiding principles, and components of an action plan for an Indigenous mental health strategy for the RMWB. Results Four key themes for setting priorities and directions for Indigenous mental health emerged from roundtable group discussions: 1) understand the realities of mental health experiences for Indigenous peoples, 2) design a holistic and culturally rooted mental health system, 3) foster cross-sectoral engagement and collaboration on mental health service delivery, and 4) focus on children and youth. The community visioning exercise helped stakeholders to visualize a direction or path forward for addressing existing gaps in the mental health system and opportunities for strengthening Indigenous mental health in the region. Conclusions Forum participants described mental health and well-being around holistic concepts of social and emotional well-being. Addressing Indigenous mental health and wellness involves multi-sectoral action in various settings including community and school through programs, policies, and other interventions that promote mental health for all Indigenous peoples, as well as for those at greater risk such as children and youth. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07682-3.
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5
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Chan AW, Reid C, Skeffington P, Marriott R. A systematic review of EPDS cultural suitability with Indigenous mothers: a global perspective. Arch Womens Ment Health 2021; 24:353-365. [PMID: 33245435 PMCID: PMC8116293 DOI: 10.1007/s00737-020-01084-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/12/2020] [Indexed: 12/20/2022]
Abstract
The Edinburgh Postnatal Depression Scale (EPDS) is used extensively as the "gold standard" perinatal depression and anxiety screening tool. This study contributes to an emerging discussion about the tool's shortcomings, specifically around cultural suitability for use with Indigenous women. A systematic search was conducted in ProQuest, PsycINFO, MEDLINE (Web of Science), PubMed, Scopus, Informit, and CINAHL research databases, and grey literature. The quality of the body of evidence was assessed using the NHMRC Level of Evidence framework. Three studies supported the cultural validation of the EPDS with Indigenous groups in Canada (n = 2) and the USA (n = 1). The remaining eleven Australian studies demonstrated that cultural concerns were suggested by either Indigenous mothers, healthcare professionals (Indigenous and non-Indigenous), or both, though cultural concerns were more weighted from the perspectives of healthcare professionals. The quality of the evidence was not strong, and thus, there is a critical and urgent need for targeted research in this area. This review identified and recommended Indigenous-specific methodologies that can be adopted for more trustworthy, culturally safe, and effective research in this area. Given that the EPDS is currently considered gold standard in routine perinatal mental health screening practice in countries around the world, these findings raise significant concerns. Using culturally relevant research methodologies, such as the use of mixed-methods design, could lay stronger groundwork for further investigation of the broader utility and cultural relevance of the tool.
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Affiliation(s)
- Ai Wen Chan
- School of Psychology, Exercise Science, Chiropractic & Counselling, Murdoch University, Perth, Australia.
| | - Corinne Reid
- Victoria University, Melbourne, Australia.
- Global Health Academy, The University of Edinburgh, Edinburgh, Scotland.
| | - Petra Skeffington
- Psychology, Exercise Science, Chiropractic & Counselling, Murdoch University, Perth, Australia
| | - Rhonda Marriott
- Ngangk Yira Research Centre for Aboriginal Health and Social Equity, Murdoch University, Perth, Australia
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6
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Plessas A, Billot MW, Tamatea A, Medvedev ON, McCormack J, Anderson A. Barriers and Facilitators of Access to Psychological Services for Indigenous Populations: A Scoping Review and Thematic Analysis. Front Psychiatry 2021; 12:747054. [PMID: 34712157 PMCID: PMC8545819 DOI: 10.3389/fpsyt.2021.747054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 09/13/2021] [Indexed: 11/21/2022] Open
Abstract
Background: The extent to which behavior-analytic interventions are offered to Indigenous populations across CANZUS in accessible and culturally appropriate ways is unknown. We conducted a scoping review with a thematic analysis of the extant literature to find: (1) what are the barriers and facilitators for providing effective and equitable delivery of psychological services (with a behavioral component) to Indigenous populations; and (2) what tools and practices exist for an effective and equitable service delivery. Methods: We systematically reviewed Medline, CINAHL, PubMed, PsycInfo, Web of science, Ovid and INNZ databases between 1990 and 2020. For the scoping review, we adhered to the JBI methodological approach (2015) and the PRISMA strategy for the identification, selection, and appraisal of the reviewed articles. A total of 1265 unique articles met the criteria for the screening by title; 238 by abstract; 57 were included for full text assessment; and 37 were included in the final analysis. Results: Three themes were revealed to account for the barriers and facilitators of culturally friendly practices: (1) connecting practices are about interactions shaping the relationship between service provider and service client; (2) innovative practices test new approaches and innovations that could facilitate access to psychological services and overcome barriers, and (3) reflective practices are about critically examining the processes and actions undertaken toward effective cultural adaptation of services. Conclusions: Our analysis suggests that the level of success in bringing together services and the recipients of treatment (connection), showing flexibility and persistence in finding solutions (innovation) and examining the role of our behaviors in reaching our goals (reflection) is determined by the providers' action in the aforementioned three dimensions of practice.
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Affiliation(s)
- Anna Plessas
- School of Psychology, Division of Arts, Law, Psychology, and Social Sciences, University of Waikato, Hamilton, New Zealand
| | - Moana W Billot
- School of Psychology, Division of Arts, Law, Psychology, and Social Sciences, University of Waikato, Hamilton, New Zealand
| | - Armon Tamatea
- School of Psychology, Division of Arts, Law, Psychology, and Social Sciences, University of Waikato, Hamilton, New Zealand
| | - Oleg N Medvedev
- School of Psychology, Division of Arts, Law, Psychology, and Social Sciences, University of Waikato, Hamilton, New Zealand
| | - Jessica McCormack
- National Institute for Health Innovation, Pacific Health, University of Auckland, Auckland, New Zealand
| | - Angelika Anderson
- School of Psychology, Division of Arts, Law, Psychology, and Social Sciences, University of Waikato, Hamilton, New Zealand
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7
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Salinas-Perez JA, Gutierrez-Colosia MR, Furst MA, Suontausta P, Bertrand J, Almeda N, Mendoza J, Rock D, Sadeniemi M, Cardoso G, Salvador-Carulla L. Patterns of Mental Health Care in Remote Areas: Kimberley (Australia), Nunavik (Canada), and Lapland (Finland): Modèles de soins de santé mentale dans les régions éloignées: Kimberley (Australie), Nunavik (Canada) et Laponie (Finlande). CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2020; 65:721-730. [PMID: 32720514 PMCID: PMC7502882 DOI: 10.1177/0706743720944312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Mental health (MH) care in remote areas is frequently scarce and fragmented and difficult to compare objectively with other areas even in the same country. This study aimed to analyze the adult MH service provision in 3 remote areas of Organization for Economic Cooperation and Development countries in the world. METHODS We used an internationally agreed set of systems indicators, terminology, and classification of services (Description and Evaluation of Services and DirectoriEs for Long Term Care). This instrument provided a standard description of MH care provision in the Kimberley region (Australia), Nunavik (Canada), and Lapland (Finland), areas characterized by an extremely low population density and high relative rates of Indigenous peoples. RESULTS All areas showed high rates of deprivation within their national contexts. MH services were mostly provided by the public sector supplemented by nonprofit organizations. This study found a higher provision per inhabitant of community residential care in Nunavik in relation to the other areas; higher provision of community outreach services in the Kimberley; and a lack of day services except in Lapland. Specific cultural-based services for the Indigenous population were identified only in the Kimberley. MH care in Lapland was self-sufficient, and its care pattern was similar to other Finnish areas, while the Kimberley and Nunavik differed from the standard pattern of care in their respective countries and relied partly on services located outside their boundaries for treating severe cases. CONCLUSION We found common challenges in these remote areas but a huge diversity in the patterns of MH care. The implementation of care interventions should be locally tailored considering both the environmental characteristics and the existing pattern of service provision.
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Affiliation(s)
- Jose A. Salinas-Perez
- Department of Quantitative Methods, Universidad Loyola Andalucía, Dos Hermanas, Sevilla, Spain
- Centre for Mental Health Research, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Mencia R. Gutierrez-Colosia
- Department of Psychology, Universidad Loyola Andalucía, Dos Hermanas, Sevilla, Spain
- Asociación Científica Psicost, Dos Hermanas, Sevilla, Spain
| | - Mary Anne Furst
- Centre for Mental Health Research, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Petra Suontausta
- Faculty of Social Sciences, Tampere University, Pirkanmaa, Finland
| | | | - Nerea Almeda
- Department of Psychology, Universidad Loyola Andalucía, Dos Hermanas, Sevilla, Spain
| | - John Mendoza
- ConNetica Consulting, Coolum, Queensland, Australia
| | - Daniel Rock
- WA Primary Health Alliance, Perth, Western Australia, Australia
- Discipline of Psychiatry, The University of Western Australia, Perth, Western Australia, Australia
| | - Minna Sadeniemi
- Unit for Mental Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Graça Cardoso
- Lisbon Institute of Global Mental Health, Comprehensive Health Research Center (CHRC), Nova Medical School, Nova University of Lisbon, Portugal
| | - Luis Salvador-Carulla
- Centre for Mental Health Research, Australian National University, Canberra, Australian Capital Territory, Australia
- Menzies Centre for Health Policy, School of Public Health, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
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8
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Palk A, Illes J, Thompson PM, Stein DJ. Ethical issues in global neuroimaging genetics collaborations. Neuroimage 2020; 221:117208. [PMID: 32736000 DOI: 10.1016/j.neuroimage.2020.117208] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 06/09/2020] [Accepted: 07/24/2020] [Indexed: 10/23/2022] Open
Abstract
Neuroimaging genetics is a rapidly developing field that combines neuropsychiatric genetics studies with imaging modalities to investigate how genetic variation influences brain structure and function. As both genetic and imaging technologies improve further, their combined power may hold translational potential in terms of improving psychiatric nosology, diagnosis, and treatment. While neuroimaging genetics studies offer a number of scientific advantages, they also face challenges. In response to some of these challenges, global neuroimaging genetics collaborations have been created to pool and compare brain data and replicate study findings. Attention has been paid to ethical issues in genetics, neuroimaging, and multi-site collaborative research, respectively, but there have been few substantive discussions of the ethical issues generated by the confluence of these areas in global neuroimaging genetics collaborations. Our discussion focuses on two areas: benefits and risks of global neuroimaging genetics collaborations and the potential impact of neuroimaging genetics research findings in low- and middle-income countries. Global neuroimaging genetics collaborations have the potential to enhance relations between countries and address global mental health challenges, however there are risks regarding inequity, exploitation and data sharing. Moreover, neuroimaging genetics research in low- and middle-income countries must address the issue of feedback of findings and the risk of essentializing and stigmatizing interpretations of mental disorders. We conclude by examining how the notion of solidarity, informed by an African Ethics framework, may justify some of the suggestions made in our discussion.
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Affiliation(s)
- Andrea Palk
- Department of Philosophy, Stellenbosch University, Bag X1, Matieland, Stellenbosch, 7602, South Africa.
| | - Judy Illes
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Paul M Thompson
- Imaging Genetics Center, Mark & Mary Stevens Institute for Neuroimaging & Informatics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Dan J Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Groote Schuur Hospital, Cape Town 7925, South Africa
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9
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Gallardo-Peralta LP, Rodríguez-Blázquez C, Ayala-García A, Forjaz MJ. Multi-ethnic validation of 15-item Geriatric Depression Scale in Chile. ACTA ACUST UNITED AC 2020; 33:7. [PMID: 32430560 PMCID: PMC7237627 DOI: 10.1186/s41155-020-00146-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 05/07/2020] [Indexed: 11/17/2022]
Abstract
Background There has been scant research published regarding the assessment of depression in ethnic groups, and few studies have addressed the validation of scales for standardized assessment of depressive symptoms among indigenous minorities. Objective The aim of this study was to analyze the psychometric properties of the 15-item Geriatric Depression Scale (GDS-15) for a multi-ethnic sample of older Chilean adults. Methods Cross-sectional study with a sample of 800 older people, 71% of whom were self-declared indigenous (Aymara/Mapuche). Results The non-indigenous group had a higher total GDS-15 score and lower quality of life and wellbeing scores than the indigenous groups (p < 0.001). The GDS-15 had a KR-20 coefficient of 0.90 for the non-indigenous group, 0.80 for Aymara, and 0.85 for Mapuche. The homogeneity index was 0.38 for non-indigenous, 0.24 for Aymara, and 0.29 for Mapuche. Discussion The GDS-15 showed satisfactory psychometric characteristics for the samples studied. However, the better results observed for the non-indigenous group suggest that some characteristics and content of the rating scale are not fully appropriate for the indigenous older population. Conclusions There is a need to develop the transcultural validation of scales such as GDS-15, which are applied in a standardized manner in geriatric evaluations as part of primary healthcare.
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Affiliation(s)
- Lorena P Gallardo-Peralta
- School of Social Work, University of Tarapacá, 18 de Septiembre 2222, 1000000, Arica, Chile. .,Faculty of Social Work, Complutense University of Madrid, Madrid, Spain.
| | - Carmen Rodríguez-Blázquez
- National Epidemiology Centre, Carlos III Health Institute, Madrid, Spain.,Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Alba Ayala-García
- National School of Public Health, Carlos III Health Institute, Madrid, Spain.,Health Services Research on Chronic Patients Network (REDISSEC), Madrid, Spain
| | - María João Forjaz
- National Epidemiology Centre, Carlos III Health Institute, Madrid, Spain.,Health Services Research on Chronic Patients Network (REDISSEC), Madrid, Spain
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10
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Plessas A, McCormack J, Kafantaris I. The Potential Role of Applied Behavior Analysis in the Cultural Environment of Māori Mental Health. Behav Anal Pract 2019; 12:854-868. [PMID: 31976298 PMCID: PMC6834803 DOI: 10.1007/s40617-019-00359-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Significant mental health disparity exists in Aotearoa New Zealand between Māori and the non-Māori majority. Although much has been written about mental health and the cultural competence of health professionals, cultural context has not been specifically considered within the behavioral paradigm, and it was placed in the center of practice in multicultural societies by the behavioral community only recently. In this article, we discuss some of the problems encountered by Māori in the mental health system and the role of behavior analysts in addressing the divide in service provision. Dialogue with other disciplines that investigate the importance of indigenous cultural values is necessary. We conclude with some suggestions about strategies that may be implemented across services by behavior analysts in order to improve mental health outcomes for Māori.
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Affiliation(s)
- Anna Plessas
- Monorodi Association, 247 Pan. Tsaldari, Kallithea, Athens, Greece
| | - Jessica McCormack
- School of Psychology, University of Auckland, Science Centre, 23 Symonds Street, Auckland, New Zealand
| | - Ignatios Kafantaris
- iCAMHS, Lakes District Health Board, Children’s Hub and Library, Rotorua, New Zealand
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11
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Coates D, Saleeba C, Howe D. Mental Health Attitudes and Beliefs in a Community Sample on the Central Coast in Australia: Barriers to Help Seeking. Community Ment Health J 2019; 55:476-486. [PMID: 29589218 DOI: 10.1007/s10597-018-0270-8] [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] [Received: 06/20/2017] [Accepted: 03/24/2018] [Indexed: 10/17/2022]
Abstract
There continues to be call for greater community awareness actions and strategies to reduce stigma and enhance mental health literacy nationally and internationally. To identify local barriers to help-seeking and perceptions around stigma, we developed a 'mental health attitudes and beliefs' survey which was administered at a range of community events on the Central Coast in New South Wales, Australia. The aim was for the results of this survey to inform the development of strategies that enhance local help-seeking behaviours that are sensitive to the role of age, gender and Indigenous status. People who approached our Mental Health Information stall were invited to complete the survey and 282 individuals completed the survey. The data was analysed descriptively with a focus on comparing subgroups based on age, gender, Indigenous status, and previous service access or experience of mental illness. Cost, stigma and mental health literacy were found to be prominent barriers to help-seeking for the overall cohort; however, the ways in which or extent to which these barriers impact on help seeking varied between subgroups. A discussion of these differences and their implications for practice is the focus of this paper.
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Affiliation(s)
- Dominiek Coates
- Faculty of Health, University of Technology Sydney, Level 11, 235 Jones St., Ultimo, NSW, 2007, Australia. .,Central Coast Mental Health Service, Central Coast Local Health District, Gosford, NSW, Australia.
| | - Christine Saleeba
- Central Coast Mental Health Service, Central Coast Local Health District, Gosford, NSW, Australia.,Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Deborah Howe
- Central Coast Mental Health Service, Central Coast Local Health District, Gosford, NSW, Australia
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Williamson A, Skinner A, Falster K, Clapham K, Eades SJ, Banks E. Mental health-related emergency department presentations and hospital admissions in a cohort of urban Aboriginal children and adolescents in New South Wales, Australia: findings from SEARCH. BMJ Open 2018; 8:e023544. [PMID: 30498044 PMCID: PMC6278810 DOI: 10.1136/bmjopen-2018-023544] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES The aim of the current study is to quantify mental health-related emergency department (ED) presentations and hospitalisations, and associated child and family characteristics, in children recruited through four Aboriginal Community Controlled Health Organisations. SETTING Four Aboriginal Community Controlled Health Services that deliver primary care. All services were located in urban or large regional centres in New South Wales, Australia. PARTICIPANTS 1476 Aboriginal children aged 0-17 years at recruitment to the Study of Environment on Aboriginal Resilience and Child Health. PRIMARY OUTCOME MEASURES ED presentations and hospital admissions with a primary mental health diagnosis obtained via linkage to population health datasets. RESULTS Over a median of 6-year follow-up, there were 96 ED presentations affecting 62 children (10.7/1000 person-years) and 49 hospitalisations affecting 34 children (5.5/1000 person-years) for mental health conditions. Presentations/admissions increased with age. ED presentation was increased with: living in foster versus parental care (adjusted rate ratio (RR)=3.97, 95% CrI 1.26 to 11.80); high versus low baseline child emotional/behavioural problems (adjusted RR=2.93, 95% CrI 1.50 to 6.10); and caregiver chronic health conditions versus none (adjusted RR=2.81, 95% CrI 1.31 to 6.63). Hospitalisations were significantly increased with caregiver unemployment versus home duties (adjusted RR=4.48, 95% CrI 1.26 to 17.94) and caregiver chronic health problems versus none (adjusted RR=3.83, 95% CrI 1.33 to 12.12). CONCLUSIONS Tertiary care for mental health issues was relatively common among participating Aboriginal children, with risk elevated for those living in foster care, with prior mental health and behavioural problems and with carers with chronic illness and/or unemployment. While this study suggests high rates of serious mental health events among children from participating communities, the optimum means for reducing these rates, and the need for tertiary care, has not yet been determined. Such information is urgently required to inform policy and programmes to support Aboriginal child and adolescent mental health.
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Affiliation(s)
- Anna Williamson
- The Sax Institute, Sydney, NSW, Australia
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | | | - Kathleen Falster
- The Centre for Big Data Research in Health, University of New South Wales, Kensington, New South Wales, Australia
- The National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute (AHSRI), University of Wollongong, Wollongong, New South Wales, Australia
| | - Sandra J Eades
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Acton, Australian Capital Territory, Australia
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