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Patwary MM, Bardhan M, Haque MA, Moniruzzaman S, Gustavsson J, Khan MMH, Koivisto J, Salwa M, Mashreky SR, Rahman AKMF, Tasnim A, Islam MR, Alam MA, Hasan M, Harun MAYA, Nyberg L, Islam MA. Impact of extreme weather events on mental health in South and Southeast Asia: A two decades of systematic review of observational studies. ENVIRONMENTAL RESEARCH 2024; 250:118436. [PMID: 38354890 DOI: 10.1016/j.envres.2024.118436] [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: 12/25/2023] [Revised: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 02/16/2024]
Abstract
Extreme weather events in South and Southeast Asia exert profound psychosocial impacts, amplifying the prevalence of mental illness. Despite their substantial consequences, there is a dearth of research and representation in the current literature. We conducted a systematic review of observational studies published between January 1, 2000, and January 20, 2024, to examine the impact of extreme weather events on the mental health of the South and Southeast Asian population. Quality assessment of the included studies was conducted using the Newcastle-Ottawa Scale (NOS) quality appraisal checklist. The search retrieved 70 studies that met the inclusion criteria and were included in our review. Most were from India (n = 22), and most used a cross-sectional study design (n = 55). Poor mental health outcomes were associated with six types of extreme weather events: floods, storm surges, typhoons, cyclones, extreme heat, and riverbank erosion. Most studies (n = 41) reported short-term outcome measurements. Findings included outcomes with predictable symptomatology, including post-traumatic stress disorder, depression, anxiety, general psychological distress, emotional distress and suicide. Limited studies on long-term effects showed higher mental disorders after floods and typhoons, while cyclone-exposed individuals had more short-term distress. Notably, the review identified over 50 risk factors influencing mental health outcomes, categorized into six classes: demographic, economic, health, disaster exposure, psychological, and community factors. However, the quantitative evidence linking extreme weather events to mental health was limited due to a lack of longitudinal data, lack of control groups, and the absence of objective exposure measurements. The review found some compelling evidence linking extreme weather events to adverse mental health in the South and Southeast Asia region. Future research should focus on longitudinal study design to identify the specific stressors and climatic factors influencing the relationship between climate extremes and mental health in this region.
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Affiliation(s)
| | - Mondira Bardhan
- Environmental Science Discipline, Khulna University, Khulna, 9208, Bangladesh; Department of Parks, Recreation and Tourism Management, Clemson University, USA
| | - Md Atiqul Haque
- Department of Public Health and Informatics, Bangabandhu Shiekh Mujib Medical University, Dhaka, Bangladesh; Center for Societal Risk Research (CSR), Karlstad University, Sweden.
| | - Syed Moniruzzaman
- Department of Political, Historical and Cultural Studies, Karlstad University, Karlstad, Sweden; Center for Societal Risk Research (CSR), Karlstad University, Sweden.
| | - Johanna Gustavsson
- Department of Political, Historical and Cultural Studies, Karlstad University, Karlstad, Sweden; Center for Societal Risk Research (CSR), Karlstad University, Sweden
| | - Md Maruf Haque Khan
- Department of Public Health and Informatics, Bangabandhu Shiekh Mujib Medical University, Dhaka, Bangladesh
| | - Jenni Koivisto
- Department of Political, Historical and Cultural Studies, Karlstad University, Karlstad, Sweden; Center for Societal Risk Research (CSR), Karlstad University, Sweden; Centre of Natural Hazards and Disaster Science (CNDS), c/o Department of Earth Sciences, Uppsala University, UPPSALA, Sweden
| | - Marium Salwa
- Department of Public Health and Informatics, Bangabandhu Shiekh Mujib Medical University, Dhaka, Bangladesh
| | - Saidur Rahman Mashreky
- Centre for Injury Prevention and Research, (CIPRB), Bangladesh; Department of Public Health, North South University, Dhaka, Bangladesh
| | - A K M Fazlur Rahman
- Center for Societal Risk Research (CSR), Karlstad University, Sweden; Centre for Injury Prevention and Research, (CIPRB), Bangladesh
| | - Anika Tasnim
- Department of Public Health and Informatics, Bangabandhu Shiekh Mujib Medical University, Dhaka, Bangladesh
| | - Md Redwanul Islam
- Department of Public Health and Informatics, Bangabandhu Shiekh Mujib Medical University, Dhaka, Bangladesh
| | - Md Ashraful Alam
- Department of Computational Diagnostic Radiology and Preventive, Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Mahadi Hasan
- Environmental Science Discipline, Khulna University, Khulna, 9208, Bangladesh
| | | | - Lars Nyberg
- Department of Political, Historical and Cultural Studies, Karlstad University, Karlstad, Sweden; Center for Societal Risk Research (CSR), Karlstad University, Sweden; Centre of Natural Hazards and Disaster Science (CNDS), c/o Department of Earth Sciences, Uppsala University, UPPSALA, Sweden
| | - Md Atikul Islam
- Environmental Science Discipline, Khulna University, Khulna, 9208, Bangladesh; Center for Societal Risk Research (CSR), Karlstad University, Sweden.
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Koly KN, Saba J, Rao M, Rasheed S, Reidpath DD, Armstrong S, Gnani S. Stakeholder perspectives of mental healthcare services in Bangladesh, its challenges and opportunities: a qualitative study. Glob Ment Health (Camb) 2024; 11:e37. [PMID: 38572252 PMCID: PMC10988148 DOI: 10.1017/gmh.2024.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 01/20/2024] [Accepted: 03/03/2024] [Indexed: 04/05/2024] Open
Abstract
This study explores Bangladesh's mental health services from an individual- and system-level perspective and provides insights and recommendations for strengthening it's mental health system. We conducted 13 in-depth interviews and 2 focus group discussions. Thirty-one participants were recruited using a combination of purposive and snowball sampling methods. All interviews and group discussions were audio-recorded and transcribed, and key findings were translated from Bengali to English. Data were coded manually and analysed using a thematic and narrative analysis approach. Stakeholders perceived scarcity of service availability at the peripheral level, shortage of professionals, weak referral systems, lack of policy implementation and regulatory mechanisms were significant challenges to the mental health system in Bangladesh. At the population level, low levels of mental health literacy, high societal stigma, and treatment costs were barriers to accessing mental healthcare. Key recommendations included increasing the number of mental health workers and capacity building, strengthening regulatory mechanisms to enhance the quality of care within the health systems, and raising awareness about mental health. Introducing measures that relate to tackling stigma, mental health literacy as well as building the capacity of the health workforce and governance systems will help ensure universal mental health coverage.
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Affiliation(s)
- Kamrun Nahar Koly
- Health System & Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Jobaida Saba
- Health System & Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mala Rao
- Department of Primary Care and Public Health, School of Public Health, Faculty of Medicine, Imperial College London, London, UK
| | - Sabrina Rasheed
- Health System & Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Daniel D. Reidpath
- Health System & Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | - Stephanie Armstrong
- School of Health and Social Care, College of Health and Science, University of Lincoln, Lincoln, UK
| | - Shamini Gnani
- Department of Primary Care and Public Health, School of Public Health, Faculty of Medicine, Imperial College London, London, UK
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Rowe O, Nadkarni A. Barriers and facilitators to the implementation of mental health and psychosocial support programmes following natural disasters in developing countries: A systematic review. Glob Ment Health (Camb) 2023; 11:e5. [PMID: 38283878 PMCID: PMC10808980 DOI: 10.1017/gmh.2023.91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 11/16/2023] [Accepted: 12/16/2023] [Indexed: 01/30/2024] Open
Abstract
Climate change is leading to more frequent and intense natural disasters, with developing countries particularly at risk. However, most research concerning mental health and natural disasters is based in high-income country settings. It is critically important to provide a mental health response to such events, given the negative psychosocial impacts they elicit. The aim of this systematic review is to explore the barriers and facilitators to implementing mental health and psychosocial support (MHPSS) following natural disasters in developing countries. Eight databases were searched for relevant quantitative and qualitative studies from developing countries. Only studies reporting barriers and/or facilitators to delivering MHPSS in response to natural disasters in a low- or middle-income country were included and full texts were critically appraised using the McGill University Mixed Methods Appraisal Tool. Reported barriers and facilitators were extracted and analysed thematically. Thirty-seven studies were included in the review, reflecting a range of natural disaster settings and developing countries. Barriers to implementing MHPSS included cultural relevance, resources for mental health, accessibility, disaster specific factors and mental health stigma. Facilitators identified included social support, cultural relevance and task-sharing approaches. A number of practical approaches can be used to facilitate the implementation of MHPSS in developing country settings. However, more research is needed on MHPSS in the developing country natural disaster context, especially in Africa, and international policies and guidelines need to be re-evaluated using a decolonial lens.
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Affiliation(s)
- Olivia Rowe
- Centre for Global Mental Health, Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Abhijit Nadkarni
- Centre for Global Mental Health, Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
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Wahid SS, Raza WA, Mahmud I, Kohrt BA. Climate-related shocks and other stressors associated with depression and anxiety in Bangladesh: a nationally representative panel study. Lancet Planet Health 2023; 7:e137-e146. [PMID: 36754469 DOI: 10.1016/s2542-5196(22)00315-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 11/13/2022] [Accepted: 11/21/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND Climate change has major implications for common mental disorders including depression and anxiety in vulnerable nations such as Bangladesh. However, knowledge gaps exist around national estimations of depression and anxiety, and the associations between the prevalence of these disorders with climate-related and sociodemographic risk factors. To address these gaps, this study analysed data from a nationally representative panel study in Bangladesh that examined climate-related and sociodemographic correlates of depression and anxiety. METHODS Two rounds of nationally representative household panel data were collected from urban and rural areas between August and September, 2019, and January and February, 2020. Households were selected for inclusion across 150 enumeration areas as the primary sampling units with use of a two-stage stratified random sampling design, and survey instruments were administered to the available adult member of the household. Depression and anxiety were measured with the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 scales, respectively, and weighted prevalence estimates were calculated on the basis of the 2011 national population census. Data on temperature and humidity were collected from 43 weather stations and constructed as mean values for the 2-month period preceding each round of the survey. Self-reported exposure to flooding was collected for a 12-month recall period. We applied a weighted population average logistic model on the pooled sample of both surveys to analyse the associations between ambient temperature, humidity, exposure to flooding, seasonality, sociodemographic variables, and three outcome conditions (depression, anxiety, and co-occurring depression and anxiety; at the level of p<0·1). The models accounted for temporal and spatial heterogeneity. Standard errors were clustered at the level of each primary sampling unit. FINDINGS 3606 individuals were included with 3·5% dropout in the second survey round (pooled sample n=7086; age range 15-90 years; 2898 [40·9%] men and 4188 [59·1%] women). National weighted prevalence estimates were 16·3% (95% CI 14·7-17·8) for depression, 6·0% (4·7-7·3) for anxiety, and 4·8% (3·7-5·9) for co-occurring depression and anxiety. We observed no significant associations between overall seasonality (summer vs winter) and the odds of depression (adjusted odds ratio 3·14 [95% CI 0·52-19·13], p=0·22), anxiety (0·16 [0·02-1·41], p=0·10), or co-occurring depression and anxiety (0·13 [0·01-1·49], p=0·10). An increase in mean temperature of 1°C within the 2 months preceding the surveys was associated with increased odds of anxiety (1·21 [1·00-1·47], p=0·046) and increased odds of co-occurring depression and anxiety (1·24 [1·00-1·53], p=0·045), whereas increased temperature was not associated with depression (0·90 [0·77-1·04], p=0·15). An increase in mean humidity of 1 g/m3 was not associated with depression (0·99 [0·96-1·02], p=0·60) or anxiety (1·04 [0·99-1·09], p=0·13), but was associated with co-occurring depression and anxiety (1·06 [1·00-1·12], p=0·064). Exposure to flooding within the 12 months preceding the survey rounds was associated with increased odds of all outcome conditions (depression, 1·31 [1·00-1·70], p=0·047; anxiety, 1·69 [1·21-2·36], p=0·0020; and co-occurring depression and anxiety, 1·87 [1·31-2·68], p=0·0006). INTERPRETATION Climate-related shocks and other stressors have an important association with the burden of depression and anxiety in Bangladesh. Community-level interventions for common mental disorders need to be developed and assessed for safety, feasibility, and effectiveness in a Bangladeshi context. Further research on climate-related stressors is needed over different timespans and time intervals. FUNDING The World Bank.
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Affiliation(s)
- Syed Shabab Wahid
- Department of Global Health, Georgetown University, Washington, DC, USA
| | - Wameq Azfar Raza
- Health, Nutrition and Population Global Practice, The World Bank, Dhaka, Bangladesh.
| | - Iffat Mahmud
- Health, Nutrition and Population Global Practice, The World Bank, Dhaka, Bangladesh
| | - Brandon A Kohrt
- Division of Global Mental Health, George Washington University, Washington, DC, USA
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Zhao Q, Yu P, Mahendran R, Huang W, Gao Y, Yang Z, Ye T, Wen B, Wu Y, Li S, Guo Y. Global climate change and human health: Pathways and possible solutions. ECO-ENVIRONMENT & HEALTH (ONLINE) 2022; 1:53-62. [PMID: 38075529 PMCID: PMC10702927 DOI: 10.1016/j.eehl.2022.04.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 04/13/2022] [Accepted: 04/28/2022] [Indexed: 12/13/2023]
Abstract
Global warming has been changing the planet's climate pattern, leading to increasing frequency, intensity and duration of extreme weather events and natural disasters. These climate-changing events affect various health outcomes adversely through complicated pathways. This paper reviews the main signs of climate change so far, e.g., suboptimal ambient temperature, sea-level rise and other conditions, and depicts the interactive pathways between different climate-changing events such as suboptimal temperature, wildfires, and floods with a broad range of health outcomes. Meanwhile, the modifying effect of socioeconomic, demographic and environmental factors on the pathways is summarised, such that the youth, elderly, females, poor and those living in coastal regions are particularly susceptible to climate change. Although Earth as a whole is expected to suffer from climate change, this review article discusses some potential benefits for certain regions, e.g., a more liveable environment and sufficient food supply. Finally, we summarise certain mitigation and adaptation strategies against climate change and how these strategies may benefit human health in other ways. This review article provides a comprehensive and concise introduction of the pathways between climate change and human health and possible solutions, which may map directions for future research.
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Affiliation(s)
- Qi Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Pei Yu
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Rahini Mahendran
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Wenzhong Huang
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Yuan Gao
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Zhengyu Yang
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Tingting Ye
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Bo Wen
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Yao Wu
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Australia
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Islam MS, Ferdous MZ, Sujan MSH, Tasnim R, Masud JHB, Kundu S, Mosaddek ASM, Choudhuri MSK, Kira IA, Gozal D. The psychometric properties of the Bangla Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): preliminary reports from a large-scale validation study. BMC Psychiatry 2022; 22:280. [PMID: 35443625 PMCID: PMC9020159 DOI: 10.1186/s12888-022-03920-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 04/01/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The Posttraumatic Stress Disorder Checklist (PCL-5) is the most widely used screening tool in assessing posttraumatic stress disorder symptoms, based on the Diagnostic and Statistical Manual of Mental disorders (DSM-5) criteria. This study aimed to evaluate the psychometric properties of the newly translated Bangla PCL-5. METHODS A cross-sectional survey was carried out among 10,605 individuals (61.0% male; mean age: 23.6 ± 5.5 [13-71 years]) during May and June 2020, several months after the onset of the COVID-19 outbreak in Bangladesh. The survey included the Bangla PCL-5 and the PHQ-9 depression scale. We used confirmatory factor analysis to test the four-factor DSM-5 model, the six-factor Anhedonia model, and the seven-factor hybrid model. RESULTS The Bangla PCL-5 displayed adequate internal consistency (Cronbach's alpha = 0.90). The Bangla PCL-5 score was significantly correlated with scores of the PHQ-9 depression scale, confirming strong convergent validity. Confirmatory factor analyses indicated the models had a good fit to the data, including the four-factor DSM-5 model, the six-factor Anhedonia model, and the seven-factor hybrid model. Overall, the seven-factor hybrid model exhibited the best fit to the data. CONCLUSIONS The Bangla PCL-5 appears to be a valid and reliable psychometric screening tool that may be employed in the prospective evaluation of posttraumatic stress disorder in Bangladesh.
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Affiliation(s)
- Md. Saiful Islam
- grid.411808.40000 0001 0664 5967Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka-1342 Bangladesh ,Centre for Advanced Research Excellence in Public Health, Savar, Dhaka-1342 Bangladesh
| | - Most. Zannatul Ferdous
- grid.411808.40000 0001 0664 5967Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka-1342 Bangladesh ,Quest Bangladesh Biomedical Research Center, Lalmatia, Dhaka-1207 Bangladesh
| | - Md. Safaet Hossain Sujan
- grid.411808.40000 0001 0664 5967Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka-1342 Bangladesh ,Centre for Advanced Research Excellence in Public Health, Savar, Dhaka-1342 Bangladesh
| | - Rafia Tasnim
- grid.411808.40000 0001 0664 5967Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka-1342 Bangladesh ,Centre for Advanced Research Excellence in Public Health, Savar, Dhaka-1342 Bangladesh
| | - Jakir Hossain Bhuiyan Masud
- Quest Bangladesh Biomedical Research Center, Lalmatia, Dhaka-1207 Bangladesh ,Public Health Informatics Foundation (PHIF), Mirpur, Dhaka-1216 Bangladesh
| | - Sourav Kundu
- Quest Bangladesh Biomedical Research Center, Lalmatia, Dhaka-1207 Bangladesh ,grid.444800.c0000 0000 9772 7011Advanced Institute of Industrial Technology, Shinagawa City, Tokyo, 140-0011 Japan
| | - Abu Syed Md. Mosaddek
- Quest Bangladesh Biomedical Research Center, Lalmatia, Dhaka-1207 Bangladesh ,Department of Pharmacology, Uttara Adhunik Medical College, Uttara, Dhaka-1230 Bangladesh
| | - M. Shahabuddin K. Choudhuri
- Quest Bangladesh Biomedical Research Center, Lalmatia, Dhaka-1207 Bangladesh ,grid.411808.40000 0001 0664 5967Department of Pharmacy, Jahangirnagar University, Savar, Dhaka-1342 Bangladesh ,United States Pharmacopeial Convention (USP) Herbal Medicines Compendium South Asia Expert Panel Member, New Delhi, India
| | - Ibrahim A. Kira
- Center for Cumulative Trauma Studies, Stone Mountain, GA USA ,grid.256304.60000 0004 1936 7400Affiliate of Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA USA
| | - David Gozal
- grid.134936.a0000 0001 2162 3504Department of Child Health and the Child Health Research Institute, The University of Missouri School of Medicine, Columbia, MO 65201 USA
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Hossain A, Ahmed B, Rahman T, Sammonds P, Zaman S, Benzadid S, Jakariya M. Household food insecurity, income loss, and symptoms of psychological distress among adults following the Cyclone Amphan in coastal Bangladesh. PLoS One 2021; 16:e0259098. [PMID: 34727102 PMCID: PMC8562802 DOI: 10.1371/journal.pone.0259098] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 10/12/2021] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Cyclone Amphan swept into Bangladesh's southwestern coast at the end of May 2020, wreaking havoc on food security and economic stability, as well as possibly worsening mental health. We studied the prevalence of post-cyclone stressors in adults following the cyclone and its association with symptoms of psychological distress. METHODS We conducted a cross-sectional study in a coastal district of Bangladesh. A five-item brief symptom rating scale was used to measure the symptoms of psychological distress. Household food insecurity was measured using the USAID Household Food Insecurity Access Scale questionnaire. We estimated adjusted prevalence ratios (aPRs) using robust log-linear models adjusted for potential confounders. RESULTS A total of 478 adults (mean [SD] age, 37.0[12.6] years; 169[35.4%] women) participated in the study. The prevalence of moderate-to-severe psychological symptoms and suicidal ideation was 55.7% and 10.9%, respectively. Following the cyclone, 40.8% of the adults reported severe food insecurity, and 66% of them reported moderate-to-severe mental health symptoms. Also, 54.4% of women and 33.7% of men reported severe food insecurity in the households. Moreover, 25.5% of respondents reported no income or a significant income loss after the cyclone, and 65.5% of them had moderate-to-severe psychological symptoms. Also, 13.8% of respondents reported housing displacement because of severely damaged houses, and 68.2% of them reported moderate-to-severe psychological symptoms. The high prevalence of mental health symptoms was found in women (aPR = 1.41, 95% CI = 1.06-1.82), people with severe food insecurity (aPR = 1.63, 95% CI = 1.01-2.64), and people who lost jobs or lost a major income source (aPR = 1.25, 95% CI = 1.02-1.54). CONCLUSION Following cyclone Amphan, many low-income individuals saw their income drop drastically while others were unemployed and living with severe food insecurity. The result suggests gender inequalities in food-security after the cyclone. Immediate action is needed to ensure household food-security for reducing the burden of mental illness. Rising opportunities of paid-jobs and decreasing income-loss, especially for the poor people, can have a protective impact on psychological distress. However, due to the high prevalence of severe psychological symptoms, long-term mental health services are required among the population of coastal Bangladesh.
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Affiliation(s)
- Ahmed Hossain
- Department of Public Health, North South University, Dhaka, Bangladesh
- Global Health Institute, North South University (NSU), Bashundhara, Dhaka, Bangladesh
- Health Management BD Foundation, Sector 6, Uttara, Dhaka, Bangladesh
| | - Bayes Ahmed
- Institute for Risk and Disaster Reduction (IRDR), University College London (UCL), London, United Kingdom
- Department of Disaster Science and Management, Faculty of Earth and Environmental Sciences, University of Dhaka, Dhaka, Bangladesh
| | - Taifur Rahman
- Department of Public Health, North South University, Dhaka, Bangladesh
- Health Management BD Foundation, Sector 6, Uttara, Dhaka, Bangladesh
| | - Peter Sammonds
- Institute for Risk and Disaster Reduction (IRDR), University College London (UCL), London, United Kingdom
| | - Shamrita Zaman
- Institute for Risk and Disaster Reduction (IRDR), University College London (UCL), London, United Kingdom
| | - Shadly Benzadid
- Department of Public Health, North South University, Dhaka, Bangladesh
- Health Management BD Foundation, Sector 6, Uttara, Dhaka, Bangladesh
| | - Md. Jakariya
- Department of Public Health, North South University, Dhaka, Bangladesh
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Gorny M, Blackstock S, Bhaskaran A, Layther I, Qoba M, Vassar C, Ellis J, Begent J, Forrester J, Goldin J, Hallet Z, Read T, Hodges S, Groszmann M, Hudson LD. Working together better for mental health in children and young people during a pandemic: experiences from North Central London during the first wave of COVID-19. BMJ Paediatr Open 2021; 5:e001116. [PMID: 34660912 PMCID: PMC8507403 DOI: 10.1136/bmjpo-2021-001116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 08/19/2021] [Indexed: 12/27/2022] Open
Abstract
Direct risk from infection from COVID-19 for children and young people (CYP) is low, but impact on services, education and mental health (so-called collateral damage) appears to have been more significant. In North Central London (NCL) during the first wave of the pandemic, in response to the needs and demands for adults with COVID-19, general paediatric wards in acute hospitals and some paediatric emergency departments were closed. Paediatric mental health services in NCL mental health services were reconfigured. Here we describe process and lessons learnt from a collaboration between physical and mental health services to provide care for CYP presenting in mental health crisis. Two new 'hubs' were created to coordinate crisis presentations in the region and to link community mental health teams with emergency departments. All CYP requiring a paediatric admission in the first wave were diverted to Great Ormond Street Hospital, a specialist children's hospital in NCL, and a new ward for CYP mental health crisis admissions was created. This brought together a multidisciplinary team of mental health and physical health professionals. The most common reason for admission to the ward was following a suicide attempt (n=17, 43%). Patients were of higher acute mental health complexity than usually admitted to the hospital, with some CYP needing an extended period of assessment. In this review, we describe the challenges and key lessons learnt for the development of this new ward setting that involved such factors as leadership, training and also new governance processes. We also report some personal perspectives from the professionals involved. Our review provides perspective and experience that can inform how CYP with mental health admissions can be managed in paediatric medical settings.
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Affiliation(s)
| | | | - Arun Bhaskaran
- University College London Hospital NHS Trust, London, UK
| | | | - Mimoza Qoba
- Royal Free Hospital, London, UK
- Royal Free Hospital NHS Trust, London, UK
| | - Carly Vassar
- Great Ormond Street Hospital for Children, London, UK
| | - Jacob Ellis
- University College London Hospital NHS Trust, London, UK
| | - Joanna Begent
- University College London Hospital NHS Trust, London, UK
| | | | - Jon Goldin
- Great Ormond Street Hospital for Children, London, UK
| | - Zoe Hallet
- Great Ormond Street Hospital for Children, London, UK
| | - Tina Read
- Barnet Enfield and Haringey CAMHS, Enfield, London, UK
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Talukder B, van Loon GW, Hipel KW, Chiotha S, Orbinski J. Health impacts of climate change on smallholder farmers. One Health 2021; 13:100258. [PMID: 34027006 DOI: 10.1016/j.onehlt.2021.100258] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 04/26/2021] [Accepted: 04/26/2021] [Indexed: 10/21/2022] Open
Abstract
The health of smallholder farmers is crucial for ensuring food and nutritional security for two billion people. However, their health is in jeopardy for several reasons including challenges from climate change impacts. Using a narrative literature review supported by field observations and informal interviews with key informants in India, Bangladesh and Malawi, this paper identifies and discusses the health impacts of climate change under four categories: (i) communicable diseases, (ii) non-communicable diseases, (iii) mental health, and (iv) occupational health, safety and other health issues. The health impacts of climate change on smallholder farmers will hamper the realization of many of the United Nations' Sustainable Development Goals, and a series of recommendations are made to regional and country governments to address the increasing health impacts of accelerating climate change among smallholder farmers.
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Affiliation(s)
- Byomkesh Talukder
- Dahdaleh Institute for Global Health Research, York University, Canada
| | - Gary W van Loon
- School of Environmental Studies, Queen's University, Kingston, Canada
| | - Keith W Hipel
- System Engineering Department, Waterloo University; Canada Centre for International Governance Innovation Coordinator, Conflict Analysis Group, Waterloo, Canada
| | | | - James Orbinski
- Dahdaleh Institute for Global Health Research, York University, Canada.,Faculty of Health, York University, Canada
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