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Stettaford T, Fehily C, Campbell E, Barker D, Oldmeadow C, McKeon E, Love S, Lawn S, Castle D, Bowman J. Risk prevalence, readiness and confidence to change lifestyle risk factors among clients of community mental health services. Aust N Z J Psychiatry 2024; 58:702-712. [PMID: 38845145 PMCID: PMC11308284 DOI: 10.1177/00048674241257751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
OBJECTIVE People with mental health conditions have high rates of chronic physical diseases, partially attributable to lifestyle risks factors. This study examined risk prevalence among community mental health service clients, their readiness and confidence to change, and associations with participant characteristics. METHODS Cross-sectional survey of adult clients from 12 community mental health services across 3 local health districts in New South Wales, Australia, collected from 2021 to 2022. Participants (n = 486) completed a telephone interview determining five risk factors, and readiness and confidence to change these. Multiple binary logistic regression models determined associations between readiness and confidence (for each risk), and participant characteristics (demographics and diagnosis). RESULTS Participants most commonly reported a diagnosis of schizophrenia (36.7%) or depression (21.1%). Risk factors were prevalent: ranging from 26% (harmful alcohol use) to 97% (poor nutrition). High readiness was greatest for smoking (68%), weight (66%) and physical inactivity (63%), while confidence was highest for changing alcohol use (67%). Two significant associations were identified; females were more likely than males to have high readiness to change nutrition (odds ratio = 1.14, confidence interval = [1.13, 2.34], p = 0.0092), with males more likely to have high confidence to change physical activity (odds ratio = 0.91, confidence interval = [0.45, 0.99], p = 0.0109). CONCLUSIONS Many participants were ready and confident to change risk factors. Gender influenced readiness to change nutrition and physical activity confidence. Training to upskill mental health clinicians in provision of preventive care that builds confidence and readiness levels may aid in supporting positive behaviour change.
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Affiliation(s)
- Tegan Stettaford
- School of Psychological Sciences, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
| | - Caitlin Fehily
- School of Psychological Sciences, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia
- Hunter New England Population Health, Wallsend, NSW, Australia
| | - Elizabeth Campbell
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
- Hunter New England Population Health, Wallsend, NSW, Australia
| | - Daniel Barker
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia
| | - Christopher Oldmeadow
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia
| | - Emma McKeon
- School of Psychological Sciences, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia
| | - Sophie Love
- School of Psychological Sciences, The University of Newcastle, Callaghan, NSW, Australia
| | - Sharon Lawn
- Lived Experience Australia, Brighton, SA, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - David Castle
- School of Psychological Sciences, University of Tasmania, Hobart, TAS, Australia
- Tasmanian Centre for Mental Health Service Innovation, Hobart, TAS, Australia
| | - Jennifer Bowman
- School of Psychological Sciences, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, Clinical Research Centre, New Lambton Heights, NSW, Australia
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Talebi M, Niroumand S, Gholami M, Samarghandi A, Shaygani F, Radfar M, Nemati A. Epidemiological aspects of individuals with mental disorders in the referral system: the experience of a Community Mental Health Center in the northeast of Iran. DISCOVER MENTAL HEALTH 2024; 4:22. [PMID: 38904905 PMCID: PMC11192706 DOI: 10.1007/s44192-024-00078-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 06/17/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND Community Mental Health Centers (CMHCs) offer affordable mental health services in a less stigmatized environment, in a domiciliary setting. This study aimed to shed light on the epidemiological factors of patients attending CMHCs of Mashhad, their referral status, and treatment. METHODS This study was conducted over the medical records of patients seen by psychiatrists between January 2014 and December 2021 in Mashhad's CMHC, the northeast of Iran. A detailed questionnaire was used to extract data from medical records about the epidemiological characteristics, diagnosed mental illnesses, referral status, and how often they visited the psychiatrist. The association between epidemiological findings and patient referral (referral system or self-referral) as well as the association between epidemiological findings and the number of psychiatric revisits were examined using the Chi-square test. RESULTS Out of 662 patients, 472 (71%) were female and 190 (29%) were male, with an average age of 29 years. Among the 475 adult patients, 367 (77.3%) were married, with the majority being homemakers (56.4%). Major Depression Disorder (MDD) (32%) and Generalized Anxiety Disorder (GAD) (18.3%) were the most prevalent mental health conditions among patients. The majority of patients (74.9%) were referred to the CMHC of Mashhad from Primary Healthcare centers (PHCs) and psychiatric hospitals. Furthermore, female gender and patients with lower level of education were associated with more referral through from referral system. Of note, 431 patients (65.1%) did not return for a second visit, the ratio of treatment dropout was higher for patients with lower education levels. CONCLUSIONS Referral system should be more practical in Iran to enhance health services in CMHCs. It is recommended that PHCs undergo certain modifications to enhance the referral process for patients with mental health conditions, focusing on common mental disorders and individuals with low socioeconomic level.
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Affiliation(s)
- Mahdi Talebi
- Department of Community and Family Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shabnam Niroumand
- Department of Community and Family Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mobin Gholami
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Azadeh Samarghandi
- Department of Psychology, Faculty of Education Sciences and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Fatemeh Shaygani
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahdi Radfar
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ahmad Nemati
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Zold AL, Jourdain MK. Empathy Amplified: Exploring the Transformative Potential of Understanding Auditory Hallucinations Through Staff Training. J Am Psychiatr Nurses Assoc 2024:10783903241252162. [PMID: 38767121 DOI: 10.1177/10783903241252162] [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] [Indexed: 05/22/2024]
Abstract
BACKGROUND Stigmatization of individuals diagnosed with psychosis, especially those who experience auditory hallucinations, is a well-documented issue with negative outcomes on provision of care. Existing research has predominantly concentrated on experiential training for students, leaving a significant gap in knowledge regarding the training's impact on practicing psychiatric nurses and technicians. AIMS This study aims to address this gap by investigating the efficacy of a concise, 1-hour educational activity designed to improve empathy, confidence, competence, and knowledge in psychiatric professionals. METHODS Participants engaged in a 1-hour training session that included simulated activities while listening to distressing voices and completed pretraining and posttraining assessments. RESULTS Results demonstrated a notable increase in empathy toward individuals who hear voices, suggesting that the training had a positive effect. Furthermore, significant differences were observed in the participants' perceptions of the level of difficulty as well as increased levels of confidence and perceived competence in their ability to provide care. CONCLUSIONS The results underscore the practicality and effectiveness of brief hearing voices simulations as a means to enhance the skills of existing health care providers. This approach allows professionals to better express empathy and gain a deeper understanding of the experiences of voice hearers.
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Affiliation(s)
- Amanda Lynn Zold
- Amanda Lynn Zold, PhD, Hartford Hospital, Hartford, CT, USA; The University of Texas Health Science Center, Houston, TX, USA
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Mwine P, Migisha R, Kwesiga B, Cheptoris J, Kadobera D, Bulage L, Nsubuga EJ, Mudiope P, Ario AR. Sexual gender-based violence among adolescent girls and young women during COVID-19 pandemic, Mid-Eastern Uganda. Pan Afr Med J 2024; 47:196. [PMID: 39119116 PMCID: PMC11308943 DOI: 10.11604/pamj.2024.47.196.42109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 02/10/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction global studies indicate that sexual gender-based violence (SGBV) may increase during pandemics including COVID-19. The Mid-Eastern region in Uganda was of concern due to the high prevalence of intimate partner sexual violence among adolescent girls and young women (AGYW). Due to limited data, we investigated factors associated with SGBV among AGYW during the COVID-19 pandemic in Eastern Uganda, in April 2022. Methods we listed all AGYW 10-24 years who obtained SGBV services at 10 high-volume health facilities from March 2020 to December 2021, the main COVID-19 period in Uganda. We conducted a case-control study among these AGYW. A case was ≥1 SGBV episode experienced by an AGYW aged 10-24 years residing in the Tororo and Busia districts. For every randomly selected case from the health facility line list, we identified two neighbourhood-matched AGYW controls who reported no SGBV. We interviewed 108 and 216 controls on socio-demographics, socio-economics, and SGBV experiences during COVID-19. We conducted logistic regression to identify associated factors. Results among 389 SGBV cases, the mean age was 16.4 (SD± 1.6: range 10-24) years, and 350 (90%) were aged 15-19 years. Among 108 cases interviewed, 79 (73%) reported forced sex. Most (n=73; 68%) knew the perpetrator. In multivariate analysis, self-reported SGBV before the COVID-19 period [aOR=5.8, 95%CI: 2.8-12] and having older siblings [aOR=1.9, 95%: CI 1.1-3.4] were associated with SGBV during the period. Living with a family that provided all the basic needs was protective [aOR=0.42, 95%: CI 0.23-0.78]. Conclusion previous SGBV experiences and family dynamics, such as having older siblings, increased the odds of SGBV during the COVID-19 pandemic in Uganda. Conversely, a supportive family environment was protective. Identifying, supporting, and enacting protective interventions for SGBV victims and socioeconomically vulnerable AGYW could reduce the burden of SGBV during similar events.
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Affiliation(s)
- Patience Mwine
- Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda
- AIDS Control Program, Ministry of Health, Kampala, Uganda
| | - Richard Migisha
- Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda
| | - Benon Kwesiga
- Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda
| | | | - Daniel Kadobera
- Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda
| | - Lilian Bulage
- Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda
| | - Edirisa Juniour Nsubuga
- Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda
| | - Peter Mudiope
- AIDS Control Program, Ministry of Health, Kampala, Uganda
| | - Alex Riolexus Ario
- Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda
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Gupta S, Kumar A, Kathiresan P, Pakhre A, Pal A, Singh V. Mental health stigma and its relationship with mental health professionals - A narrative review and practice implications. Indian J Psychiatry 2024; 66:336-346. [PMID: 38778855 PMCID: PMC11107930 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_412_23] [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: 06/02/2023] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 05/25/2024] Open
Abstract
The extent and magnitude of the mental health stigma are enormous, with substantial clinical and social implications. There is a complex relationship between mental health stigma and mental health professionals (MHPs); MHPs can be anti-stigma crusaders, victims of stigma, and even a source of stigma. Unfortunately, literature is scarce talking about the relationship between stigma and MHPs. Hence, the current review aims to bridge the existing gap in the literature on various aspects of stigma and the role of MHPs. For the current review, we ran a search in PubMed and Google Scholar databases; we restricted our study to records focusing on the interplay of mental health stigma and the MHPs, published during 2012-2022, in English, and having a full text available. We found that MHPs (psychiatrists, psychologists, and psychiatric nurses) can also be the recipients of the stigma. The stigma faced by the MHPs is determined by the negative stereotypes set by the media, or medical students, or other health professionals; the marginal position of psychiatry in the health system; difficult-to-treat mental disorders; MHPs' own experience of stigma; and the attitude or beliefs of various caders of the MHPs, their professional experience, and expertise in managing various mental health conditions. Notably, MHPs can also be a source of stigma (stigmatizers). MHPs need to be sensitized concerning this, and the anti-stigma interventions must incorporate this aspect of stigma. Novel interventions, such as digital-based programs, should be used instead of traditional anti-stigma programs in order to decrease stigma around mental health issues and make anti-stigma initiatives more appealing and scalable. To address the issues of stigma, there has to be more communication between MHPs, other health professionals, service users, and policymakers.
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Affiliation(s)
- Snehil Gupta
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Akash Kumar
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Preethy Kathiresan
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Ashish Pakhre
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Arghya Pal
- Department of Psychiatry, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Vijender Singh
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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Keynejad RC, Bitew T, Sorsdahl K, Myers B, Honikman S, Mulushoa A, Demissie M, Deyessa N, Howard LM, Hanlon C. Adapting brief problem-solving therapy for pregnant women experiencing depressive symptoms and intimate partner violence in rural Ethiopia. Psychother Res 2024; 34:538-554. [PMID: 37384929 DOI: 10.1080/10503307.2023.2222899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/04/2023] [Accepted: 06/05/2023] [Indexed: 07/01/2023] Open
Abstract
OBJECTIVE To adapt an evidence-based psychological intervention for pregnant women experiencing depressive symptoms and intimate partner violence (IPV) in rural Ethiopia. METHOD We conducted a desk review of contextual factors in Sodo, Ethiopia, followed by qualitative interviews with 16 pregnant women and 12 antenatal care (ANC) providers. We engaged stakeholders through participatory theory of change (ToC) workshops, to select the intervention and articulate a programme theory. We used "ADAPT" guidance to adapt the intervention to the context, before mapping potential harms in a "dark logic model". RESULTS Brief problem-solving therapy developed for South Africa was the most contextually relevant model. We adapted the delivery format (participants prioritised confidentiality and brevity) and training and supervision (addressing IPV). Consensus long-term outcomes in our ToC were ANC providers skilled in detecting and responding to emotional difficulties and IPV, women receiving appropriate support, and emotional difficulties improving. Our dark logic model highlighted the risk of more severe IPV and mental health symptoms not being referred appropriately. CONCLUSION Although intervention adaptation is recommended, the process is rarely reported in depth. We comprehensively describe how contextual considerations, stakeholder engagement, programme theory, and adaptation can tailor psychological interventions for the target population in a low-income, rural setting.
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Affiliation(s)
- Roxanne C Keynejad
- Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Tesera Bitew
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Psychology, College of Education and Behavioural Sciences, Injibara University
| | - Katherine Sorsdahl
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Bronwyn Myers
- Division of Addiction Psychiatry, Department of Psychiatry and Mental health, University of Cape Town, South Africa
- Curtin enAble Institute, Curtin University, Bentley, Western Australia
- Mental health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Simone Honikman
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Perinatal Mental Health Project, Department of Psychiatry and Mental Health, University of Cape Town, Rondebosch, Cape Town, South Africa
| | - Adiyam Mulushoa
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mekdes Demissie
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Negussie Deyessa
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Louise M Howard
- Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Charlotte Hanlon
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
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Gbahabo DD, Duma SE. I did not scream. i could not; i was terrified. i just followed them. . .i blocked my mind. then they all raped me: A narrative inquiry on the onset of tonic immobility among women rape victims in Nigeria. PLoS One 2024; 19:e0278810. [PMID: 38315681 PMCID: PMC10843104 DOI: 10.1371/journal.pone.0278810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 10/30/2023] [Indexed: 02/07/2024] Open
Abstract
Tonic immobility (TI) is a common uncontrollable autonomic mammalian response to an extremely fearful situation. It is one of the most immediate devastating consequences of rape and remains poorly understood. While controversies over its definition persist among researchers, this also reflects on the care for and support to victims. The study aimed to explore and describe the onset of TI and the meaning attached to the experience among women raped victims in Nigeria. The study design was the qualitative narrative inquiry approach. Criterion and purposive sampling were conducted across four post-rape care facilities in Lagos, Nigeria, to recruit 13 participants. In-depth face-to-face interviews were conducted using a semi-structured interview guide to generate data that were thematically analysed. The findings of the study revealed five themes relating to the onset of TI as follows: the first two focused on the experience of TI: (1) the onset of TI prior to rape due to perceived imminent danger, (2) the onset of TI as a self-protection mechanism from further harm) while the last three relate to the meaning-making of the experience of TI (3) self-loathing as a meaning attached to TI, (4) suicidal ideations as a meaning attached to TI, and (5) divine intervention as a meaning attached to TI. Conclusion: The findings underscore the experiences and meanings that participants attach to TI following rape. There is a strong likelihood that tonic-immobility is not an uncommon experience amongst rape victims, but that in the absence of research, specialized care on the condition, and its associated consequences will haunt many women, affecting their psychological well-being and their entire quality of life. Describing the phenomenon as it is experienced by the participants is critical because understanding the condition is the first step toward effective appropriate management.
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Affiliation(s)
- Dooshima Dorothy Gbahabo
- Discipline of Nursing, School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Howard College Campus, Durban, South Africa
| | - Sinegugu Evidence Duma
- Discipline of Nursing, School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Howard College Campus, Durban, South Africa
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Kiflu M, Azale T, Gubae K, Agegnew Wondm S, Mebratu E, EliasErgena A, Abubeker O, Mekonnen GA. Predictors of antipsychotics switching among ambulatory patients with schizophrenia in Ethiopia: a multicenter hospital-based cross-sectional study. Ann Gen Psychiatry 2024; 23:2. [PMID: 38172853 PMCID: PMC10765750 DOI: 10.1186/s12991-023-00472-z] [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: 04/07/2023] [Accepted: 10/13/2023] [Indexed: 01/05/2024] Open
Abstract
INTRODUCTION A change of therapy from one to another antipsychotic medication is currently the main challenge of therapy. This study aimed to assess the prevalence of antipsychotic medication switches and determinants among patients with schizophrenia in Northwest Ethiopia. METHODS Multi-center hospital-based cross-sectional study was conducted at five Comprehensive Specialized Hospitals found in Northwest Ethiopia from April 30, 2021, to August 30, 2021. Data were extracted from both patients' medical charts and interviews. Data were entered into Epi-data software version 3.5.1 and exported to SPSS version 25.0 for analysis. A multivariable logistic regression model was fitted to identify factors associated with medication regimen switch. The level of significance of the study was kept at a p-value of 0.05 with a 95% confidence interval. RESULT A total of 414 patients are involved in the study, and 188 (45.5%) of patients switched antipsychotics within one year. The unavailability of the medication is the commonest reason for switching. Being male [AOR = 2.581, 95% CI (1.463, 4.552)], having relapse [AOR = 2.341,95% CI (1.169,4.687)], history of hospitalization in the past year [AOR = 3.00,95% CI (1.478,5.715)] and taking typical antipsychotics [AOR = 3.340, CI (1.76, 6.00)] had a significant association with antipsychotics switching. CONCLUSIONS AND RECOMMENDATIONS There is a high prevalence of antipsychotic switches among schizophrenia patients. Prescribers need to be careful while dosing, selecting, and switching antipsychotics, hence may help reduce discontinuation and unnecessary switch and thus achieve optimal clinical management.
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Affiliation(s)
- Mekdes Kiflu
- Unit of Clinical Pharmacy, Department of Pharmacy, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Telake Azale
- Department of Health Education and Behavioral Science, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Kale Gubae
- Unit of Pharmacology, Department of Pharmacy, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Samuel Agegnew Wondm
- Unit of Clinical Pharmacy, Department of Pharmacy, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Ephrem Mebratu
- Unit of Clinical Pharmacy, Department of Pharmacy, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Asrat EliasErgena
- Department of Pharmaceutical Chemistry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ousman Abubeker
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Gizework Alemnew Mekonnen
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
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Sansbury GM, Pence BW, Zimba C, Yanguela J, Landrum K, Matewere M, Mbota M, Malava JK, Tikhiwa H, Morrison AM, Akiba CF, Gaynes BN, Udedi M, Hosseinipour MC, Stockton MA. Improving integrated depression and non-communicable disease care in Malawi through engaged leadership and supportive implementation climate. BMC Health Serv Res 2023; 23:1413. [PMID: 38098079 PMCID: PMC10722817 DOI: 10.1186/s12913-023-10344-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 11/17/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Low- and middle-income countries often lack access to mental health services, leading to calls for integration within other primary care systems. In sub-Saharan Africa, integration of depression treatment in non-communicable disease (NCD) settings is feasible, acceptable, and effective. However, leadership and implementation climate challenges often hinder effective integration and quality of services. The aim of this study was to identify discrete leadership strategies that facilitate overcoming barriers to the integration of depression care in NCD clinics in Malawi and to understand how clinic leadership shapes the implementation climate. METHODS We conducted 39 in-depth interviews with the District Medical Officer, the NCD coordinator, one NCD provider, and the research assistant from each of the ten Malawian NCD clinics (note one District Medical Officer served two clinics). Based on semi-structured interview guides, participants were asked their perspectives on the impact of leadership and implementation climate on overcoming barriers to integrating depression care into existing NCD services. Thematic analysis used both inductive and deductive approaches to identify emerging themes and compare among participant type. RESULTS The results revealed how engaged leadership can fuel a positive implementation climate where clinics had heightened capacity to overcome implementation barriers. Effective leaders were approachable and engaged in daily operations of the clinic and problem-solving. They held direct involvement with and mentorship during the intervention, providing assistance in patient screening and consultation with treatment plans. Different levels of leadership utilized their respective standings and power dynamics to influence provider attitudes and perceptions surrounding the intervention. Leaders acted by informing providers about the intervention source and educating them on the importance of mental healthcare, as it was often undervalued. Lastly, they prioritized teamwork and collective ownership for the intervention, increasing provider responsibility. CONCLUSION Training that prioritizes leadership visibility and open communication will facilitate ongoing Malawi Ministry of Health efforts to scale up evidence-based depression treatment within NCD clinics. This proves useful where extensive and external monitoring may be limited. Ultimately, these results can inform successful strategies to close implementation gaps to achieve integration of mental health services in low-resource settings through improved leadership and implementation climate. TRIAL REGISTRATION These findings are reported from ClinicalTrials.gov, NCT03711786. Registered on 18/10/2018. https://clinicaltrials.gov/ct2/show/NCT03711786 .
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Affiliation(s)
- Griffin M Sansbury
- Tidziwe Centre, University of North Carolina Project-Malawi, Private Bag A-104, Lilongwe, Malawi.
| | - Brian W Pence
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC, 27599-7440, USA
| | - Chifundo Zimba
- Tidziwe Centre, University of North Carolina Project-Malawi, Private Bag A-104, Lilongwe, Malawi
| | - Juan Yanguela
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, 1101 McGavran-Greenberg Hall, CB #7411, Chapel Hill, NC, 27599-7411, USA
| | - Kelsey Landrum
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC, 27599-7440, USA
| | - Maureen Matewere
- Tidziwe Centre, University of North Carolina Project-Malawi, Private Bag A-104, Lilongwe, Malawi
| | - MacDonald Mbota
- Tidziwe Centre, University of North Carolina Project-Malawi, Private Bag A-104, Lilongwe, Malawi
| | - Jullita K Malava
- Malawi Epidemiology and Intervention Research Unit (MEIRU), P.O. Box 46, Chilumba, Karonga District, Malawi
| | - Harriet Tikhiwa
- Tidziwe Centre, University of North Carolina Project-Malawi, Private Bag A-104, Lilongwe, Malawi
| | - Abigail M Morrison
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC, 27599-7440, USA
| | - Christopher F Akiba
- RTI International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC, 27709-2194, USA
| | - Bradley N Gaynes
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC, 27599-7440, USA
- Division of Global Mental Health, Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, 101 Manning Dr #1, Chapel Hill, NC, 27514, USA
| | - Michael Udedi
- Malawi Ministry of Health and Population, Non-Communicable Diseases and Mental Health Clinical Services, P.O. Box 30377, Lilongwe, 3, Malawi
| | - Mina C Hosseinipour
- Tidziwe Centre, University of North Carolina Project-Malawi, Private Bag A-104, Lilongwe, Malawi
- Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, 101 Manning Dr #1, Chapel Hill, NC, 27514, USA
| | - Melissa A Stockton
- Tidziwe Centre, University of North Carolina Project-Malawi, Private Bag A-104, Lilongwe, Malawi
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC, 27599-7440, USA
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10
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Susanto TD, Widysanto A, Cipta DA, Tanara A, Wirawan GR, Kosim AB, Djoni CM, Tantri E, Kumar C, Angelius C. Anxiety and depression level of patients with multidrug-resistant tuberculosis (MDR-TB) in two hospitals in Banten province, Indonesia. DIALOGUES IN HEALTH 2023; 2:100115. [PMID: 38515492 PMCID: PMC10953925 DOI: 10.1016/j.dialog.2023.100115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 01/26/2023] [Accepted: 02/12/2023] [Indexed: 03/23/2024]
Abstract
Purpose Anxiety and depression can be found in patients diagnosed with multidrug-resistant Tuberculosis (MDR-TB). The purpose of this research is to measure the level of anxiety and depression in new patients with MDR-TB. Methods One hundred two new patients newly diagnosed with MDR TB in two hospitals in Banten province, Indonesia, are measured for depression and anxiety symptoms. The measurements used the Indonesian language version of the Zung Anxiety Self-Assessment Scale Questionnaire and the Indonesian version of Zung Self-Rating Depression Scale Questionnaire for Pulmonary Tuberculosis Patients that have been validated. The results include the demographic data presented descriptively as tables and charts. Results The mean age of the patients is 39,57+12,48 years. The monthly income of the patients is 54,9% low and 45,1% medium with no high income. Male is 61,8%, and 38,2% are female. The mean score of the anxiety index is 57,32+10,23. The mean score of the depression index is 55,02+12,36. The percentage of patients with no anxiety is 13,7%, minimal to moderate anxiety 46,1%, marked to severe anxiety 33,3%, and most extreme anxiety 6,9%. Conclusions A significant proportion of patients newly diagnosed with MDR-TB experience anxiety and depression.
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Affiliation(s)
| | - Allen Widysanto
- Department of Internal Medicine, Universitas Pelita Harapan, Banten, Indonesia
| | - Darien Alfa Cipta
- Department of Psychiatry, Universitas Pelita Harapan, Banten, Indonesia
| | - Arron Tanara
- Faculty of Medicine, Universitas Pelita Harapan, Banten, Indonesia
| | | | | | | | - Ervinna Tantri
- Faculty of Medicine, Universitas Pelita Harapan, Banten, Indonesia
| | - Chandni Kumar
- Faculty of Medicine, Universitas Pelita Harapan, Banten, Indonesia
| | - Chelsie Angelius
- Faculty of Medicine, Universitas Pelita Harapan, Banten, Indonesia
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11
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Baumann F, Bergamaschi V, Warnke I, Corbisiero S, Felleiter KG, Fellmann S, Ludwig F, Riedel A, Znoj H, Schmidt S. Study protocol of an observational study in acute psychiatric home treatment: How does home treatment work? Identification of common factors and predictors of treatment success. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2023; 37:214-220. [PMID: 36941465 DOI: 10.1007/s40211-023-00457-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 01/21/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Systematic reviews indicated that home treatment is an effective and cost-saving alternative to conventional acute psychiatric treatment options. Treatment success has often been defined as a reduction of hospital admissions. In the current study, symptoms and well-being are assessed regularly during treatment as an indicator for treatment success. Patients' characteristics such as diagnosis, age, substance use, and motivation for treatment were discussed as predictors for treatment success. A second focal point of the study lies in the examination of the therapeutic relationship in terms of the outcome, which has not yet been systematically investigated in home treatment. METHODS This is an observational study with a prospective naturalistic design. Measurements are carried out at baseline, during and at the end of treatment as well as at the 3‑month follow-up. Patients' characteristics as potential predictors for treatment success will be assessed at baseline. In addition, the perceived relationship between the patients and the team will be measured daily and weekly throughout the treatment. Treatment success is by the changes in symptoms and general well-being assessed weekly. We aim to include 82 participants assigned to home treatment. Variance analyses with repeated measurements will be conducted to evaluate treatment success. CONCLUSION By examining potential patient- and relationship-related predictors of treatment success, insights into relevant determining variables of treatment success in this setting are expected. The results might help to better identify who benefits the most from home treatment.
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Affiliation(s)
- Felix Baumann
- Institute of Psychology, University of Berne, Berne, Switzerland.
- GiA Stadt, Lucerne Psychiatry, Voltastr. 42, 6005, Lucerne, Switzerland.
| | - Vera Bergamaschi
- Institute of Psychology, University of Berne, Berne, Switzerland.
- GiA Stadt, Lucerne Psychiatry, Voltastr. 42, 6005, Lucerne, Switzerland.
| | | | | | | | | | | | | | - Hansjörg Znoj
- Institute of Psychology, University of Berne, Berne, Switzerland
| | - Stefanie Schmidt
- Institute of Psychology, University of Berne, Berne, Switzerland
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12
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Simbar M, Kiani Z, Nasiri Z, KhodaKarami N, Nazarpour S, Fakari FR, Keyvanfar S, Majd HA. The self-care situation analysis of reproductive-aged women in Tehran: a survey study. BMC Womens Health 2023; 23:624. [PMID: 38007431 PMCID: PMC10675894 DOI: 10.1186/s12905-023-02763-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 11/04/2023] [Indexed: 11/27/2023] Open
Abstract
BACKGROUND Along with a global increase in the prevalence of infectious and non-communicable diseases, self-care with an emphasis on reproductive health Self-care has received special attention. Given the importance of women's health, assessment of their self-care status using a valid and reliable tool seems to be necessary to determine the needs for future women's reproductive health promotion interventions. The present study aimed to assess the women's self-care at reproductive age in Tehran, to determine women's health needs based on global guidelines for women's health. METHODS This was a descriptive cross-sectional study on 1051 women of reproductive age, living in Tehran. The Subjects were recruited using a multi-stage sampling method. The women completed a socio-demographic and valid and reliable questionnaire to assess their self-care status. The data were analyzed using SPSS 24 and by Pearson, Spearman, ANOVA, and regression tests. RESULTS The mean score of self-care was 49.57 ± 23.50% in the reproductive-aged women. The lowest scores were related to psychosocial health (32.12 ± 29.93%) and reproductive-sexual health (49.74 ± 27.99%) respectively. There were significant positive correlations between the self-care and women's education level (r = 0.180; p < 0.01), and husband's education level (r = 0.272; p < 0.01), while there was a negative significant correlation between the self-care and the family size (r = - 0.135; p < 0.01). CONCLUSION The findings showed inadequate self-care among reproductive-aged women in Tehran. The most important challenge in their self-care behaviors was related to psychosocial and reproductive-sexual health. It seems to provide a package for promoting women's self-care in four areas of physical, psychosocial, reproductive-sexual health, and screening tests, with an emphasis on the first two priorities, namely psychosocial and reproductive health necessary in Tehran.
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Affiliation(s)
- Masoumeh Simbar
- Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Zahra Kiani
- Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zeinab Nasiri
- General Directorate of Health, The Deputy of Social and Cultural Affairs of Tehran Municipality, Tehran, Iran
| | - Nahid KhodaKarami
- Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soheila Nazarpour
- Department of Midwifery, Chalous Branch, Islamic Azad University, Chalous, Iran
| | - Farzaneh Rashidi Fakari
- Department of Midwifery, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Sepideh Keyvanfar
- Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Alavi Majd
- Department of Biostatistics, School of Paramedicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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13
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Crowley S, McDonagh S, Carolan D, O'Connor K. The clinical impact of a crisis resolution home treatment team. Ir J Psychol Med 2023:1-8. [PMID: 37929580 DOI: 10.1017/ipm.2023.45] [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] [Indexed: 11/07/2023]
Abstract
OBJECTIVES To evaluate the impact of treatment provided by a Crisis Resolution Home Treatment Team (CRHTT) in terms of preventing hospital admission, impact on service user's symptoms and overall functioning, as well as service user's satisfaction with the service. Secondary objectives were to evaluate the patient characteristics of those attending the CRHTT. METHODS All the service users treated by the CRHTT between 2016 and 2020 were included. Service users completed the Brief Psychiatric Rating Scale (BPRS), the Health of the Nation Outcome Scale (HoNOS), and the Client Satisfaction Questionnaire-version 8 (CSQ-8) before and after treatment by the CRHTT. Admission rates were compared between areas served by the CRHTT and control, before and after the introduction of the CRHTT, using two-way ANOVA. RESULTS Between 2016 and 2020, 1041 service users were treated by the service. Inpatient admissions in the areas served by the CRHTT fell by 38.5% after its introduction. There was a statistically significant interaction between CRHTT availability and time on admission rate, F (1,28) = 8.4, p = .007. BPRS scores were reduced significantly (p < .001), from a mean score of 32.01 before treatment to 24.64 after treatment. Mean HoNOS scores were 13.6 before and 9.1 after treatment (p < .001). Of the 1041 service users receiving the CSQ-8, only 180 returned it (17.3%). Service users' median responses were "very positive" to all eight items on the CSQ-8. CONCLUSIONS Although our study design has limitations this paper provides some support that CRHTT might be effective for the prevention of inpatient admission. The study also supports that CRHTT might be an effective option for the treatment of acute mental illness and crisis, although further research is needed in this area.
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Affiliation(s)
- S Crowley
- Department of Psychiatry, Acute Mental Health Unit, Cork University Hospital, Wilton, Cork, Ireland
- Department of Psychiatry, University College Cork, Cork, Ireland
| | - S McDonagh
- Department of Psychiatry, Acute Mental Health Unit, Cork University Hospital, Wilton, Cork, Ireland
- Department of Psychiatry, University College Cork, Cork, Ireland
| | - D Carolan
- Department of Psychiatry, University College Cork, Cork, Ireland
- Home Based Treatment Team & RISE Early Intervention in Psychosis Team, South Lee Mental Health Services, Blackrock Hall Primary Care Centre, Cork, Ireland
| | - K O'Connor
- Department of Psychiatry, Acute Mental Health Unit, Cork University Hospital, Wilton, Cork, Ireland
- Department of Psychiatry, University College Cork, Cork, Ireland
- Home Based Treatment Team & RISE Early Intervention in Psychosis Team, South Lee Mental Health Services, Blackrock Hall Primary Care Centre, Cork, Ireland
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14
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Zhao S, Akhter S. Negative psychological and educational impacts of Corona Virus Anxiety on Chinese university students: Exploring university students' perceptions. Heliyon 2023; 9:e20373. [PMID: 37780746 PMCID: PMC10539632 DOI: 10.1016/j.heliyon.2023.e20373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/16/2023] [Accepted: 09/20/2023] [Indexed: 10/03/2023] Open
Abstract
COVID-19 has greatly affected various aspects of societies worldwide, including the mental health and quality of education for students. Different studies investigated the consequences of the pandemic, but only a few studies have addressed the negative psychological and educational impacts of Corona Virus Anxiety (CVA). This study addresses the effects of CVA on Chinese students and explores university perceptions of its consequences. A mixed-methods research design was used, with 440 university students selected through convenience sampling. The researchers used the CVA scale, generalized anxiety scale, mental health questionnaire, and a self-report scale to assess the students' educational attainment. In addition, 14 students were interviewed for the qualitative phase of the study. Data from the quantitative phase were analyzed using Pearson correlation and descriptive statistics, while content analysis techniques were employed for analyzing the qualitative data. Results showed that CVA is negatively associated with students' anxiety, stress, and depression. Furthermore, stress, anxiety, depression, and CVA were found to be negatively associated with students' GPAs. Qualitative findings revealed that CVA negatively affected students' GPAs, research projects, classroom engagement, and graduations. The findings are theoretically and practically important to universities, schools, and educational centers to avoid the effects of the CVA on students' educational attainment and mental health through appropriate planning and providing facilities to the students during the lockdown.
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Affiliation(s)
- Sujuan Zhao
- School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Shamim Akhter
- Research Scholar, School of Languages, Civilisation and Philosophy, University Utara Malaysia, Malaysia
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15
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Harvey C, Zirnsak TM, Brasier C, Ennals P, Fletcher J, Hamilton B, Killaspy H, McKenzie P, Kennedy H, Brophy L. Community-based models of care facilitating the recovery of people living with persistent and complex mental health needs: a systematic review and narrative synthesis. Front Psychiatry 2023; 14:1259944. [PMID: 37779607 PMCID: PMC10539575 DOI: 10.3389/fpsyt.2023.1259944] [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: 07/17/2023] [Accepted: 08/23/2023] [Indexed: 10/03/2023] Open
Abstract
Objective This study aims to assess the effectiveness of community-based models of care (MoCs) supporting the recovery of individuals who experience persistent and complex mental health needs. Method We conducted a systematic review and narrative synthesis of MoC studies reporting clinical, functional, or personal recovery from October 2016 to October 2021. Sources were Medline, EMBASE, PsycInfo, CINAHL, and Cochrane databases. Studies were grouped according to MoC features. The narrative synthesis was led by our researchers with lived experience. Results Beneficial MoCs ranged from well-established to novel and updated models and those explicitly addressing recovery goals and incorporating peer support: goal-focused; integrated community treatment; intensive case management; partners in recovery care coordination; rehabilitation and recovery-focused; social and community connection-focused; supported accommodation; and vocational support. None of our diverse group of MoCs supporting recovery warranted a rating of best practice. Established MoCs, such as intensive case management, are promising practices regarding clinical and functional recovery, with potential for enhancements to support personal recovery. Emerging practice models that support personal and functional recovery are those where consumer goals and priorities are central. Conclusion Evidence for established models of care shows that there is a need for inevitable evolution and adaptation. Considering the high importance of effective MoCs for people experiencing persistent and complex mental health needs, further attention to service innovation and research is required. Greater emphasis on the inclusion of lived and living experience in the design, delivery, implementation, and research of MoCs is needed, to enhance MOCs' relevance for achieving individual consumer recovery outcomes.
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Affiliation(s)
- Carol Harvey
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
- North West Area Mental Health, Division of Mental Health, Northern Health, Melbourne, VIC, Australia
| | - Tessa-May Zirnsak
- Social Work and Social Policy, Department of Community and Clinical Health, La Trobe University, Bundoora, VIC, Australia
| | - Catherine Brasier
- Social Work and Social Policy, Department of Community and Clinical Health, La Trobe University, Bundoora, VIC, Australia
| | | | - Justine Fletcher
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Bridget Hamilton
- Centre for Mental Health Nursing, Department of Nursing, The University of Melbourne, Melbourne, VIC, Australia
| | - Helen Killaspy
- Department of Epidemiology and Applied Clinical Research, Division of Psychiatry, University College London, London, United Kingdom
- Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Peter McKenzie
- The Bouverie Centre, School of Psychology and Public Health, La Trobe University, Brunswick, VIC, Australia
| | - Hamilton Kennedy
- Centre for Mental Health Nursing, Department of Nursing, The University of Melbourne, Melbourne, VIC, Australia
| | - Lisa Brophy
- Social Work and Social Policy, Department of Community and Clinical Health, La Trobe University, Bundoora, VIC, Australia
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16
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Weinmann S, Nikolaidis K, Längle G, von Peter S, Brieger P, Timm J, Fischer L, Raschmann S, Holzke M, Schwarz J, Klocke L, Rout S, Hirschmeier C, Herwig U, Richter J, Kilian R, Baumgardt J, Hamann J, Bechdolf A. Premature termination, satisfaction with care, and shared decision-making during home treatment compared to inpatient treatment: A quasi-experimental trial. Eur Psychiatry 2023; 66:e71. [PMID: 37681407 PMCID: PMC10594305 DOI: 10.1192/j.eurpsy.2023.2443] [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] [Received: 03/29/2023] [Revised: 08/01/2023] [Accepted: 08/01/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Inpatient equivalent home treatment (IEHT), implemented in Germany since 2018, is a specific form of home treatment. Between 2021 and 2022, IEHT was compared to inpatient psychiatric treatment in a 12-months follow-up quasi-experimental study with two propensity score matched cohorts in 10 psychiatric centers in Germany. This article reports results on the treatment during the acute episode and focuses on involvement in decision-making, patient satisfaction, and drop-out rates. METHODS A total of 200 service users receiving IEHT were compared with 200 matched statistical "twins" in standard inpatient treatment. Premature termination of treatment as well as reasons for this was assessed using routine data and a questionnaire. In addition, we measured patient satisfaction with care with a specific scale. For the evaluation of patient involvement in treatment decisions, we used the 9-item Shared Decision Making Questionnaire (SDM-Q-9). RESULTS Patients were comparable in both groups with regard to sociodemographic and clinical characteristics. Mean length-of-stay was 37 days for IEHT and 28 days for inpatient treatment. In both groups, a similar proportion of participants stopped treatment prematurely. At the end of the acute episode, patient involvement in decision-making (SDM-Q-9) as well as treatment satisfaction scores were significantly higher for IEHT patients compared to inpatients. CONCLUSIONS Compared to inpatient care, IEHT treatment for acute psychiatric episodes was associated with higher treatment satisfaction and more involvement in clinical decisions.
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Affiliation(s)
- Stefan Weinmann
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Hospital an der Lindenhöhe, Offenburg, Germany
- University Psychiatric Hospital Basel, University of Basel, Basel, Switzerland
| | - Konstantinos Nikolaidis
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Hospital Am Urban und Vivantes Hospital im Friedrichshain, Charité University Medicine Berlin, Berlin, Germany
- Department for Psychiatry and Psychotherapy, Charité University Medicine Berlin, Berlin, Germany
| | - Gerhard Längle
- Centre for Psychiatry Suedwuerttemberg, Zwiefalten, Germany
- Gemeinnützige GmbH für Psychiatrie Reutlingen (PP.rt), Academic Hospital of Tuebingen University, Reutlingen, Germany
| | - Sebastian von Peter
- Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Immanuel Hospital Rüdersdorf, Rüdersdorf, Germany
| | - Peter Brieger
- kbo-Isar-Amper-Klinikum, Region München, Munich, Germany
| | - Jürgen Timm
- Competence Center for Clinical Trials Bremen, University of Bremen, Bremen, Germany
| | - Lasse Fischer
- Competence Center for Clinical Trials Bremen, University of Bremen, Bremen, Germany
| | | | - Martin Holzke
- Centre for Psychiatry Suedwuerttemberg, Ravensburg, Germany
- Department of Psychiatry and Psychotherapy I, Ulm University, Ravensburg, Germany
| | - Julian Schwarz
- Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Immanuel Hospital Rüdersdorf, Rüdersdorf, Germany
| | - Luisa Klocke
- kbo-Isar-Amper-Klinikum, Region München, Munich, Germany
| | - Sandeep Rout
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Hospital Neukölln, Berlin, Germany
| | - Constanze Hirschmeier
- Department for Psychiatry and Psychotherapy, Charité University Medicine Berlin, Berlin, Germany
| | - Uwe Herwig
- Center for Psychiatry Reichenau, Reichenau, Germany
| | - Janina Richter
- Department of Psychiatry and Psychotherapy, University Hospital Tuebingen, Tübingen, Germany
| | - Reinhold Kilian
- Department of Psychiatry and Psychotherapy II, BKH Günzburg, Ulm University, GünzburgGermany
| | - Johanna Baumgardt
- Research Institute of the Local Health Care Funds (WIdO), Berlin, Germany
| | | | - Andreas Bechdolf
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Hospital Am Urban und Vivantes Hospital im Friedrichshain, Charité University Medicine Berlin, Berlin, Germany
- Department for Psychiatry and Psychotherapy, Charité University Medicine Berlin, Berlin, Germany
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17
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Rameez S, Nasir A. Barriers to mental health treatment in primary care practice in low- and middle-income countries in a post-covid era: A systematic review. J Family Med Prim Care 2023; 12:1485-1504. [PMID: 37767443 PMCID: PMC10521856 DOI: 10.4103/jfmpc.jfmpc_391_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 06/02/2022] [Accepted: 06/13/2022] [Indexed: 09/29/2023] Open
Abstract
General primary care workers and family physicians are a crucial work force in managing the mental health of people in any given region. However, the barriers they face in low- and middle-income countries (LMICs) may be worsened by the pandemic. This review aims to bring together evidence about mental health treatment challenges experienced by people in LMICs in primary care settings. The review focuses on the shortage of essential mental healthcare services, stigma and lack of competent primary care professionals in establishing these services and their importance in the COVID-19 pandemic context. The systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the search strategy included keyword search terms (MeSH) to perform a search across three electronic databases - Critical Appraisal Skills Program assessed PubMed, SpringerLink, and Cochrane and quality of the articles. The articles selected were analyzed through thematic analysis to identify the main themes and conclude our findings. Findings indicate that out of 1792 publications found, 14 studies matched the desired criteria for the studies. Endnotes, database search filters, and Covidence data extraction tools were used to generate the relevant articles in this study. This study shows that primary care institutions have financial and management issues in providing mental health services and a shortage of competent mental health experts in primary care, especially mental health-trained family physicians. The study also identifies community stigma as the most prevalent barrier to seeking mental health therapy, reflecting the lack of community health education in LMICs.
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Affiliation(s)
- Sahar Rameez
- Student Health and Wellbeing Organization (SHAW), Pakistan
| | - Almas Nasir
- Pakistan Association of Lifestyle Medicine, Pakistan
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18
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Abstract
PURPOSE OF REVIEW We review recent research on the epidemiology and etiology of suicide in the global context. We focus on data from low- and middle-income countries (LMIC), with the goal of highlighting findings from these under-researched, over-burdened settings. RECENT FINDINGS Prevalence of suicide in LMIC adults varies across region and country income-level, but is, on average, lower than in high-income countries. Recent gains in suicide reduction, however, have been smaller in LMIC compared to global rates. LMIC youth have much higher rates of suicide attempts than youth from high-income countries. Females as well as people with psychiatric disorders, those living with HIV, those who are LGBTQ + , and those with poor socioeconomic status are highly vulnerable populations in LMIC. Limited and low-quality data from LMIC hinder clear interpretation and comparison of results. A greater body of more rigorous research is needed to understand and prevent suicide in these settings.
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Affiliation(s)
- Kathryn L Lovero
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | | | - Amalio X Come
- Department of Mental Health, Ministry of Health, Maputo, Mozambique
| | - Milton L Wainberg
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Maria A Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 200, Philadelphia, PA, 19104, USA.
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Vancampfort D, Mugisha J, Rosenbaum S, Van Damme T. Physical activity counselling in women with HIV/AIDS and suicidal ideation: a secondary analysis of a real-world intervention in Ugandan HIV counselling centres. Pan Afr Med J 2023; 45:70. [PMID: 37637405 PMCID: PMC10460103 DOI: 10.11604/pamj.2023.45.70.40093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 05/10/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction people with HIV/AIDS have higher rates of suicidal ideation than the general population. Consequently, HIV counselling settings should implement suicide risk reduction initiatives. Physical activity (PA) counselling could be a relevant add-on intervention. The aim of this secondary analysis from a single-arm pre- and post-study exploring the efficacy of PA counselling for HIV/AIDS patients with mental health problems was to investigate the efficacy of PA counselling on reducing suicidal ideation. Methods out of 41 participants in an 8-week PA counselling intervention, 15 participants reported suicidal ideation. These 15 (15♀, median age=42 years, interquartile range=24 years) participants completed the Patient Health Questionnaire-9 (PHQ-9), Alcohol Use Disorder Identification Test -10 (AUDIT-10), and the Simple Physical Activity Questionnaire (SIMPAQ) pre- and immediately post-intervention. Results the prevalence of suicidal ideation (PHQ-9 item 9≥1) dropped to 20% post-intervention, i.e. only three patients with HIV still reported suicidal ideation. Also, following the intervention significant (P<0.05) increases in walking and incidental PA (SIMPAQ) levels, and reductions in depressive and alcohol abuse symptoms were observed. Conclusion our data demonstrate that PA counselling might be promising in reducing suicidal ideation in most HIV patients in low-resourced settings. Randomized controlled trials are warranted to confirm these beneficial findings.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
- University Psychiatric Centre KU Leuven, Leuven-Kortenberg, Belgium
| | - James Mugisha
- Department of Sociology and Social Administration, Kyambogo University, Kampala, Uganda
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Tine Van Damme
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
- University Psychiatric Centre KU Leuven, Leuven-Kortenberg, Belgium
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Tarkie K, Altaye KD, Berhe YW. Current patterns of care at adult emergency department in Ethiopian tertiary university hospital. Int J Emerg Med 2023; 16:25. [PMID: 37041467 PMCID: PMC10088255 DOI: 10.1186/s12245-023-00502-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 04/02/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND The complexity and demands of emergency healthcare service are continuously increasing, and it is important to regularly track the patterns of care at the emergency department (ED). METHODOLOGY A retrospective study was conducted at the ED of the University of Gondar Comprehensive Specialized Hospital (UoGCSH) from April 1 to June 30, 2021. Ethical approval was obtained from the Emergency and Critical Care Directorate of UoGCSH. Data was collected from the emergency registry and descriptive analysis was performed. RESULTS A total of 5232 patients have visited and triaged at the ED. All patients who visited the ED have received triage service within 5 min of arrival. The average length of stay at the ED was 3 days. About 79.1% of patients have stayed at the ED beyond 24 h, and the unavailability of beds at admission areas was responsible for 62% of delays. Mortality rate at the ED was 1.4%, and male to female ratio of death was 1.2 to 1. Shock (all types combined), pneumonia with/without COVID-19, and poisoning were the leading causes of death at the ED which were responsible for 32.5%, 15.5%, and 12.7% of deaths respectively. CONCLUSIONS Triage has been done within the recommended time after patient arrival. However, many patients were staying at the ED for an unacceptably prolonged time. Unavailability of beds at the admission areas, waiting long for senior clinicians' decisions, delays in investigation results, and lack of medical equipment were the causes of delayed discharge from the ED. Shock, pneumonia, and poisoning were the leading causes of death. Healthcare administrators should address the lack of medical resources, and clinicians should provide timely clinical decision and investigation results.
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Affiliation(s)
- Kibur Tarkie
- Department of Internal Medicine, University of Gondar, Gondar, Ethiopia
| | - Kassaye Demeke Altaye
- Department of Emergency Medicine and Critical Care, University of Gondar, Gondar, Ethiopia
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Fakhari A, Herizchi S, Sadeghi-Bazargani H, Amiri S, Noorazar SG, Mirzajanzade M, Barzegar H, Farahbakhsh M, Azizi H. Prevalence of psychiatric disorders in the aging population in the northeastern of Iran. MIDDLE EAST CURRENT PSYCHIATRY 2023. [DOI: 10.1186/s43045-023-00287-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
Abstract
Background
The prevalence of psychiatric disorders by demographic characteristics in elderly people is poorly understood, at least in the northwest of Iran. We aimed to estimate the prevalence of various psychiatric disorders in the elderly population in East Azerbaijan Province, Tabriz. A total of 1000 aging people were randomly selected from the general population. Data were collected using valid structured instruments and face-to-face interviews by trained psychologists. The Structured Clinical Interview for DSM-IV-TR (SCID-IV) and Abbreviated Mental Test Questionnaire were used. Chi-square (χ2) test was used for categorized variables, and an independent T-test was carried out for quantitative variables.
Results
Overall, 38.5% of the elderly had at least one mental disorder (47.2% women, 27.3% men). The prevalence of major depressive disorder (MDD) and any anxiety disorders was 16.6% (22.4% female and 9.3% male) and 16.7% (23.1% female and 8.6% male), respectively. Likewise, the overall prevalence of any depressive symptoms, post-traumatic stress disorder (PTSD), general anxiety disorder (GAD), obsessive-compulsive disorder (OCD), and panic disorders were 21.6%, 7%, 5.3%, and 5.9%, respectively. The prevalence of any mental disorder in the first, second, and third quartiles of the socio-economic level was 54.3%, 37%, and 17.8%, respectively. The prevalence of any mental disorders among the marginalized and the non-marginalized population is 55.3 and 31.5%, respectively.
Conclusions
We found 38.5% (47.2% women, 27.3% men) of the elderly people had any mental disorders, and 21.6% of them had any depressive disorders. The prevalence of mental disorders in elders was almost like adults and middle-aged people in this study. However, the prevalence of mental disorders was higher than in marginalized population and low socio-economic status.
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Rates and correlates of psychological distress and PTSD among persons with physical disabilities in Cambodia. Int J Equity Health 2023; 22:30. [PMID: 36765360 PMCID: PMC9912539 DOI: 10.1186/s12939-023-01842-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/25/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Compared to the general population, persons with disabilities are at increased risk of poor mental health. The aim of this study was to determine the rates and correlates of psychological distress and post-traumatic stress disorder (PTSD) among persons with physical disabilities in Cambodia. METHODS From July to December 2021 data were collected as part of a mental health screening programme for persons with physical disabilities who access prosthetic and orthotic services. Psychological distress was measured using the Kessler-10 (K-10) and PTSD using the PC-PTSD-5. Bivariate and multiple linear regression analyses were conducted to identify factors associated with levels of psychological distress and PTSD among this population. RESULTS Our study found a high prevalence of psychological distress and PTSD in this patient cohort. Of the 213 participants, 31.5% were likely to be experiencing mild to moderate psychological distress indicative of a mental health disorder, with 13.6% likely to have a severe mental health disorder. Sixty-five percent of patients reported experiencing PTSD symptoms, with forty-six percent meeting the criteria for probable PTSD. Psychological distress was associated with pathological worry, rumination, and facets of mindfulness. Rumination and pathological worry were found to be significant predictors of psychological distress. PTSD symptoms were associated with pathological worry but not facets of mindfulness or rumination. Facets of mindfulness and pathological worry were found to be significant predictors of PTSD. CONCLUSION Integration of mental health services within the disability sector is required to address psychological distress and PTSD symptoms among people with physical disabilities in Cambodia. Health system interventions, such as screening, referral, and the training of health providers, need to be strengthened. Further studies focussing on the psychosocial determinants of mental health of persons with disabilities in Cambodia are required.
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Azizi H, Esmaeili ED, Khodamoradi F, Sarbazi E. Effective suicide prevention strategies in primary healthcare settings: a systematic review. MIDDLE EAST CURRENT PSYCHIATRY 2022. [DOI: 10.1186/s43045-022-00271-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract
Background
There is a fundamental need for health systems, health managers, and policymakers to identify effective components of suicide prevention strategies (SPS) and programs in primary healthcare (PHC) settings. Accordingly, this systematic review aimed to identify and summarize effective and significant evidence on suicide prevention in PHC setting. We systematically searched the published literature in English from PubMed, Web of Science, Scopus, CINAHL, PsychoINFO, and Embase up to 31 July 2022. The study searched all records reporting effective and significant strategies and programs on suicide prevention in PHC settings. A content analysis approach was carried out to extract major components of suicide prevention strategies in PHC settings.
Results
A total of 10 records (8 original articles and 2 reports) with 1,199,986 samples were included. In all the included articles, SPS decreased suicide rates. The majority of studies were conducted among the general population. The content analysis approach emerged five major components to SPS in PHC setting: (1) training and educating healthcare providers, (2) screening and suicide risk assessment, (3) managing depression symptoms and mental disorders, (4) managing suicide attempters and at-risk cases, and (5) prevention strategies at the general population.
Conclusions
This review provided reliable evidence for health systems to develop SPS in PHC and practitioners who are eager to provide brief and effective contact interventions for suicide risk to well-serve their patients.
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Nyashanu T, Visser M. Treatment barriers among young adults living with a substance use disorder in Tshwane, South Africa. Subst Abuse Treat Prev Policy 2022; 17:75. [PMCID: PMC9675246 DOI: 10.1186/s13011-022-00501-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2022] [Indexed: 11/21/2022] Open
Abstract
Background Despite increasing substance use globally, substance use treatment utilisation remains low. This study sought to explore and measure substance use treatment barriers among young adults in South Africa. Methods The study was done in collaboration with the Community-Oriented Substance Use Programme run in Tshwane, South Africa. A mixed methods approach employing focus group discussions with key informants (n = 15), a survey with a random sample of people using substances and receiving treatment (n = 206), and individual semi-structured interviews (n = 15) was used. Descriptive statistics and thematic analysis were used to analyse data. Results Contextual barriers seemed more prominent than attitudinal barriers in the South African context. Fragmented services, stigma-related factors, an information gap and lack of resources and support (contextual factors), perceived lack of treatment efficacy, privacy concerns, and denial and unreadiness to give up (attitudinal factors) were treatment barriers that emerged as themes in both quantitative and qualitative data. Culture and religion/spirituality emerged as an important barrier/facilitator theme in the qualitative data. Conclusion Interventions need to embrace contextual factors such as culture, and more resources should be channelled towards substance use treatment. Multi-level stakeholder engagement is needed to minimise stigmatising behaviours from the community and to raise awareness of available treatment services. There is a need for strategies to integrate cultural factors, such as religion/spirituality and traditional healing, into treatment processes so that they complementarily work together with pharmacological treatments to improve health outcomes.
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Affiliation(s)
- Tichaenzana Nyashanu
- grid.49697.350000 0001 2107 2298Department of Psychology, University of Pretoria, Private Bag X20, Hatfield, 0028 South Africa
| | - Maretha Visser
- grid.49697.350000 0001 2107 2298Department of Psychology, University of Pretoria, Private Bag X20, Hatfield, 0028 South Africa
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Tay DL, Thygesen LC, Kozlov E, Ornstein KA. Serious Mental Illness Exacerbation Post-Bereavement: A Population-Based Study of Partners and Adult Children. Clin Epidemiol 2022; 14:1065-1077. [PMID: 36164496 PMCID: PMC9508997 DOI: 10.2147/clep.s372936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 08/25/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose The death of a close family member is commonly accompanied by intense grief, stress, and loss of social support. We hypothesized that recent bereavement would be associated with an increase in symptom exacerbations among adults with serious mental illness (SMI) whose partners or parents had died. Patients and Methods Adults whose partners and parents had died in Denmark between January 1, 2010, and June 30, 2016, were identified using linked population-based registries. History of SMI was defined as having a diagnosis of schizophrenia and schizoaffective disorders, major depression, and bipolar disorder in the five years preceding their family member's death in the Danish Psychiatric Central Research Register using International Classification of Diseases-10 codes. The odds of SMI exacerbation (ie, attempt or completion of suicide or psychiatric hospitalization) among partners and children in the first two years after death in 3-month intervals were estimated with generalized estimating equations. Results 12.8% of partners and 15.0% of adult children with a history of SMI experienced any SMI exacerbation two years after bereavement. Among bereaved partners, older age (80+ years) was associated with a lower risk of experiencing an SMI exacerbation compared with partners aged 18-49 years (ORadj=0.29, [0.18-0.45]). Partners with a history of SMI had significantly increased odds of SMI exacerbations three months after their partners' death compared to prior to their partners' death (ORadj = 1.43, [1.13-1.81]). There was no evidence that adult children with SMI experience increased SMI exacerbations after the death of their parents compared to prior to death. Conclusion Adults with a history of SMI whose partners had died are at increased risk for an SMI exacerbation post bereavement. Additional bereavement resources and support should be provided to those with a history of SMI, especially in the period immediately after death.
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Affiliation(s)
- Djin L Tay
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | - Lau C Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Elissa Kozlov
- Department of Health Behavior, Society and Policy, School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
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Suicide ideation and/or attempt with substance use and associated factors among the youth in northwest Ethiopia, community-based. BMC Psychiatry 2022; 22:507. [PMID: 35902853 PMCID: PMC9331079 DOI: 10.1186/s12888-022-04157-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Substance use is referring to the use of psychoactive substances like chat, cigarettes, alcohol, and others. The use of substances particularly (alcohol, chat, and cigarette) is a major mental health burden in developing countries including Ethiopia among youth. Suicide ideation and an attempt are thinking or trying to kill oneself that facilitates the act of a person intentionally causing his or her death. Suicide is one of the most serious mental health problems and has a great social impact in the world as it is currently the third leading cause of death for youth. Youth is defined as the period of life between childhood and maturity with an age interval of (15-25). METHOD A cross-sectional study design was used to assess the prevalence of suicidal ideation and attempts with substance use among youth in northwest Ethiopia. Multi-stage sampling techniques of stratified with simple random sample ware used. In the first stage, substance users are selected then as the second stage among substance users the burden of suicide behavior is assessed. ASIST, DASS-21, and other tools were used to assess suicidal behavior with substance use and associated factors. Data were edited, purified, and entered into Epi-data version 4.6 before being exported to the statistical package for social sciences version 20 for analysis of bi-variables to see the associations' p-value < 0.2 and multi-variables to identify the associated variables with a p-value of < 0.05 AOR and CI also done. RESULTS From a total of 372 substance user participants over all prevalence of suicidal ideation and attempt among youth was 54(14.5%) with 95% CI of (11.0,18.0) and 37(9.9%) with 95% CI (7.0, 13.0) respectively. Being female [AOR =2.36;95% CI:(1.19, 4.68)], poor social support [AOR =3.03; 95% CI: (1.11, 8.25)], and anxiety [AOR = 3.82: 95% CI; (1.96, 7.46)]. CONCLUSION AND RECOMMENDATIONS The prevalence of suicidal ideation and attempt among substance users was 14.5 and 9.9% respectively therefore, immediate interventional actions needed to be administered to decrease the burden of suicide by reducing substance use and other associated factors.
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Babatunde GB, van Rensburg AJ, Bhana A, Petersen I. Identifying multilevel and multisectoral strategies to develop a Theory of Change for improving child and adolescent mental health services in a case-study district in South Africa. Child Adolesc Psychiatry Ment Health 2022; 16:45. [PMID: 35717400 PMCID: PMC9206219 DOI: 10.1186/s13034-022-00484-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 06/01/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The lack of child and adolescent mental health (CAMH) policies and implementation plans constitute major barriers to CAMH services in low resource settings. Engaging with on-the-ground stakeholders to identify possible contextually appropriate strategies for developing a CAMH collaborative system and inform CAMH plans and policies is important to ensure that resultant policies and plans are feasible and appropriate. Together with key stakeholders across multiple sectors, this study aims to (i) co-identify causal factors and potential strategies to overcome bottlenecks in one district in SA as a case study; and (ii) Co-develop a Theory of Change (ToC) for increasing access to CAMH services within the resource constraints of a remote resource-scarce district as a case study. METHODS A participatory workshop was held with key stakeholders (n = 40) from the Departments of Health (DoH), Basic Education (DBE), and Social Development (DSD) and three community-based organisations offering CAMH services in the district. The stakeholders identified context-specific causal factors and possible strategies to address the bottlenecks in the workshop. All the factors identified in the workshop were compared and consolidated. A ToC map was developed based on the data obtained from the workshop. The ToC was further refined by conducting a follow-up virtual workshop with stakeholders (n = 15). RESULTS Mapping out the strategies identified in the workshop facilitated the development of a ToC model for the resource-scarce context. Key multilevel and multisectoral task-sharing strategies emerged in support of the development of a collaborative system of care that includes the development of (i) community awareness programs and user-friendly CAMH psychoeducation and screening tools to strengthen mental health literacy and facilitate early identification at the community level; (ii) an intersectoral working group to facilitate intersectoral collaboration (iii) a functional district CAMH referral system, (iv) youth-friendly CAMH care packages. CONCLUSIONS In scarce-resource contexts, it is feasible to work collaboratively with key stakeholders across multiple sectors to identify feasible multilevel and multisectoral strategies that can be used to develop a ToC for improved access to CAMH services within a task-sharing approach.
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Affiliation(s)
- Gbotemi B. Babatunde
- grid.16463.360000 0001 0723 4123Centre for Rural Health, School of Nursing & Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - André Janse van Rensburg
- grid.16463.360000 0001 0723 4123Centre for Rural Health, School of Nursing & Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Arvin Bhana
- grid.16463.360000 0001 0723 4123Centre for Rural Health, School of Nursing & Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Inge Petersen
- grid.16463.360000 0001 0723 4123Centre for Rural Health, School of Nursing & Public Health, University of KwaZulu-Natal, Durban, South Africa
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Hart LM, Morgan AJ, Rossetto A, Kelly CM, Gregg K, Gross M, Johnson C, Jorm AF. teen Mental Health First Aid: 12-month outcomes from a cluster crossover randomized controlled trial evaluation of a universal program to help adolescents better support peers with a mental health problem. BMC Public Health 2022; 22:1159. [PMID: 35681130 PMCID: PMC9185965 DOI: 10.1186/s12889-022-13554-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 06/01/2022] [Indexed: 11/28/2022] Open
Abstract
Background teen Mental Health First Aid (tMHFA) is a universal mental health literacy, stigma reduction, help-seeking, and suicide prevention program designed for adolescents in Years 10–12 of secondary school (16–18 years). tMHFA is delivered by trained instructors, in a regular classroom setting, to increase the knowledge, attitudes and behaviours that adolescents’ require to better support peers with mental health problems or mental health crises. Methods To explore the efficacy of tMHFA, a cluster crossover randomised controlled trial was conducted with Year 10 students in four schools in Victoria, Australia, using physical first aid training as the control intervention. Of the 1942 eligible students, 1,624 completed baseline and 894 completed follow-up surveys. Online surveys, administered one week before training and again 12-months later, included vignettes depicting peers John (depression and suicide risk) and Jeanie (social anxiety/phobia), measures of mental health first aid (quality of first aid intentions, confidence, first aid behaviours provided, and first aid behaviours received), mental health literacy (beliefs about adult help, help-seeking intentions), and stigma (social distance, weak-not-sick, dangerous/unpredictable, and would not tell anyone). Results The primary outcome—quality of first aid intentions towards the John vignette—showed statistically significant group x time interactions, with tMHFA students reporting more helpful and less unhelpful first aid intentions, than PFA students did over time. Confidence in providing first aid also showed significant interactions. First aid behaviours—both those provided to a peer with a mental health problem and those received from a peer—showed null results. Ratings of both beliefs about adult help and help-seeking intentions were found to be significantly improved among tMHFA students at follow-up. A group x time interaction was found on one stigma scale (would not tell anyone). Conclusions This trial showed that, one year after training, tMHFA improves first aid intentions towards peers with depression and suicide risk, confidence in helping peers with mental health problems, willingness to tell someone and seek help from an adult or health professional if experiencing a mental health problem. Trial registration This research was registered with Australia New Zealand Clinical Trials Registry: ACTRN12614000061639. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13554-6.
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Affiliation(s)
- Laura M Hart
- Centre for Mental Health, Melbourne School of Population and Global Health , University of Melbourne, Melbourne, Australia. .,School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
| | - Amy J Morgan
- Centre for Mental Health, Melbourne School of Population and Global Health , University of Melbourne, Melbourne, Australia
| | - Alyssia Rossetto
- Centre for Mental Health, Melbourne School of Population and Global Health , University of Melbourne, Melbourne, Australia.,Mental Health First Aid Australia, Melbourne, Australia
| | | | - Karen Gregg
- Centre for Mental Health, Melbourne School of Population and Global Health , University of Melbourne, Melbourne, Australia
| | - Maxine Gross
- Centre for Mental Health, Melbourne School of Population and Global Health , University of Melbourne, Melbourne, Australia
| | - Catherine Johnson
- Centre for Mental Health, Melbourne School of Population and Global Health , University of Melbourne, Melbourne, Australia
| | - Anthony F Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health , University of Melbourne, Melbourne, Australia
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Lew B, Lester D, Kõlves K, Yip PSF, Chen YY, Chen WS, Hasan MT, Koenig HG, Wang ZZ, Fariduddin MN, Zeyrek-Rios EY, Chan CMH, Mustapha F, Fitriana M, Dolo H, Gönültaş BM, Dadfar M, Davoudi M, Abdel-Khalek AM, Chan LF, Siau CS, Ibrahim N. An analysis of age-standardized suicide rates in Muslim-majority countries in 2000-2019. BMC Public Health 2022; 22:882. [PMID: 35509027 PMCID: PMC9066769 DOI: 10.1186/s12889-022-13101-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 03/22/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND This study examines the 20-year trend of suicide in 46 Muslim-majority countries throughout the world and compares their suicide rates and trends with the global average. Ecological-level associations between the proportion of the Muslim population, the age-standardized suicide rates, male-to-female suicide rate ratio, and the Human Development Index (HDI) in 2019 were examined. METHODS Age-standardized suicide rates were extracted from the WHO Global Health Estimates database for the period between 2000 and 2019. The rates in each country were compared with the age-standardized global average during the past 20 years. The countries were further grouped according to their regions/sub-regions to calculate the regional and sub-regional weighted age-standardized suicide rates involving Muslim-majority countries. Correlation analyses were conducted between the proportion of Muslims, age-standardized suicide rate, male: female suicide rate ratio, and the HDI in all countries. Joinpoint regression was used to analyze the age-standardized suicide rates in 2000-2019. RESULTS The 46 countries retained for analysis included an estimated 1.39 billion Muslims from a total worldwide Muslim population of 1.57 billion. Of these countries, eleven (23.9%) had an age-standardized suicide rate above the global average in 2019. In terms of regional/sub-regional suicide rates, Muslim-majority countries in the Sub-Saharan region recorded the highest weighted average age-standardized suicide rate of 10.02/100,000 population, and Southeastern Asia recorded the lowest rate (2.58/100,000 population). There were significant correlations between the Muslim population proportion and male-to-female rate ratios (r=-0.324, p=0.028), HDI index and age-standardized suicide rates (r=-0.506, p<0.001), and HDI index and male-to-female rate ratios (r=0.503, p<0.001) in 2019. Joinpoint analysis revealed that seven Muslim-majority countries (15.2%) recorded an increase in the average annual percentage change regarding age-standardized suicide rates during 2000-2019. CONCLUSIONS Most Muslim-majority countries had lower age-standardized suicide rates than the global average, which might reflect religious belief and practice or due to Muslim laws in their judicial and social structure which may lead to underreporting. This finding needs further in-depth country and region-specific study with regard to its implication for public policy.
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Affiliation(s)
- Bob Lew
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
| | - David Lester
- Stockton University, Galloway, New Jersey, United States
| | - Kairi Kõlves
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia.,WHO Collaborating Centre for Research and Training in Suicide Prevention, Griffith University, Brisbane, Queensland, Australia
| | - Paul S F Yip
- Hong Kong Jockey Club Center for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China
| | - Ying-Yeh Chen
- Taipei City Psychiatric Centre, Taipei City Hospital, Taipei, Taiwan
| | - Won Sun Chen
- School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
| | - M Tasdik Hasan
- Jeeon Bangladesh Ltd., Dhaka, Bangladesh.,Department of Primary Care & Mental Health, University of Liverpool, Liverpool, United Kingdom
| | - Harold G Koenig
- Duke University Medical Center, Durham, NC, USA.,King Abdulaziz University, Jeddah, Saudi Arabia
| | - Zhi Zhong Wang
- Department of Epidemiology and Statistics, School of Public Health at Guangdong Medical University, Dongguan, Guangdong, China
| | - Muhamad Nur Fariduddin
- Faculty of Education, Universiti Teknologi MARA, Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia
| | | | - Caryn Mei Hsien Chan
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Feisul Mustapha
- Non-Communicable Diseases Section, Disease Control Division, Ministry of Health, Putrajaya, Malaysia
| | - Mimi Fitriana
- Department of Psychology, International University of Malaya-Wales, Kuala Lumpur, Malaysia.,Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Housseini Dolo
- Filariasis Unit, Faculty of Medicine, Pharmacy and Dentistry, University of Bamako, Bamako, Mali
| | - Burak M Gönültaş
- Social Work Department., Faculty of Letters, Sivas Cumhuriyet University, Sivas, Turkey
| | - Mahboubeh Dadfar
- Department of Addiction, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Davoudi
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ahmed M Abdel-Khalek
- Department of Psychology, Faculty of Arts, Alexandria University, Alexandria, Egypt
| | - Lai Fong Chan
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ching Sin Siau
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
| | - Norhayati Ibrahim
- Centre for Healthy Ageing and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.,Institute of Islam Hadhari, Universiti Kebangsaan Malaysia, Bangi, Malaysia
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Memiah P, Wagner FA, Kimathi R, Anyango NI, Kiogora S, Waruinge S, Kiruthi F, Mwavua S, Kithinji C, Agache JO, Mangwana W, Merci NM, Ayuma L, Muhula S, Opanga Y, Nyambura M, Ikahu A, Otiso L. Voices from the Youth in Kenya Addressing Mental Health Gaps and Recommendations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5366. [PMID: 35564760 PMCID: PMC9104498 DOI: 10.3390/ijerph19095366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/24/2022] [Accepted: 04/14/2022] [Indexed: 11/16/2022]
Abstract
Studies including adolescents and young people (AYP) enhance the relevance of research results, benefit stakeholders, and inform future research. There exists a mental health gap in services for AYP living in low and middle-income countries. This study aims to identify mental health challenges faced by adolescents and young people in Kenya, develop practical recommendations to mitigate these issues, and reduce the mental health burden among this population. We convened an AYP-led meeting that involved 41 participants. The meeting objectives were to (1) identify efforts to support existing national and regional strategic priorities and review goals for addressing mental health needs among AYPs, (2) develop immediate action plans for strengthened mental health services, (3) review and strengthen country-level coordination mechanisms, and (4) identify how participating county experiences can inform mental health services in Kenya. Ministry of Health (MoH) officials from national and county levels, academic experts, and implementing partner agencies involved in mental health services participated in the meeting. The team, including AYP representatives, identified various mental health challenges among the AYA and recommended interventions aimed towards improving their mental health situation in the country. The challenges were clustered into three themes and comprehensively reviewed to establish the precipitating factors to mental health outcomes among AYPs in Kenya and provide recommendations. The themes included (1) legislative, (2) service provider/Ministry of Health, and (3) adolescent/individual-level factors. To bridge the mental health gap in the country and scale up mental health outcomes, the stakeholders recommended interventions within the context of the three clusters. The key suggestions included an increase in insurance financing, acceleration of community health interventions, the establishment of adolescent-friendly spaces, the training of adolescent youth champions, interactive service provision models, implementation of the existing mental health policies and structures, the development of comprehensive assessment tools, well equipped mental health departments in health facilities, the enhancement of telehealth services and digital villages, the mobilization of a functional mental health response team, and the development of a mental health database.
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Affiliation(s)
- Peter Memiah
- Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland Baltimore, Baltimore, MD 21201, USA
| | - Fernando A. Wagner
- School of Social Work, University of Maryland Baltimore, Baltimore, MD 21201, USA;
| | - Robert Kimathi
- LVCT Health, Nairobi P.O. Box 19835-00202, Kenya; (R.K.); (A.I.); (L.O.)
| | - Naomi Idah Anyango
- Ministry of Health Kenya, Nairobi P.O. Box 30016-00100, Kenya; (N.I.A.); (S.K.); (M.N.)
| | - Samuel Kiogora
- Ministry of Health Kenya, Nairobi P.O. Box 30016-00100, Kenya; (N.I.A.); (S.K.); (M.N.)
| | - Stella Waruinge
- Nairobi Metropolitan Services, Nairobi P.O. Box 30430-00100, Kenya; (S.W.); (F.K.); (S.M.)
| | - Faith Kiruthi
- Nairobi Metropolitan Services, Nairobi P.O. Box 30430-00100, Kenya; (S.W.); (F.K.); (S.M.)
| | - Shillah Mwavua
- Nairobi Metropolitan Services, Nairobi P.O. Box 30430-00100, Kenya; (S.W.); (F.K.); (S.M.)
| | - Celina Kithinji
- Mombasa County Department of Health, Mombasa P.O. Box 81599-80100, Kenya;
| | | | - Wincolyne Mangwana
- Youth Advisory Champions for Health, Nairobi Youth Advisory Council, Mombasa P.O. Box 81599-80100, Kenya; (W.M.); (N.M.M.); (L.A.)
| | - Niyibeshaho Marie Merci
- Youth Advisory Champions for Health, Nairobi Youth Advisory Council, Mombasa P.O. Box 81599-80100, Kenya; (W.M.); (N.M.M.); (L.A.)
| | - Leonidah Ayuma
- Youth Advisory Champions for Health, Nairobi Youth Advisory Council, Mombasa P.O. Box 81599-80100, Kenya; (W.M.); (N.M.M.); (L.A.)
| | - Samuel Muhula
- Amref Health Africa in Kenya, Nairobi P.O. Box 30125-00100, Kenya; (S.M.); (Y.O.)
| | - Yvonne Opanga
- Amref Health Africa in Kenya, Nairobi P.O. Box 30125-00100, Kenya; (S.M.); (Y.O.)
| | - Maureen Nyambura
- Ministry of Health Kenya, Nairobi P.O. Box 30016-00100, Kenya; (N.I.A.); (S.K.); (M.N.)
| | - Annrita Ikahu
- LVCT Health, Nairobi P.O. Box 19835-00202, Kenya; (R.K.); (A.I.); (L.O.)
| | - Lillian Otiso
- LVCT Health, Nairobi P.O. Box 19835-00202, Kenya; (R.K.); (A.I.); (L.O.)
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Having a Say in Research Directions: The Role of Community Researchers in Participatory Research with Communities of Refugee and Migrant Background. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084844. [PMID: 35457711 PMCID: PMC9024418 DOI: 10.3390/ijerph19084844] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/07/2022] [Accepted: 04/07/2022] [Indexed: 12/10/2022]
Abstract
Research teams in high-income countries often fail to acknowledge the capacity and contributions of Community Researchers. This qualitative exploratory study used decolonising methodology and the Foundation House ‘Refugee Recovery Framework’ to understand Community Researchers’ perceptions and experiences of their role, and how research teams can integrate the knowledge they bring into research. Purposive sampling was used to facilitate the recruitment of eight Community Researchers from five different community groups working in Melbourne, Victoria. Semi-structured interviews lasting forty to sixty minutes occurred between December 2020 and January 2021. Data were analysed using reflexive thematic analysis. Findings reported in this paper include eight themes: ‘nothing about us without us’; ‘open the door’; a safe space to share; every step of the way; this does not translate; finding the right way to ask; a trauma-informed approach; and support within the workplace. The knowledge obtained demonstrates that Community Researchers facilitate meaningful participation in research for women, families, and communities of refugee or migrant background. Community Researchers’ presence, knowledge, and skills are vital in establishing culturally safe research practices and developing accessible language to facilitate conversations about sensitive research topics across multiple languages. Community Researchers can make important contributions at all stages of research, including data collection and interpretation.
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Bond KS, Cottrill FA, Morgan AJ, Chalmers KJ, Lyons JN, Rossetto A, Kelly CM, Kelly L, Reavley NJ, Jorm AF. Evaluation of the Conversations About Gambling Mental Health First Aid course: effects on knowledge, stigmatising attitudes, confidence and helping behaviour. BMC Psychol 2022; 10:78. [PMID: 35331327 PMCID: PMC8943993 DOI: 10.1186/s40359-022-00785-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 03/10/2022] [Indexed: 11/28/2022] Open
Abstract
Background The effects of problem gambling are wide-ranging, affecting many aspects of health and negatively impacting the person who gambles, their family and friends, and their community. People experiencing problem gambling have low rates of help-seeking and perceive many barriers to treatment, although evidence suggests that encouragement and support from friends and family can increase rates of help-seeking. Mental Health First Aid Australia’s Conversations About Gambling course aims to teach members of the public evidence-based strategies for recognising and responding to signs of problem gambling in a person they know. Methods This research evaluated the effects of the Conversations About Gambling course on participants’ knowledge, confidence, stigmatising attitudes, intended helping behaviour and actual helping behaviour towards a person experiencing problem gambling. Participants from Australia completed surveys before the course, immediately after the course and six months later. Changes over time (pre-course to post-course, and pre-course to 6-month follow-up) were assessed with linear mixed models. Descriptive statistics and content analyses of open-ended questions pertaining to participants’ satisfaction with the course were also produced. Results Between 2018 and 2020, 166 participants were recruited into this study. At 6-month follow-up 87 participants (52.4%) provided data. Participants’ knowledge about gambling and gambling problems, confidence, desire for social distance and intentions to help a person experiencing problem gambling significantly improved from pre-course to post-course, and from pre-course to 6-month follow-up. The quality of some actions taken to support a person they knew who was experiencing problem gambling also improved from pre-course to 6-month follow-up, in line with the teachings of the course. Participants perceived the course to be highly acceptable. Conclusions The results of this initial evaluation of Mental Health First Aid Australia’s Conversations About Gambling course suggest that it is an effective and acceptable educational intervention for those who wish to support a person experiencing problem gambling. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-022-00785-w.
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Affiliation(s)
- Kathy S Bond
- Mental Health First Aid Australia, 369 Royal Parade, Parkville, VIC, 3052, Australia
| | - Fairlie A Cottrill
- Mental Health First Aid Australia, 369 Royal Parade, Parkville, VIC, 3052, Australia
| | - Amy J Morgan
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, 3010, Australia
| | - Kathryn J Chalmers
- Mental Health First Aid Australia, 369 Royal Parade, Parkville, VIC, 3052, Australia.,Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, 3010, Australia
| | - Julia N Lyons
- Mental Health First Aid Australia, 369 Royal Parade, Parkville, VIC, 3052, Australia
| | - Alyssia Rossetto
- Mental Health First Aid Australia, 369 Royal Parade, Parkville, VIC, 3052, Australia. .,Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, 3010, Australia.
| | - Claire M Kelly
- Mental Health First Aid Australia, 369 Royal Parade, Parkville, VIC, 3052, Australia
| | - Louise Kelly
- Mental Health First Aid Australia, 369 Royal Parade, Parkville, VIC, 3052, Australia
| | - Nicola J Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, 3010, Australia
| | - Anthony F Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, 3010, Australia
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Prevalence and associated factors of suicidal behavior among pregnant mothers in southern Ethiopia: a cross-sectional study. BMC Public Health 2022; 22:490. [PMID: 35279113 PMCID: PMC8918309 DOI: 10.1186/s12889-022-12957-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 03/07/2022] [Indexed: 11/15/2022] Open
Abstract
Background Suicidal behavior among pregnant mothers is one of the most common psychiatric emergencies that require a major public health concern by researchers and mental health task forces. Pregnant mothers experience suicidal attempt, which is a fatal problem to end life. Therefore, there was a need to assess the prevalence and associated factors of suicidal behavior among pregnant mothers to integrate mental health care, particularly suicide, with maternal management. Methods A cross-sectional study was conducted among 504 pregnant mothers in the Gedeo zone, southern Ethiopia. Suicidal behavior was assessed using revised suicidal behavior questionnaire (SBQ-R) with a total score of 3-18; those scoring ≥7 were considered as having Suicidal behavior. Data were entered into Epi-data 3.1 and analyzed using SPSS version 20. Bivariate and multivariate binary logistic regression analysis was performed to identify associated factors of suicidal behavior. Variables with a P-value less than 0.05 with 95% CI were considered statistically significant. Results In this study, the overall prevalence of suicidal behavior among pregnant mothers was 47(9.3%) with 95% CI (7.1- 11.9). Regarding the factors; being unmarried [AOR = 5.69, 95% CI, (1.19, 27.23)], gestation age greater than 27 weeks, [AOR = 4.92, 95% CI (1.67, 14.53)], history of having chronic medical illness [AOR = 4.47, 95% CI (1.35, 14.85)], depression [AOR = 4.20, 95% CI (1.90, 9.28], and intimate partner violence [AOR = 7.60, 95% CI (3.27, 17.67)] were significantly associated with suicidal behavior at P value less than 0.05 and corresponding 95% CI. Conclusion Pregnant mothers in the community had a high prevalence of suicidal behavior compared to studies conducted among general populations. It is better to include and implement the assessment of suicidal risk factors as a primary treatment package for pregnant mothers, training of health extension workers and other primary health workers on how to assess the risk of suicide among pregnant mothers is warranted.
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Mirsepassi Z, Raisi F, Shahvari Z, FirooziKhojastefar R, Yahyavi ST. Evaluating family knowledge about sexual health in patients with severe mental illness: a qualitative study in Iran. BMC Psychiatry 2022; 22:174. [PMID: 35272647 PMCID: PMC8908587 DOI: 10.1186/s12888-022-03788-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 02/16/2022] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Although paying more attention to sex education in patients with severe mental illness is recommended in the literature, the role of families has not been specifically clarified. AIM: This study aims to explore family knowledge about sexual health in patients with severe mental illness in Iran. METHODS We conducted a total number of 21 interviews with 4 patients, 5 families, 7 psychiatrists, 1 general practitioner, 2 nurses, and 2 psychologists through purposive sampling. The text was analyzed using conventional qualitative content analysis. RESULTS The family knowledge about patients' sexual health is described in three subcategories: 'informal sources for knowledge acquisition', 'common myths, and 'inappropriate reaction to the patients' needs". CONCLUSIONS Family sex education should be integrated into a comprehensive rehabilitation program to promote sexual health in patients with severe mental illness. Family members should be aware of the necessity of accurate information about patients' sexual concerns.
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Affiliation(s)
- Zahra Mirsepassi
- grid.411705.60000 0001 0166 0922Department of Psychiatry, Roozbeh Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Firoozeh Raisi
- Department of Psychiatry, Roozbeh Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Zahra Shahvari
- grid.510409.90000 0004 6092 1266Department of Nursing and Midwifery, Gachsaran Branch, Islamic Azad University, Gachsaran, Iran
| | - Reihaneh FirooziKhojastefar
- grid.411705.60000 0001 0166 0922Department of Psychiatry, Roozbeh Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyyed Taha Yahyavi
- grid.411705.60000 0001 0166 0922Department of Psychiatry, Roozbeh Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Stress, PTSD, and COVID-19: the Utility of Disaster Mental Health Interventions During the COVID-19 Pandemic. CURRENT TREATMENT OPTIONS IN PSYCHIATRY 2022; 9:14-40. [PMID: 35223372 PMCID: PMC8860255 DOI: 10.1007/s40501-021-00253-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/06/2021] [Indexed: 02/08/2023]
Abstract
Purpose of review In the context of an ongoing, highly uncertain pandemic, disaster mental health measures can increase community capacity for resilience and well-being, support formal mental health treatment, and help address the risk for mental health reactions in high-stress occupations. The purpose of this review is to summarize the literature on disaster mental health interventions that have been helpful both prior to and during the pandemic in a broad range of applications, including for use with high-stress occupations in an effort to mitigate risk for post-traumatic stress disorder (PTSD) and other mental health sequelae. Recent findings Evidence-based and evidence-informed disaster mental health interventions, frameworks, and treatments have been studied in pilot studies, non-randomized trials, and randomized clinical trials prior to and in the context of the current COVID-19 pandemic. The studies have demonstrated feasibility and acceptability of these modalities and improved perceived support, as well as significant reductions in distress, and mental health symptoms such as depression, anxiety, and PTSD. Summary A disaster mental health approach to the COVID-19 pandemic can generate opportunities for prevention and support at multiple levels with timely interventions tailored for different concerns, cultures, and available resources.
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Fakhari A, Allahverdipour H, Esmaeili ED, Chattu VK, Salehiniya H, Azizi H. Early marriage, stressful life events and risk of suicide and suicide attempt: a case-control study in Iran. BMC Psychiatry 2022; 22:71. [PMID: 35090417 PMCID: PMC8796480 DOI: 10.1186/s12888-022-03700-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 01/11/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Early Marriage (EM) and associated Stressful Life Events (SLEs) and consequences such as psychological and physical well-being issues can lead to suicide and suicide attempts (SA). The study aimed to investigate the risk of suicide and SA among early married people who experienced SLEs. METHODS A case-control study was conducted based on the registry for suicide in Malekan county in Iran during 2016-18. Cases included 154 SAs and 32 suicides. Simultaneously, 201 outpatients from the emergency department were chosen as controls. Holms and Rahe life event questionnaire was used to assess SLEs. Sub-group analysis (Mantel-Haenszel) by sex and age groups and multiple logistic regression were used to calculate adjusted Odds Ratios (ORs) with 95% Confidence Intervals (CIs) for the association between EM and suicide risk after adjusting for the potential confounders. RESULTS The proportion (female vs male) of EM among suicides, controls, and SAs was 31.25% (18.7 vs 12.5%), 15.92% (11.9 vs 4.0%), and 13.0% (11.7 vs 1.3%), respectively. In subgroup analyses by sex, EM was associated with an increased risk of suicide in both females and males 2.64 and 2.36 times, respectively. Likewise, subgroup analysis by age groups revealed that EM increased suicide risk in subjects aged 10-15 years, while no association was found for age groups of 26-40 and > 40. After adjusting for the potential confounders, EM (OR: 3.01; 95% CI: 1.15 -7.29), financial problems (OR = 4.50; 95% CI: 1.83 -9.07), and family problems (OR = 2.60; 95% CI: 1.19-9.59), were associated with an increased risk of suicide. However, no association was found between EM, various types of SLEs, and the risk of SA. CONCLUSIONS We found EM and SLEs were correlated with suicide risk, while no evidence found that EM increased the risk of SA. Progress in reducing EM and addressing its serious consequences can occur by a stronger political commitment and by sharing the experiences and voices of the early married. Our study provided preliminary findings to guide future studies; however, methodological and longitudinal studies are needed to understand and address the effect of EM on suicidal behaviors.
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Affiliation(s)
- Ali Fakhari
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Allahverdipour
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Health Education and Promotion, School of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Vijay Kumar Chattu
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5G 2C4 Canada
- Department of Public Health, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, 600077 India
- Department of Community Medicine, Faculty of Medicine, Datta Meghe Institute of Medical Sciences, Wardha, 442107 India
| | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Hosein Azizi
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Nyongesa MK, Nasambu C, Mapenzi R, Koot HM, Cuijpers P, Newton CRJC, Abubakar A. Psychosocial and mental health challenges faced by emerging adults living with HIV and support systems aiding their positive coping: a qualitative study from the Kenyan coast. BMC Public Health 2022; 22:76. [PMID: 35022012 PMCID: PMC8756635 DOI: 10.1186/s12889-021-12440-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 12/17/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND In sub-Saharan Africa, there is little data on the challenges faced by young people living with HIV transitioning into adult life. Adapting the socio-ecological framework, this qualitative study investigated the challenges faced by emerging adults living with HIV from a rural Kenyan setting. Additionally, the study explored support systems that aid positive coping among these young adults. METHODS In April 2018, in-depth interviews were conducted with a convenience sample of 22 young adults living with HIV (12 females), 18-24 years old, from rural Kilifi, coast of Kenya. Data were analyzed thematically using NVIVO 11 software. RESULTS Young adults living with HIV from this setting face various challenges at different levels of the social ecosystem. At the individual level, key challenges they reported included acceptance of HIV positive status, antiretroviral adherence, economic burden associated with access to healthcare, building an intimate relationship, mental health problems, and HIV status disclosure. At the family level, death of parents, poverty, and being unaccepted were the commonly mentioned challenges. At the community level, socialization difficulties and long waiting time at the HIV clinic were highlighted. HIV stigma and discrimination were frequently reported across the different levels. Economic independence, social support (from families, friends, organizations, healthcare providers and peer meetings), and reliance on spirituality aided positive coping among these young adults amidst the challenges of living with HIV. CONCLUSIONS In this rural setting, emerging adults living with HIV face various challenges at the individual, family, and community level, some of which are cross-cutting. Our findings underscore the need for designing multi-level youth-friendly interventions that can address modifiable challenges encountered by emerging adults living with HIV in this and similar settings. Such interventions should incorporate appropriate context-specific support structures that may help these young people smoothly transit into adult life.
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Affiliation(s)
- Moses K Nyongesa
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), KEMRI, Box 230, Kilifi, Kenya.
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
| | - Carophine Nasambu
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), KEMRI, Box 230, Kilifi, Kenya
| | - Rachael Mapenzi
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), KEMRI, Box 230, Kilifi, Kenya
| | - Hans M Koot
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Charles R J C Newton
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), KEMRI, Box 230, Kilifi, Kenya
- Department of Public Health, Pwani University, Kilifi, Kenya
- Department of Psychiatry, University of Oxford, Oxford, UK
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Amina Abubakar
- KEMRI-Wellcome Trust Research Programme, Centre for Geographic Medicine Research (Coast), KEMRI, Box 230, Kilifi, Kenya
- Department of Public Health, Pwani University, Kilifi, Kenya
- Department of Psychiatry, University of Oxford, Oxford, UK
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
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Cruz CM, Dukpa C, Vanderburg JL, Rauniyar AK, Giri P, Bhattarai S, Thapa A, Hampanda K, Gaynes BN, Lamb MM, Matergia M. Teacher, caregiver, and student acceptability of teachers delivering task-shifted mental health care to students in Darjeeling, India: a mixed methods pilot study. DISCOVER MENTAL HEALTH 2022; 2:21. [PMID: 36341156 PMCID: PMC9622553 DOI: 10.1007/s44192-022-00024-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/10/2022] [Indexed: 11/07/2022]
Abstract
Background The acceptability of teachers delivering task-shifted mental health care to their school-aged students is understudied. Here, we evaluate teachers', students', and caregivers' acceptability of Tealeaf (Teachers Leading the Frontlines), an alternative system of care in which teachers are trained and supervised to deliver transdiagnostic, non-manualized task-shifted care to their students. Methods In a 2019 single-arm, mixed methods, pragmatic acceptability pilot study in Darjeeling, India, 13 teachers delivered task-shifted child mental health care to 26 students in need. Teachers delivered care through using a transdiagnostic, non-manualized therapy modality, "education as mental health therapy" (Ed-MH). Measured with validated scales, teachers' and students' acceptability were compared after teacher training (PRE) and at the end of intervention (POST) using paired t tests. Teachers (n = 7), students (n = 7), and caregivers (n = 7) completed semi-structured interviews POST. Results Teachers' quantitative measures indicated moderate acceptability PRE and POST and did not change PRE to POST. Children's measures showed acceptability PRE and POST but decreased PRE to POST. Teachers and caregivers universally expressed acceptability in interviews. Facilitators of acceptability included impact, trust of teachers, and teachers' ability to make adaptations. Conditions required for acceptability included supervision and teachers emphasizing academics benefits over mental health benefits to caregivers. Barriers to acceptability included a lack of teacher time and stigma. Interviewed students universally were unaware of receiving care; teachers intentionally avoided singling them out. Conclusion Teachers, caregivers, and children found teacher delivering task-shifted care acceptable, a key factor in care adoption and sustainability, though interviewed children were unaware of receiving care.Trial registration The trial was registered on January 01, 2018 with Clinical Trials Registry-India (CTRI), Reg. No. CTRI/2018/01/011471, Ref. No. REF/2017/11/015895. http://ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=21129&EncHid=&modid=&compid=%27,%2721129det%27. Supplementary Information The online version contains supplementary material available at 10.1007/s44192-022-00024-z.
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Affiliation(s)
- Christina M. Cruz
- grid.10698.360000000122483208Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, 101 Manning Drive, CB #7160, Chapel Hill, NC 27599 USA ,grid.10698.360000000122483208School Psychology Program, University of North Carolina at Chapel Hill School of Education, Chapel Hill, NC USA
| | - Choden Dukpa
- Darjeeling Ladenla Road Prerna, Darjeeling, West Bengal India
| | - Juliana L. Vanderburg
- grid.10698.360000000122483208School Psychology Program, University of North Carolina at Chapel Hill School of Education, Chapel Hill, NC USA
| | - Abhishek K. Rauniyar
- grid.414594.90000 0004 0401 9614Department of Epidemiology, Colorado School of Public Health, Aurora, CO USA
| | - Priscilla Giri
- Darjeeling Ladenla Road Prerna, Darjeeling, West Bengal India
| | | | - Arpana Thapa
- Darjeeling Ladenla Road Prerna, Darjeeling, West Bengal India
| | - Karen Hampanda
- grid.414594.90000 0004 0401 9614Center for Global Health, Colorado School of Public Health, 131999 E. Montview Blvd., Suite 310, Mail Box A090, Aurora, CO USA ,grid.430503.10000 0001 0703 675XDepartment of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Bradley N. Gaynes
- grid.10698.360000000122483208Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, 101 Manning Drive, CB #7160, Chapel Hill, NC 27599 USA ,grid.10698.360000000122483208Department of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Global Public Health, MacNider Bldg. Suite 304, CB#7160, 333 S. Columbia St., Chapel Hill, NC 27599 USA
| | - Molly M. Lamb
- grid.414594.90000 0004 0401 9614Department of Epidemiology, Colorado School of Public Health, Aurora, CO USA ,grid.414594.90000 0004 0401 9614Center for Global Health, Colorado School of Public Health, 131999 E. Montview Blvd., Suite 310, Mail Box A090, Aurora, CO USA
| | - Michael Matergia
- grid.414594.90000 0004 0401 9614Center for Global Health, Colorado School of Public Health, 131999 E. Montview Blvd., Suite 310, Mail Box A090, Aurora, CO USA ,Broadleaf Health and Education Alliance, Stroudsburg, PA USA
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Wang M, Wang J, Wang Y, Huang X, Huang Y, Huang J, Feng Y, Li X. Reliability and validity of the Mental Health Self-management Questionnaire among Chinese patients with mood and anxiety disorders. Front Psychiatry 2022; 13:952951. [PMID: 35966465 PMCID: PMC9372341 DOI: 10.3389/fpsyt.2022.952951] [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: 05/25/2022] [Accepted: 07/01/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Self-management plays an important role in promoting and restoring mental health for individuals with mental health issues. However, there is no valid and reliable Chinese tool assessing the self-management behaviors of people with mood and anxiety disorders. This study aimed to develop a Chinese version of the Mental Health Self-management Questionnaire (MHSQ-C) and to verify its psychometric properties. METHODS A total of 440 potential participants were recruited by convenience sampling from June to August 2020. Item analysis and analyses of internal consistency, test-retest reliability, content validity, construct validity and criterion validity were performed. RESULTS Data from 326 participants were used. Three factors obtained via principal component analysis and varimax rotation explained 53.68% of the total variance. The average content validity index was 0.99. The Cronbach's α coefficient (total: 0.874, clinical: 0.706, empowerment: 0.818, vitality: 0.830) and test-retest reliability (ICC: total: 0.783, 95% confidence interval (CI) [0.616, 0.882], clinical: 0.525, 95% CI [0.240, 0.725], empowerment: 0.786, 95% CI [0.622, 0.884], vitality: 0.748, 95% CI [0.564, 0.862]) were good. The MHSQ-C was well correlated with the Partners in Health scale and showed no floor or ceiling effect. DISCUSSION The MHSQ-C is a reliable and valid tool to evaluate the self-management strategies of patients with mood and anxiety disorders.
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Affiliation(s)
- Mengmeng Wang
- West China School of Nursing and West China Hospital, Sichuan University, Chengdu, China
| | - Jingjun Wang
- West China School of Nursing and West China Hospital, Sichuan University, Chengdu, China
| | - Ya Wang
- Department of Nursing, West China Hospital and West China School of Nursing, Sichuan University, Chengdu, China
| | - Xia Huang
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Yalin Huang
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Junqiang Huang
- Chengdu Dekang Hospital/Chengdu Psychiatric Hospital, Chengdu, China
| | - Yan Feng
- Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaolin Li
- West China School of Nursing and West China Hospital, Sichuan University, Chengdu, China
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Lilley R, Lawson W, Hall G, Mahony J, Clapham H, Heyworth M, Arnold SR, Trollor JN, Yudell M, Pellicano E. 'A way to be me': Autobiographical reflections of autistic adults diagnosed in mid-to-late adulthood. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:1395-1408. [PMID: 34674564 DOI: 10.1177/13623613211050694] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
LAY ABSTRACT Using oral history methods, we interviewed and recorded 26 autistic adults in Australia about their life history. We wanted to better understand interviewees' self-reflections about their lives. The interviewers were autistic researchers and the interviews were analysed by autistic and non-autistic researchers. All of the adults we interviewed were born before 1975 and formally identified as autistic after age 35 years. This group of people is sometimes referred to as 'late-diagnosed autistic adults'. In general, there is not much research done about autistic adults and even less is known about those diagnosed late in life. In this article, we explore what these adults said about their sense of self and how that changed over time. These autistic adults told us about many negative experiences, including trauma, which had shaped how they think about themselves. For most, autism diagnosis had a very positive impact on their sense of self, allowing them to understand more about their own past and to feel good about their autistic identity. Previously some researchers have said that autistic people have a limited or impaired sense of self. Instead, our results show some autistic people can actually reflect deeply on their lives and their changing sense of self-identity over time.
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Affiliation(s)
- Rozanna Lilley
- Macquarie University, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Wenn Lawson
- Macquarie University, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Gabrielle Hall
- Macquarie University, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Joanne Mahony
- Macquarie University, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | | | | | - Samuel Rc Arnold
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia.,UNSW Sydney, Australia
| | - Julian N Trollor
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia.,UNSW Sydney, Australia
| | | | - Elizabeth Pellicano
- Macquarie University, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Australia
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Rutakumwa R, Ssebunnya J, Mugisha J, Mpango RS, Tusiime C, Kyohangirwe L, Taasi G, Sentongo H, Kaleebu P, Patel V, Kinyanda E. Stakeholders' perspectives on integrating the management of depression into routine HIV care in Uganda: qualitative findings from a feasibility study. Int J Ment Health Syst 2021; 15:63. [PMID: 34210344 PMCID: PMC8247159 DOI: 10.1186/s13033-021-00486-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 06/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND HIV/AIDS continues to be a major global public health problem with Eastern and Southern Africa being the regions most affected. With increased access to effective antiretroviral therapy, HIV has become a chronic and manageable disease, bringing to the fore issues of quality of life including mental wellbeing. Despite this, the majority of HIV care providers in sub-Saharan Africa, including Uganda's Ministry of Health, do not routinely provide mental health care including depression management. The purpose of this paper is to explore stakeholders' perspectives on the feasibility and acceptability of integrating depression management into routine adult HIV care. The paper addresses a specific objective of the formative phase of the HIV + D study aimed at developing and evaluating a model for integrating depression management into routine HIV care in Uganda. METHODS This was a qualitative study. Data were collected through in-depth interviews with 11 patients at enrollment and follow-up in the pilot phase, and exit interviews with 11 adherent patients (those who completed their psychotherapy sessions) and six non-adherent patients (those missing at least two sessions) at the end of the pilot phase. Key informant interviews were held with four clinicians, five supervisors and one mental health specialist, as were three focus group discussions with lay health workers. These were purposively sampled at four public health facilities in Mpigi District. Data were analysed thematically. RESULTS Patients highlighted the benefits of treating depression in the context of HIV care, including improved adherence to antiretroviral therapy, overcoming sleeplessness and suicidal ideation, and regaining a sense of self-efficacy. Although clinicians and other stakeholders reported benefits of treating depression, they cited challenges in managing depression with HIV care, which were organisational (increased workload) and patient related (extended waiting time and perceptions of preferential treatment). Stakeholders generally shared perspectives on how best to integrate, including recommendations for organisational level interventions-training, harmonisation in scheduling appointments and structural changes-and patient level interventions to enhance knowledge about depression. CONCLUSIONS Integrating depression management into routine HIV care in Uganda is acceptable among key stakeholders, but the technical and operational feasibility of integration would require changes both at the organisational and patient levels.
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Affiliation(s)
- Rwamahe Rutakumwa
- MRC/UVRI & LSHTM Uganda Research Unit & Senior Wellcome Trust Fellowship, Mental Health Section, 50-59 Nakiwogo Street, Entebbe, Uganda.
| | - Joshua Ssebunnya
- MRC/UVRI & LSHTM Uganda Research Unit & Senior Wellcome Trust Fellowship, Mental Health Section, 50-59 Nakiwogo Street, Entebbe, Uganda.,Butabika National Referral Mental Hospital, Old Port Bell Road, Kampala, Uganda
| | | | - Richard Steven Mpango
- MRC/UVRI & LSHTM Uganda Research Unit & Senior Wellcome Trust Fellowship, Mental Health Section, 50-59 Nakiwogo Street, Entebbe, Uganda
| | - Christine Tusiime
- MRC/UVRI & LSHTM Uganda Research Unit & Senior Wellcome Trust Fellowship, Mental Health Section, 50-59 Nakiwogo Street, Entebbe, Uganda.,Butabika National Referral Mental Hospital, Old Port Bell Road, Kampala, Uganda
| | - Leticia Kyohangirwe
- MRC/UVRI & LSHTM Uganda Research Unit & Senior Wellcome Trust Fellowship, Mental Health Section, 50-59 Nakiwogo Street, Entebbe, Uganda
| | - Geoffrey Taasi
- STD/AIDS Control Program, Ministry of Health, Ministry of Health, Kampala, Uganda
| | - Hafsa Sentongo
- Mental Health Division, Ministry of Health, Kampala, Uganda
| | - Pontiano Kaleebu
- Director of the MRC/UVRI & LSHTM Uganda Research Unit, Kampala, Uganda
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Eugene Kinyanda
- MRC/UVRI & LSHTM Uganda Research Unit & Senior Wellcome Trust Fellowship, Mental Health Section, 50-59 Nakiwogo Street, Entebbe, Uganda.,Department of Psychiatry, Makerere University, Kampala, Uganda
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Weine SM, Arënliu A, Görmez V, Lagenecker S, Demirtas H. Conducting research on building psychosocial support for Syrian refugee families in a humanitarian emergency. Confl Health 2021; 15:31. [PMID: 33892768 PMCID: PMC8066477 DOI: 10.1186/s13031-021-00365-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 04/13/2021] [Indexed: 12/19/2022] Open
Abstract
Background This case study describes research, which is located in Turkey, where more than 750,000 Syrian refugees reside autonomously in Istanbul. The research developed and pilot tested a novel model for helping urban refugee families with limited to no access to evidence-based mental health services, by delivering a transdiagnostic family intervention for common mental disorders in health and non-health sector settings using a task-sharing approach. This case study addresses the following question: What challenges were encountered in developing and piloting a low intensity trans-diagnostic family support intervention in a humanitarian emergency setting? Discussion The rapidly growing scale of humanitarian crises requires new response capabilities geared towards addressing populations with prolonged high vulnerability to mental health consequences and limited to no access to mental health, health, and social resources. The research team faced multiple challenges in conducting this research in a humanitarian emergency setting including: 1) Non-existent or weak partnerships geared towards mental health research in a humanitarian emergency; 2) Lack of familiarity with task-sharing; 3). Insufficient language and cultural competency; 3) Fit with families’ values and demands; 4) Hardships of urban refugees. Through the research process, the research team learned lessons concerning: 1) building a coalition of academic and humanitarian organization partners; 2) investing in the research capacity building of local researchers and partners; 3) working in a community-collaborative and multi-disciplinary approach. Conclusion Conducting research in humanitarian emergency settings calls for innovative collaborative and multidisciplinary approaches to understanding and addressing many sociocultural, contextual, practical and scientific challenge.
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Affiliation(s)
- Stevan Merill Weine
- Center for Global Health, University of Illinois in Chicago, 1940 W. Taylor M/C 584, Chicago, IL, 60612, USA
| | - Aliriza Arënliu
- Department of Psychology, Philosophical Faculty, University of Prishtina "Hasan Prishtina, Eqrem Çabej, nn., 10000, Prishtina, Kosovo.
| | - Vahdet Görmez
- Child and Adolescent Psychiatry, Medeniyet Universitesi, Dr. Erkin Cd, 34722, Kadıköy/İstanbul, Turkey
| | - Scott Lagenecker
- University Neuropsychiatric Institute, 501 Chipeta Way, Salt Lake City, UT, 84108, USA
| | - Hakan Demirtas
- School of Public Health, University of Illinois in Chicago, 1603 W. Taylor St., 183, Chicago, Illinois, 60608, USA
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