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Pigeon-Gagné É, Hassan G, Yaogo M, Saïas T. Discrimination and Social Exclusion of People Experiencing Mental Disorders in Burkina Faso: A Socio-anthropological Study. Cult Med Psychiatry 2024:10.1007/s11013-024-09860-w. [PMID: 39017776 DOI: 10.1007/s11013-024-09860-w] [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] [Accepted: 05/05/2024] [Indexed: 07/18/2024]
Abstract
Stigma has been pointed out as a barrier to mental healthcare in sub-Saharan Africa. Among the manifestations of stigma, the use of physical restraints is condemned as a form of violation of basic human rights. Research on this phenomenon is limited in West Africa and more particularly in Burkina Faso. This study explores the phenomenon of stigma of individuals experiencing mental disorders in Bobo-Dioulasso (Burkina Faso). As part of 8 months of socio-anthropological fieldwork, we interviewed 94 informants (7 focus groups and 25 individual interviews) to document exclusionary practices, their perceptions, and justifications. Exclusionary practices can be divided in five subgroups: ignoring, physically and sexually abusing, abandoning, banning, and restraining. Some practices were linked to a lack of financial and material resources, while others were justified by an inferior moral status. We observed differences in the type of exclusion experienced between men and women. Restrictive, abusive, and exclusionary measures are common in Bobo-Dioulasso. These practices can either be understood as part of families' adaptative strategies when dealing with chronic conditions, as part of security measures in the case of patients with aggressive behaviors, or as part of punitive measures when transgressions are committed. We conclude the article by addressing the tensions between local and global meanings of stigma.
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Affiliation(s)
| | - Ghayda Hassan
- Department of Psychology, Université de Québec à Montréal, Montreal, Canada
| | - Maurice Yaogo
- Université Catholique de l'Afrique de l'Ouest, Bobo-Dioulasso, Burkina Faso
| | - Thomas Saïas
- Department of Psychology, Université de Québec à Montréal, Montreal, Canada
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Mion ABZ, Ventura CAA. The WHO QualityRights Initiative and its use worldwide: A literature review. Int J Soc Psychiatry 2024; 70:424-436. [PMID: 38149349 DOI: 10.1177/00207640231207580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
BACKGROUND To subsidize and win the fight against the violation of the human rights of people with mental disorders, an international working group has built a toolkit of quality assurance services and the exercise of human rights by users, both in low-, middle, and high-income countries. The World Health Organization's (WHO) QualityRights Initiative has been discussed and agreed upon by government entities in many countries in its use and implementation. The program includes a service assessment kit and training modules. AIMS In this context, this article aims to synthesize, from database searches, how the QualityRights Initiative is being used worldwide. METHOD This is an integrative literature review, in which 354 articles were initially obtained. After analysis, 25 articles were included in this study. RESULTS The results show different ways of using the initiative: service evaluation; QualityRights Initiative service evaluation and training provision; innovations on how to use the QualityRights Initiative; and QualityRights Initiative trainings. CONCLUSIONS As the first part of the initiative, the service assessment part, was launched before the training materials, most of the articles found (17) were using it. Despite the recent launch of the training part of the initiative, five articles were found to have already conducted the training. In addition, three articles reported on the use of the initiative in other ways, such as translation and cultural adaptation of the modules; updating the document in light of the QualityRights project; and assessing whether its implementation would be effective in reducing coercive practices.
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Affiliation(s)
- Ana Beatriz Zanardo Mion
- PAHO/WHO Collaborating Center for Nursing Research Development, Department of Psychiatric Nursing and Human Sciences at the University of São Paulo at Ribeirão Preto College of Nursing, Brazil
| | - Carla Aparecida Arena Ventura
- PAHO/WHO Collaborating Center for Nursing Research Development, Department of Psychiatric Nursing and Human Sciences at the University of São Paulo at Ribeirão Preto College of Nursing, Brazil
- Institute of Advanced Studies - Ribeirão Preto, São Paulo, Brazil
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Poynton-Smith E, Orrell M, Osei A, Ohene SA, Ansong J, Gyimah L, McKenzie C, Moro MF, Drew-Bold N, Baingana F, Carta MG, Tawiah P, Brobbey K, Funk M. A quantitative analysis of human rights-related attitude changes towards people with mental health conditions and psychosocial, intellectual, or cognitive disabilities following completion of the WHO QualityRights e-training in Ghana. Int J Ment Health Syst 2023; 17:46. [PMID: 38053116 PMCID: PMC10698997 DOI: 10.1186/s13033-023-00609-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 10/27/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Despite growing recognition of essential human rights, people with mental health conditions and psychosocial, intellectual, or cognitive disabilities' rights are known to be frequently violated in mental healthcare worldwide, with common use of coercive practices and limited recognition of people's right to exercise their legal capacity and make decisions for themselves on treatment and other issues affecting them. To tackle this issue, Ghana adopted the WHO QualityRights Initiative in 2019. This aims to introduce a right-based, person-centred recovery approach within the mental health care system, protecting and promoting the rights of people with mental health conditions, psychosocial, cognitive, and intellectual disabilities in the healthcare context and community. METHODS E-training (capacity-building) was provided in Ghana across a broad array of stakeholder groups including healthcare professionals, carers, and people with lived experience. The training covered legal capacity, coercion, community inclusion, recovery approach, service environment, and the negative attitudes commonly held by stakeholder groups; it was completed by 17,000 people in Ghana as of December 2021. We assessed the impact of the e-training on attitudes through comparing trainees' pre- and post-questionnaire responses on 17 items, each measured on a 5-point Likert scale (strongly disagree to strongly agree), such that higher scores indicated negative attitudes towards persons with mental health conditions and psychosocial disabilities as rights holders. Analyses were conducted on two main groups: matched pairs (417 pairs of baseline and follow-up questionnaire responses matched to a high degree of certainty), and the unmatched group (4299 individual completed questionnaire responses). RESULTS We assessed the impact of the WHO QualityRights e-training on attitudes: training resulted in highly significant attitude changes towards alignment with human rights, with scores changing by approximately 40% between baseline and follow-up. In particular, attitude changes were seen in items representing treatment choice, legal capacity, and coercion. This change was not affected by age, gender, or background experience. CONCLUSIONS The QualityRights e-training programme is effective in changing people's (especially healthcare professionals') attitudes towards people with mental health conditions and psychosocial, intellectual, or cognitive disabilities: this is a step towards mental healthcare being more with human rights-based worldwide.
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Affiliation(s)
| | | | - Akwasi Osei
- Ghana Ministry of Health-Mental Health Authority, Accra, Ghana
| | | | | | - Leveana Gyimah
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | | | | | | | | | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Kwaku Brobbey
- Ghana Ministry of Health-Mental Health Authority, Accra, Ghana
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Moitra M, Owens S, Hailemariam M, Wilson KS, Mensa-Kwao A, Gonese G, Kamamia CK, White B, Young DM, Collins PY. Global Mental Health: Where We Are and Where We Are Going. Curr Psychiatry Rep 2023; 25:301-311. [PMID: 37256471 PMCID: PMC10230139 DOI: 10.1007/s11920-023-01426-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/15/2023] [Indexed: 06/01/2023]
Abstract
PURPOSE OF REVIEW To summarize recent findings in global mental health along several domains including socioeconomic determinants, inequities, funding, and inclusion in global mental health research and practice. RECENT FINDINGS Mental illness continues to disproportionately impact vulnerable populations and treatment coverage continues to be low globally. Advances in integrating mental health care and adopting task-shifting are accompanied by implementation challenges. The mental health impact of recent global events such as the COVID-19 pandemic, geo-political events, and environmental change is likely to persist and require coordinated care approaches for those in need of psychosocial support. Inequities also exist in funding for global mental health and there has been gradual progress in terms of building local capacity for mental health care programs and research. Lastly, there is an increasing effort to include people with lived experiences of mental health in research and policy shaping efforts. The field of global mental health will likely continue to be informed by evidence and perspectives originating increasingly from low- and middle-income countries along with ongoing global events and centering of relevant stakeholders.
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Affiliation(s)
- Modhurima Moitra
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, 98195, USA.
| | - Shanise Owens
- Department of Public Health, Department of Obstetrics, Gynecology and Reproductive Biology, Charles Stewart Mott, Michigan State University, East Lansing, USA
| | - Maji Hailemariam
- Department of Global Health, University of Washington, Seattle, USA
| | - Katherine S Wilson
- Department of Health Systems and Population Health, University of Washington, Seattle, USA
| | - Augustina Mensa-Kwao
- Department of Health Systems and Population Health, University of Washington, Seattle, USA
| | - Gloria Gonese
- Department of Health Systems and Population Health, University of Washington, Seattle, USA
| | - Christine K Kamamia
- Department of Health Systems and Population Health, University of Washington, Seattle, USA
| | - Belinda White
- Department of Health Systems and Population Health, University of Washington, Seattle, USA
| | - Dorraine M Young
- Department of Health Systems and Population Health, University of Washington, Seattle, USA
| | - Pamela Y Collins
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, 98195, USA
- Department of Health Systems and Population Health, University of Washington, Seattle, USA
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Respect for human rights as a component of organisational well-being: factor structure analysis in three countries of Latin America. Int Rev Psychiatry 2023; 35:221-227. [PMID: 37105154 DOI: 10.1080/09540261.2023.2178288] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
People with psychosocial disabilities are often discriminated against and experience violations of their human rights. With the QualityRights program, World Health Organisation highlights that one of element founding the quality of services is the respect for users' rights, in the belief that there is no quality of care without respect for human rights and vice versa. To date, studies explored the issue mainly in Europe. In this sense, the purpose of the study is to verify if the perception of respect for patients' rights is a component of organisational well-being for mental health workers in three countries of Latin America (Argentina, Colombia, Peru). A random sample representative of professionals working in three mental healthcare networks in Argentina, Colombia, and Peru was enrolled (n = 310). Each health worker completed a questionnaire on sociodemographic data and the Well-Being at work and respect for human rights (WWRR). The WWRR consists of seven items on satisfaction at work, beliefs about users' satisfaction in received care, the satisfaction of work's organisation, respect of users' and staff's human rights, adequacy of resources, and perceived needs of resources in the mental health service. The principal components analysis of the instrument was carried out with Varimax rotation and Kaiser normalisation (including all components with Eigen value > 1). The total explained variance was 67.2%. Item 6 saturated in one single factor, and the first five items saturated in factor 1 with factor loadings ranging from 0.52 to 0.86. Parallel test suggested a one-factor structure as acceptable. The results show in three countries of Latin America that the more workers perceive that the human rights of users are respected, the more satisfied they are of own work. This article confirms previous observations in Italy, North Macedonia, Tunisia and Palestine.
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Aluh DO, Ayilara O, Onu JU, Grigaitė U, Pedrosa B, Santos-Dias M, Cardoso G, Caldas-de-Almeida JM. Experiences and perceptions of coercive practices in mental health care among service users in Nigeria: a qualitative study. Int J Ment Health Syst 2022; 16:54. [PMID: 36424651 PMCID: PMC9694572 DOI: 10.1186/s13033-022-00565-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 11/09/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND People with mental health problems are more vulnerable to a broad range of coercive practices and human rights abuses. There is a global campaign to eliminate, or at the very least decrease, the use of coercion in mental health care. The use of coercion in psychiatric hospitals in developing countries is poorly documented. The primary aim of this study was to explore service users' perceptions and experiences of coercion in psychiatric hospitals in Nigeria. METHODS Four focus group discussions were carried out among 30 service users on admission in two major psychiatric hospitals in Nigeria. The audio recordings were transcribed verbatim and then analyzed thematically with the aid of MAXQDA software. RESULTS The Focus group participants included 19 males and 11 females with a mean age of 34.67 ± 9.54. Schizophrenia was the most common diagnosis (40%, n = 12) and had a secondary school education (60%, n = 18). The focus group participants perceived coercion to be a necessary evil in severe cases but anti-therapeutic to their own recovery, an extension of stigma and a vicious cycle of abuse. The experience of involuntary admission revolved mainly around deception, maltreatment, and disdain. Participants in both study sites narrated experiences of being flogged for refusing medication. Mechanical restraint with chains was a common experience for reasons including refusing medications, to prevent absconding and in other cases, punitively. The use of chains was viewed by participants as dehumanizing and excruciatingly painful. CONCLUSION The experiences of coercion by participants in this study confirm that human rights violations occur in large psychiatric hospitals and underscore the need for mental health services reform. The use of coercion in this context reflects agelong underinvestment in the mental health care system in the country and obsolete mental health legislation that does not protect the rights of people with mental health problems. The study findings highlight an urgent need to address issues of human rights violations in psychiatric hospitals in the country.
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Affiliation(s)
- Deborah Oyine Aluh
- Comprehensive Health Research Centre (CHRC), Nova Medical School, Nova University of Lisbon, Rua Do Instituto Bacteriológico nº5, 1150-082, Lisbon, Portugal.
- Lisbon Institute of Global Mental Health, Lisbon, Portugal.
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria Nsukka, Nsukka, Enugu State, Nigeria.
| | - Olaniyi Ayilara
- Department of Clinical Services, Federal Neuropsychiatric Hospital, Uselu, Edo State, Nigeria
| | - Justus Uchenna Onu
- Department of Mental Health, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi Campus, Awka, Anambra State, Nigeria
| | - Ugnė Grigaitė
- Comprehensive Health Research Centre (CHRC), Nova Medical School, Nova University of Lisbon, Rua Do Instituto Bacteriológico nº5, 1150-082, Lisbon, Portugal
- Lisbon Institute of Global Mental Health, Lisbon, Portugal
| | - Barbara Pedrosa
- Comprehensive Health Research Centre (CHRC), Nova Medical School, Nova University of Lisbon, Rua Do Instituto Bacteriológico nº5, 1150-082, Lisbon, Portugal
- Lisbon Institute of Global Mental Health, Lisbon, Portugal
| | - Margarida Santos-Dias
- Comprehensive Health Research Centre (CHRC), Nova Medical School, Nova University of Lisbon, Rua Do Instituto Bacteriológico nº5, 1150-082, Lisbon, Portugal
- Lisbon Institute of Global Mental Health, Lisbon, Portugal
| | - Graça Cardoso
- Comprehensive Health Research Centre (CHRC), Nova Medical School, Nova University of Lisbon, Rua Do Instituto Bacteriológico nº5, 1150-082, Lisbon, Portugal
- Lisbon Institute of Global Mental Health, Lisbon, Portugal
| | - José Miguel Caldas-de-Almeida
- Comprehensive Health Research Centre (CHRC), Nova Medical School, Nova University of Lisbon, Rua Do Instituto Bacteriológico nº5, 1150-082, Lisbon, Portugal
- Lisbon Institute of Global Mental Health, Lisbon, Portugal
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Hunt X, Abdurahman H, Omobowale O, Afolayan A, Munetsi E, Dzapasi L, Mokaya N, Koroma A, Barrie I, Ogunmola O, Koroma A, Shakespeare T, Eaton J, Ryan G. Interventions for adolescents and adults with psychosis in Africa: a systematic review and narrative synthesis. Glob Ment Health (Camb) 2022; 9:223-240. [PMID: 36618745 PMCID: PMC9806991 DOI: 10.1017/gmh.2022.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 01/11/2023] Open
Abstract
Background The Global Burden of Disease attributable to psychotic disorders in African countries is high and has increased sharply in recent years. Yet, there is a scarcity of evidence on effective, appropriate and acceptable interventions for schizophrenia and other psychotic disorders on the continent. Methods We carried out a systematic review and narrative synthesis of peer-reviewed literature evaluating the impact of non-pharmacological interventions for adolescents and adults (10-65 years) in African countries. Two reviewers independently double-screened all articles and performed data extraction and quality appraisal using standardized tools. Results Of the 8529 unique texts returned by our search, 12 studies were identified for inclusion, from seven countries: Egypt, Ethiopia, Ghana, Kenya, Nigeria, South Africa and Sudan. They evaluated a range of interventions with one or more clinical, psychological or psychosocial, education or awareness or traditional or faith-based components, and were delivered by either mental health specialists or non-specialist health workers. Ten of the 12 included studies reported significant, positive effects on a range of outcomes (including functioning, symptoms and stigma). Nearly half of the interventions were based out of health facilities. Based on quality appraisals, confidence in these studies' findings is only rated low to medium. Conclusion Further research is needed to develop and evaluate interventions that meet the diverse needs of people with psychosis, within and beyond the health sector.
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Affiliation(s)
- Xanthe Hunt
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
| | - Haleem Abdurahman
- Department of Child and Adolescent Psychiatry, University College Hospital, Ibadan, Nigeria
- Centre for Child and Adolescent Mental Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Olubukola Omobowale
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Adeola Afolayan
- Centre for Child and Adolescent Mental Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Lloyd Dzapasi
- Research Support Centre, University of Zimbabwe, Harare, Zimbabwe
| | - Nyareso Mokaya
- London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Olusegun Ogunmola
- Centre for Child and Adolescent Mental Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Tom Shakespeare
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK
| | - Julian Eaton
- CBM Global Disability Inclusion, Laudenbach, Germany
- Centre for Global Mental Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Grace Ryan
- Centre for Global Mental Health, London School of Hygiene & Tropical Medicine, London, UK
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Moro MF, Kola L, Fadahunsi O, Jah EM, Kofie H, Samba D, Thomas S, Drew N, Nwefoh E, Pathare S, Eaton J, Funk M, Gureje O. Quality of care and respect of human rights in mental health services in four West African countries: collaboration between the mental health leadership and advocacy programme and the World Health Organization QualityRights initiative - ADDENDUM. BJPsych Open 2022; 8:e93. [PMID: 35579218 PMCID: PMC9169496 DOI: 10.1192/bjo.2022.67] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Moro MF, Carta MG, Gyimah L, Orrell M, Amissah C, Baingana F, Kofie H, Taylor D, Chimbar N, Coffie M, Cole C, Ansong J, Ohene SA, Tawiah PE, Atzeni M, D’Oca S, Gureje O, Funk M, Drew N, Osei A. A nationwide evaluation study of the quality of care and respect of human rights in mental health facilities in Ghana: results from the World Health Organization QualityRights initiative. BMC Public Health 2022; 22:639. [PMID: 35366832 PMCID: PMC8976418 DOI: 10.1186/s12889-022-13102-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 03/28/2022] [Indexed: 11/10/2022] Open
Abstract
Background In 2012, Ghana ratified the United Nations Convention on the Rights of Persons with Disabilities and enacted a Mental Health Act to improve the quality of mental health care and stop human rights violations against people with mental health conditions. In line with these objectives, Ghanaian stakeholders collected data on the quality of mental health services and respect for human rights in psychiatric facilities to identify challenges and gather useful information for the development of plans aimed to improve the quality of the services offered. This study aimed to assess psychiatric facilities from different Ghanaian regions and provide evidence on the quality of care and respect of human rights in mental health services. Methods Assessments were conducted by independent visiting committees that collected data through observation, review of documentation, and interviews with service users, staff, and carers, and provided scores using the World Health Organization QualityRights Toolkit methodology. Results This study revealed significant key challenges in the implementation of the United Nations Convention on the Rights of Persons with Disabilities principles in Ghanaian psychiatric services. The rights to an adequate standard of living and enjoyment of the highest attainable standard of health were not fully promoted. Only initial steps had been taken to guarantee the right to exercise legal capacity and the right to personal liberty and security. Significant gaps in the promotion of the right to live independently and be included in the community were identified. Conclusions This study identifies shortcomings and critical areas that the Ghanaian government and facilities need to target for implementing a human rights-based approach in mental health and improve the quality of mental health care throughout the country.
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Carta MG, Sancassiani F, Ganassi R, Melis P, D’Oca S, Atzeni M, Velluzzi F, Ferreli C, Atzori L, Aviles-Gonzales CI, Serrentino MR, Angermeyer MC, Cossu G. Why Was the Perception of Human Rights Respect and Care Satisfaction So High in Users of Italian Mental Health Services during the COVID-19 Pandemic? J Clin Med 2022; 11:997. [PMID: 35207268 PMCID: PMC8880584 DOI: 10.3390/jcm11040997] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/03/2022] [Accepted: 02/08/2022] [Indexed: 12/16/2022] Open
Abstract
The aim of this study was to compare users' and mental health workers' (MHW) perception of respect of human rights and job/care satisfaction in mental health services in Italy during the COVID-19 pandemic. A sample of users and MHW of Sardinia, Italy, fulfilled the "Well-Being at work and respect for human rights questionnaire" (WWRR). The study included 240 MHW and 200 users. Users showed a higher level of satisfaction of care than MHW of work, and a higher perception of the satisfaction of users and human rights respected for health workers. Both user and MHW responses were about 85% of the maximum score, except for satisfaction with resources. Responses were higher for users, but users and MHW both showed high levels of satisfaction. In previous surveys, MHW of Sardinia showed higher scores in all items of WWRR, except for satisfaction with resources, compared with workers from other health sectors of the same region, and with MHW from other countries. The low score for satisfaction with resources (in users and staff) is consistent with a progressive impoverishment of resources for mental health care in Italy. The study, although confirming the validity of the Italian model, fully oriented towards community, sets off an alarm bell on the risks resulting from the decrease in resources.
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Affiliation(s)
- Mauro G. Carta
- Department of Medical Sciences and Public Health, University of Cagliari, SS 554, 09042 Monserrato, CA, Italy; (F.S.); (R.G.); (P.M.); (S.D.); (M.A.); (F.V.); (C.F.); (L.A.); (C.I.A.-G.); (M.R.S.); (G.C.)
| | - Federica Sancassiani
- Department of Medical Sciences and Public Health, University of Cagliari, SS 554, 09042 Monserrato, CA, Italy; (F.S.); (R.G.); (P.M.); (S.D.); (M.A.); (F.V.); (C.F.); (L.A.); (C.I.A.-G.); (M.R.S.); (G.C.)
| | - Ruben Ganassi
- Department of Medical Sciences and Public Health, University of Cagliari, SS 554, 09042 Monserrato, CA, Italy; (F.S.); (R.G.); (P.M.); (S.D.); (M.A.); (F.V.); (C.F.); (L.A.); (C.I.A.-G.); (M.R.S.); (G.C.)
| | - Paola Melis
- Department of Medical Sciences and Public Health, University of Cagliari, SS 554, 09042 Monserrato, CA, Italy; (F.S.); (R.G.); (P.M.); (S.D.); (M.A.); (F.V.); (C.F.); (L.A.); (C.I.A.-G.); (M.R.S.); (G.C.)
| | - Silvia D’Oca
- Department of Medical Sciences and Public Health, University of Cagliari, SS 554, 09042 Monserrato, CA, Italy; (F.S.); (R.G.); (P.M.); (S.D.); (M.A.); (F.V.); (C.F.); (L.A.); (C.I.A.-G.); (M.R.S.); (G.C.)
| | - Michela Atzeni
- Department of Medical Sciences and Public Health, University of Cagliari, SS 554, 09042 Monserrato, CA, Italy; (F.S.); (R.G.); (P.M.); (S.D.); (M.A.); (F.V.); (C.F.); (L.A.); (C.I.A.-G.); (M.R.S.); (G.C.)
| | - Fermanda Velluzzi
- Department of Medical Sciences and Public Health, University of Cagliari, SS 554, 09042 Monserrato, CA, Italy; (F.S.); (R.G.); (P.M.); (S.D.); (M.A.); (F.V.); (C.F.); (L.A.); (C.I.A.-G.); (M.R.S.); (G.C.)
| | - Caterina Ferreli
- Department of Medical Sciences and Public Health, University of Cagliari, SS 554, 09042 Monserrato, CA, Italy; (F.S.); (R.G.); (P.M.); (S.D.); (M.A.); (F.V.); (C.F.); (L.A.); (C.I.A.-G.); (M.R.S.); (G.C.)
| | - Laura Atzori
- Department of Medical Sciences and Public Health, University of Cagliari, SS 554, 09042 Monserrato, CA, Italy; (F.S.); (R.G.); (P.M.); (S.D.); (M.A.); (F.V.); (C.F.); (L.A.); (C.I.A.-G.); (M.R.S.); (G.C.)
| | - Cesar I. Aviles-Gonzales
- Department of Medical Sciences and Public Health, University of Cagliari, SS 554, 09042 Monserrato, CA, Italy; (F.S.); (R.G.); (P.M.); (S.D.); (M.A.); (F.V.); (C.F.); (L.A.); (C.I.A.-G.); (M.R.S.); (G.C.)
| | - Maria Roberta Serrentino
- Department of Medical Sciences and Public Health, University of Cagliari, SS 554, 09042 Monserrato, CA, Italy; (F.S.); (R.G.); (P.M.); (S.D.); (M.A.); (F.V.); (C.F.); (L.A.); (C.I.A.-G.); (M.R.S.); (G.C.)
| | | | - Giulia Cossu
- Department of Medical Sciences and Public Health, University of Cagliari, SS 554, 09042 Monserrato, CA, Italy; (F.S.); (R.G.); (P.M.); (S.D.); (M.A.); (F.V.); (C.F.); (L.A.); (C.I.A.-G.); (M.R.S.); (G.C.)
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