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Guerrero Z, Civišová D, Winkler P. Mental health and access to care among the Roma population in Europe: A scoping review. Transcult Psychiatry 2024; 61:118-130. [PMID: 37769608 DOI: 10.1177/13634615231200853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
The Roma are Europe's largest ethnic minority group, and often face discrimination and social exclusion. Social strife and lack of access to healthcare are associated with increased symptoms of psychopathology. We aimed to review evidence on mental health outcomes and on access to mental healthcare among the Roma population in Europe. We systematically searched five databases (PsycINFO, Global Health, Social Policy and Practice, Web of Science and PubMed) and conducted a grey literature search in August 2020. We identified 133 studies, 26 of which were included for final analysis. We present the results using a narrative synthesis. The available literature indicates a relatively high prevalence of anxiety, depression and substance abuse among Roma, and females seem to be more affected than males. Roma children exhibit more externalizing and internalizing disorders when compared with non-Roma children. Mental health and perceived well-being among the Roma population are strongly linked to social determinants of health such as housing or economic income. Access to mental healthcare is limited for Roma people because of several barriers pertaining to language, lack of information regarding available services, and the insurance and economic status of Roma people. Roma people report mainly negative experiences with mental health services, including a lack of understanding from healthcare providers, and instances of racism and discrimination. There is a need for more research on mental health and access to healthcare in Roma people. Future studies should be participatory in order to provide guidelines for mental healthcare that addresses the needs of the Roma population.
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Affiliation(s)
- Zoe Guerrero
- National Institute of Mental Health, Czech Republic
- WHO Collaborating Center for Public Mental Health Research and Service Development
| | - Dagmar Civišová
- National Institute of Mental Health, Czech Republic
- WHO Collaborating Center for Public Mental Health Research and Service Development
| | - Petr Winkler
- National Institute of Mental Health, Czech Republic
- WHO Collaborating Center for Public Mental Health Research and Service Development
- King's College London
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Guerrero Z, Melicharová H, Kavanová M, Prokop D, Škvrňák M, Kunc M, Leontiyeva Y, Vitíková J, Spurný M, Pilnáček M, Kyselá M, Zhmurko O, Tabery P, Winkler P. Mental health conditions and help-seeking among Ukrainian war refugees in Czechia: A cross-sectional study. Psychiatry Res 2023; 329:115552. [PMID: 37864995 DOI: 10.1016/j.psychres.2023.115552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 10/16/2023] [Accepted: 10/17/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND We aimed to screen Ukrainian war refugees (UWR) in Czechia for depression and anxiety, and to assess their recognition of personal mental health problems and related help-seeking. METHODS We conducted a cross-sectional study on a sample of UWR in Czechia. We used PHQ-8 and GAD-7 to screen for depression and anxiety, SELF-I to assess the recognition of respondents' own mental health problems, and a set of questions regarding mental health-related help-seeking. FINDINGS Our sample consisted of 1,347 UWR. More than 41 % of respondents screened positively for moderate or severe depression and more than 23 % for moderate or severe anxiety. Self-recognition of mental health as well as help-seeking was very low among those who screened positively for moderate or severe depression or anxiety. INTERPRETATION Even those UWR who report severe symptoms do not identify themselves as potentially having mental health issues and are not seeking help.
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Affiliation(s)
- Zoe Guerrero
- Department of Public Mental Health, National Institute of Mental Health, Czechia; WHO Collaborating Center for Public Mental Health Research and Service Development, National Institute of Mental Health, Czechia
| | - Hana Melicharová
- Department of Public Mental Health, National Institute of Mental Health, Czechia
| | | | | | | | | | - Yana Leontiyeva
- Institute of Sociology of the Czech Academy of Sciences, Czechia
| | - Jana Vitíková
- Institute of Sociology of the Czech Academy of Sciences, Czechia
| | - Martin Spurný
- Institute of Sociology of the Czech Academy of Sciences, Czechia
| | - Matouš Pilnáček
- Institute of Sociology of the Czech Academy of Sciences, Czechia
| | - Monika Kyselá
- Institute of Sociology of the Czech Academy of Sciences, Czechia
| | - Olga Zhmurko
- Institute of Sociology of the Czech Academy of Sciences, Czechia
| | - Paulína Tabery
- Institute of Sociology of the Czech Academy of Sciences, Czechia
| | - Petr Winkler
- WHO Collaborating Center for Public Mental Health Research and Service Development, National Institute of Mental Health, Czechia; Health Service and Population Research Department, Institute of Psychology, Psychiatry and Neuroscience, King's College London.
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Kågström A, Juríková L, Guerrero Z. Developmentally appropriate mental health literacy content for school-aged children and adolescents. Glob Ment Health (Camb) 2023; 10:e25. [PMID: 37854395 PMCID: PMC10579665 DOI: 10.1017/gmh.2023.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 02/22/2023] [Accepted: 04/26/2023] [Indexed: 10/20/2023] Open
Abstract
Although improving the mental health of children and adolescents has become a global priority, resources outlining developmentally appropriate content for improving mental health literacy (MHL) across school-aged children are scarce. A comprehensive, life-course approach to building MHL is needed to address the evolving competencies, needs, capacities, and risk factors for mental health, especially to establish school-based interventions that can be equitably and sustainably implemented. We conducted a theoretical review highlighting the relation of research and practice in building MHL through developmentally appropriate knowledge and competencies for children and adolescents. A two-pronged review of the literature was conducted to provide an overview of (1) research with a focus on neurobiological, psychological, cognitive, and social developmental milestones of school-aged children relevant for building MHL and (2) evidence-based and theory-driven content for the development of universal MHL interventions for children and adolescents considering the four components of MHL. A map of relevant key milestones highlights the range of development that occurs and ample opportunity for increasing universal MHL during these sensitive years primed for learning. We reflect on current understandings and global considerations for MHL interventions with an emphasis on applying developmental science to the future strengthening of intervention development, uptake, adaptation, implementation, evaluation, and scale-up.
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Affiliation(s)
- Anna Kågström
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic
- WHO Collaborating Center for Public Mental Health Research and Service Development, National Institute of Mental Health, Klecany, Czech Republic
| | - Laura Juríková
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czech Republic
| | - Zoe Guerrero
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic
- WHO Collaborating Center for Public Mental Health Research and Service Development, National Institute of Mental Health, Klecany, Czech Republic
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Aliev AA, Tomaskova H, Winkler P, Yon Y, Kagstrom A, Guerrero Z, Lazeri L, Reinap M, Redlich C, Tijerino Inestroza AM, Maurer J. Methods and tools to assess implementation of mental health policies and plans: A systematic review. Glob Ment Health (Camb) 2023; 10:e12. [PMID: 37854405 PMCID: PMC10579679 DOI: 10.1017/gmh.2023.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 01/17/2023] [Accepted: 02/07/2023] [Indexed: 03/19/2023] Open
Abstract
Mental health policies and plans (MHPPs) are important policy instruments and powerful tools to facilitate development of mental health systems and services across the world. We aimed to map and analyse methods and tools used to assess the extent, process and impact of implementing MHPPs. We systematically searched peer-reviewed and grey literature across seven scientific databases. We extracted and analysed the data on a) the characteristics of included studies (e.g., policy areas, region of origin, income setting) and b) the methodology and evaluation tools applied to assess the extent and process of implementation. We included 48 studies in the analyses. Twenty-six of these studies employed only qualitative methods (e.g., semi-structured interviews, focus group discussions, desk review, stakeholder consultations); 12 studies used quantitative methods (e.g., trend analysis, survey) and 10 used mixed-methods approaches. Generally, methods and tools used for assessment were described poorly with less than half of the studies providing partial or full details about them. Only three studies provided assessment of full policies. There is a lack of rigorous research to assess implementation MHPPs. Assessments of the implementation of entire MHPPs are almost non-existent. Strategies to assess the implementation of MHPPs should be an integral part of MHPPs.
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Affiliation(s)
- Akmal Alikhan Aliev
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czechia
- WHO Collaborating Centre for Public Mental Health Research and Service Development, Klecany, Czechia
| | - Hana Tomaskova
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czechia
- WHO Collaborating Centre for Public Mental Health Research and Service Development, Klecany, Czechia
- Department of Psychology, Charles University, Prague, Czechia
| | - Petr Winkler
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czechia
- WHO Collaborating Centre for Public Mental Health Research and Service Development, Klecany, Czechia
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Yongjie Yon
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Anna Kagstrom
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czechia
- WHO Collaborating Centre for Public Mental Health Research and Service Development, Klecany, Czechia
| | - Zoe Guerrero
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czechia
- WHO Collaborating Centre for Public Mental Health Research and Service Development, Klecany, Czechia
| | - Ledia Lazeri
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Marge Reinap
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Cassie Redlich
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | | | - Jason Maurer
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
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Guerrero Z, Iruretagoyena B, Parry S, Henderson C. Anti-stigma advocacy for health professionals: a systematic review. J Ment Health 2023:1-21. [PMID: 36919957 PMCID: PMC10173949 DOI: 10.1080/09638237.2023.2182421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 09/21/2022] [Accepted: 11/14/2022] [Indexed: 03/16/2023]
Abstract
BACKGROUND Many anti-stigma programs for healthcare workers already exist however there is less research on the effectiveness of training in skills for health professionals to counter stigma and its impacts on patients. AIMS The objective of this study was to examine the theory base, content, delivery, and outcomes of interventions for healthcare professionals which aim to equip them with knowledge and skills to aid patients to mitigate stigma and discrimination and their health impacts. METHODS Five electronic databases and grey literature were searched. Data were screened by two independent reviewers, conflicts were discussed. Quality appraisal was realized using the ICROMS tool. A narrative synthesis was carried out. RESULTS The final number of studies was 41. In terms of theory base, there are three strands - responsibility as part of the professional role, correction of wrongful practices, and collaboration with local communities. Content focusses either on specific groups experiencing health-related stigma or health advocacy in general. CONCLUSIONS Findings suggest programs should link definitions of stigma to the role of the professional. They should be developed following a situational analysis and include people with lived experience. Training should use interactive delivery methods. Evaluation should include follow-up times that allow examination of behavioural change. PROSPERO, ID: CRD42020212527.
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Affiliation(s)
- Zoe Guerrero
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic
| | - Barbara Iruretagoyena
- Department of Neurology and Psychiatry, Clínica Alemana Universidad del Desarrollo, Las Condes, Chile
| | - Sarah Parry
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Claire Henderson
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Health Service and Population Research, King’s College London Institute of Psychiatry, Psychology and Neuroscience, London, UK
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Thornicroft G, Sunkel C, Alikhon Aliev A, Baker S, Brohan E, El Chammay R, Davies K, Demissie M, Duncan J, Fekadu W, Gronholm PC, Guerrero Z, Gurung D, Habtamu K, Hanlon C, Heim E, Henderson C, Hijazi Z, Hoffman C, Hosny N, Huang FX, Kline S, Kohrt BA, Lempp H, Li J, London E, Ma N, Mak WWS, Makhmud A, Maulik PK, Milenova M, Morales Cano G, Ouali U, Parry S, Rangaswamy T, Rüsch N, Sabri T, Sartorius N, Schulze M, Stuart H, Taylor Salisbury T, Vera San Juan N, Votruba N, Winkler P. The Lancet Commission on ending stigma and discrimination in mental health. Lancet 2022; 400:1438-1480. [PMID: 36223799 DOI: 10.1016/s0140-6736(22)01470-2] [Citation(s) in RCA: 93] [Impact Index Per Article: 46.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/19/2022] [Accepted: 07/28/2022] [Indexed: 02/07/2023]
Affiliation(s)
- Graham Thornicroft
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London UK; Centre for Implementation Science, King's College London, London UK.
| | | | - Akmal Alikhon Aliev
- National Institute of Mental Health (Czechia), WHO Collaborating Centre for Public Mental Health Research and Service Development, Klecany, Czechia
| | - Sue Baker
- Mind international, London, UK; Changing Minds Globally, London, UK
| | - Elaine Brohan
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London UK
| | | | - Kelly Davies
- Centre for Implementation Science, King's College London, London UK
| | - Mekdes Demissie
- College of Health Sciences and Medicine, School of Nursing and Midwifery, Haramaya University, Ethiopia; Centre for Innovative Drug Development and Therapeutic Studies for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Ethiopia
| | | | - Wubalem Fekadu
- Department of Psychiatry, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Petra C Gronholm
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London UK; Centre for Implementation Science, King's College London, London UK
| | - Zoe Guerrero
- National Institute of Mental Health (Czechia), WHO Collaborating Centre for Public Mental Health Research and Service Development, Klecany, Czechia
| | - Dristy Gurung
- Centre for Implementation Science, King's College London, London UK; Transcultural Psychosocial Organization (TPO), Kathmandu Nepal
| | - Kassahun Habtamu
- Addis Ababa University, School of Psychology, Addis Ababa, Ethiopia
| | - Charlotte Hanlon
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London UK; WHO Collaborating Centre for Mental Health Research and Training, King's College London, London UK; Department of Psychiatry, School of Medicine, College of Health Sciences Addis Ababa University, Addis Ababa, Ethiopia
| | - Eva Heim
- Institut de Psychologie, University of Lausanne, Lausanne, Switzerland
| | - Claire Henderson
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London UK
| | | | | | - Nadine Hosny
- Institut de Psychologie, University of Lausanne, Lausanne, Switzerland
| | | | | | - Brandon A Kohrt
- Division of Global Mental Health, George Washington University, Washington DC, USA
| | - Heidi Lempp
- Institute of Psychiatry, Psychology and Neuroscience, and Academic Department of Rheumatology, King's College London, London UK
| | - Jie Li
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | | | - Ning Ma
- Institute of Mental Health, Peking University, Beijing, China
| | - Winnie W S Mak
- Department of Psychology, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Akerke Makhmud
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London UK; Centre for Implementation Science, King's College London, London UK
| | - Pallab K Maulik
- George Institute for Global Health, New Delhi, India; University of New South Wales, Sydney, NSW, Australia
| | - Maria Milenova
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London UK; Centre for Implementation Science, King's College London, London UK
| | | | - Uta Ouali
- Razi Hospital and El Manar Medical School, University of Tunis, La Manouba, Tunisia
| | - Sarah Parry
- South London and the Maudsley NHS Foundation Trust, London, UK
| | | | - Nicolas Rüsch
- Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm, Germany; Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Bezirkskrankenhaus Günzburg, Günzburg, Germany
| | - Taha Sabri
- Taskeen Health Initiative, Karachi, Pakistan
| | - Norman Sartorius
- Association for the Improvement of Mental health Programs, Geneva, Switzerland
| | | | | | - Tatiana Taylor Salisbury
- Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London UK
| | - Norha Vera San Juan
- Health Service and Population Research Department, King's College London, London UK
| | - Nicole Votruba
- and Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
| | - Petr Winkler
- National Institute of Mental Health (Czechia), WHO Collaborating Centre for Public Mental Health Research and Service Development, Klecany, Czechia
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