scholarly journals Applications of the epidemiological modelling outputs for targeted mental health planning in conflict-affected populations: the Syria case-study

2016 ◽  
Vol 3 ◽  
Author(s):  
F. J. Charlson ◽  
Y. Y. Lee ◽  
S. Diminic ◽  
H. Whiteford
Keyword(s):  
Mental Health ◽  
Major Depression ◽  
Disease Burden ◽  
Health Planning ◽  
Scale Up ◽  
Health Benefit ◽  
World Health ◽  
Steady Increase ◽  
Linear Scale ◽  
Post Traumatic Stress

BackgroundEpidemiological models are frequently utilised to ascertain disease prevalence in a population; however, these estimates can have wider practical applications for informing targeted scale-up and optimisation of mental health services. We explore potential applications for a conflict-affected population, Syria.MethodsWe use prevalence estimates of major depression and post-traumatic stress disorder (PTSD) in conflict-affected populations as inputs for subsequent estimations. We use Global Burden of Disease (GBD) methodology to estimate years lived with a disability (YLDs) for depression and PTSD in Syrian populations. Human resource (HR) requirements to scale-up recommended packages of care for PTSD and depression in Syria over a 15-year period were modelled using the World Health Organisation mhGAP costing tool. Associated avertable burden was estimated using health benefit analyses.ResultsThe total number of cases of PTSD in Syria was estimated at approximately 2.2 million, and approximately 1.1 million for depression. An age-standardised major depression rate of 13.4 (95% UI 9.8–17.5) YLDs per 1000 Syrian population is estimated compared with the GBD 2010 global age-standardised YLD rate of 9.2 (95% UI 7.0–11.8). HR requirements to support a linear scale-up of services in Syria using the mhGAP costing tool demonstrates a steady increase from 0.3 FTE in at baseline to 7.6 FTE per 100 000 population after scale-up. Linear scale-up over 15 years could see 7–9% of disease burden being averted.ConclusionEpidemiological estimates of mental disorders are key inputs into determining disease burden and guiding optimal mental health service delivery and can be used in target populations such as conflict-affected populations.

Psychological/psychiatric impact of the novel coronavirus outbreak: lessons learnt from China and call for timely crisis interventions in Italy

2020 ◽  
Author(s):  
Patrizia Zeppegno ◽  
Carla Gramaglia ◽  
Chiara Guerriero ◽  
Fabio Madeddu ◽  
Raffaella Calati
Keyword(s):  
Mental Health ◽  
Migrant Workers ◽  
Mental Health Problems ◽  
Virus Disease ◽  
Selection Process ◽  
Psychiatric Patients ◽  
Homeless People ◽  
World Health ◽  
Rapid Review ◽  
Post Traumatic Stress

Background: The World Health Organization declared the Corona Virus Disease 19 (Covid-19) a pandemic in March 2020. Psychological impact of Covid-19 can be consisent and should be prevented with adequate measures. Methods: We performed a literature mini review searching for studies in PubMed focusing on the psychological/psychiatric impact of Covid-19.Results: The selection process yielded 34 papers focusing on the relation between Covid-19 and mental health: 9 correspondence, 8 letters to the editor, 7 commentaries, 3 editorials, 4 original studies, 2 brief reports, and 1 a rapid review. The majority of the articles were performed in China. They focused on the general population and particular categories considered more fragile, e.g., psychiatric patients, older adults, international migrant workers, homeless people. Authors are unanimous in believing that Covid-19 will likely increase the risk of mental health problems and worsen existing psychiatric disorders/symptoms in patients, exposed subjects, and staff. Together with the negative emotionality related to the unpredictability of the situation, uncertainty concerning the risk, excessive fear, fear of death, loneliness, guilt, stigma, denial, anger, frustration, boredome, some symptoms might appear such as insomnia until patophobia (specifically, coronaphobia), depressive and anxiety disorders, post-traumatic stress disorder, and suicidal risk.Limitations: Literature is rapidly increasing and present results are only partial. Conclusions: Mental health care should not be overlooked in this moment. The experience of China should be of help for all the countries facing with Covid-19, among them Italy.

Psychiatric morbidity in December 2015 flood-affected population in Tamil Nadu, India

2019 ◽  
Vol 65 (4) ◽  
pp. 338-344 ◽  
Author(s):  
Shailaja Bandla ◽  
NR Nappinnai ◽  
Srinivasagopalan Gopalasamy
Keyword(s):  
Mental Health ◽  
Tamil Nadu ◽  
Mental Health Problems ◽  
Negative Impact ◽  
Psychiatric Morbidity ◽  
Well Being ◽  
World Health ◽  
Post Traumatic Stress ◽  
Chi Square ◽  
Health Organization

Background: Floods are the most common type of natural disaster, which have a negative impact on mental health. Following floods, survivors are vulnerable to develop PTSD (post-traumatic stress disorder), depression, anxiety and other mental health problems. Aim: The aim is to study the psychiatric morbidity in the persons affected by floods during December 2015. Materials and methods: This study was carried out in Chennai and Cuddalore. In total, 223 persons who were directly exposed to floods were assessed. PTSD Checklist–Civilian Version, Beck’s Depression Inventory, Beck’s Anxiety Inventory and World Health Organization–Five Well-Being Scale (WHO-5) were used in the study. Chi-square test was used to compare the means. Results: Overall, psychiatric morbidity was found to be 45.29%; 60 (26.9%) persons had symptoms of PTSD. Anxiety was found in 48 (27.4%) and depression was found in 101 (45.29%) persons; and 11 (4.9%) persons have reported an increase in substance abuse. Conclusion: Following disaster like floods, there is a need for better preparedness in terms of basic necessities and medical and psychological assistance, particularly emphasizing the needs of older persons in order to prevent the development of psychiatric problems.

scholarly journals Including information about co-morbidity in estimates of disease burden: results from the World Health Organization World Mental Health Surveys

2010 ◽  
Vol 41 (4) ◽  
pp. 873-886 ◽  
Author(s):  
J. Alonso ◽  
G. Vilagut ◽  
S. Chatterji ◽  
S. Heeringa ◽  
M. Schoenbaum ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Surveys ◽  
Disease Burden ◽  
World Health ◽  
Individual Level ◽  
Specific Effects ◽  
Co Morbidity ◽  
The World ◽  
Societal Level ◽  
Health Organization

BackgroundThe methodology commonly used to estimate disease burden, featuring ratings of severity of individual conditions, has been criticized for ignoring co-morbidity. A methodology that addresses this problem is proposed and illustrated here with data from the World Health Organization World Mental Health Surveys. Although the analysis is based on self-reports about one's own conditions in a community survey, the logic applies equally well to analysis of hypothetical vignettes describing co-morbid condition profiles.MethodFace-to-face interviews in 13 countries (six developing, nine developed; n=31 067; response rate=69.6%) assessed 10 classes of chronic physical and nine of mental conditions. A visual analog scale (VAS) was used to assess overall perceived health. Multiple regression analysis with interactions for co-morbidity was used to estimate associations of conditions with VAS. Simulation was used to estimate condition-specific effects.ResultsThe best-fitting model included condition main effects and interactions of types by numbers of conditions. Neurological conditions, insomnia and major depression were rated most severe. Adjustment for co-morbidity reduced condition-specific estimates with substantial between-condition variation (0.24–0.70 ratios of condition-specific estimates with and without adjustment for co-morbidity). The societal-level burden rankings were quite different from the individual-level rankings, with the highest societal-level rankings associated with conditions having high prevalence rather than high individual-level severity.ConclusionsPlausible estimates of disorder-specific effects on VAS can be obtained using methods that adjust for co-morbidity. These adjustments substantially influence condition-specific ratings.

scholarly journals Pathways towards scaling up Problem Management Plus in Turkey: A Theory of Change Workshop

2020 ◽  
Author(s):  
Daniela Fuhr ◽  
Ceren Acarturk ◽  
Ersin Uygun ◽  
Michael McGrath ◽  
Zeynep Ilkkursun ◽  
...  
Keyword(s):  
Mental Health ◽  
Health System ◽  
Psychological Intervention ◽  
Scale Up ◽  
Scaling Up ◽  
Theory Of Change ◽  
World Health ◽  
Syrian Refugees ◽  
Problem Management ◽  
Causal Pathways

Abstract Background A considerable evidence base has been produced in recent years highlighting the effectiveness of brief scalable psychological interventions for people living in communities exposed to adversity. However, practical guidance on how to scale up these interventions to wider populations does not exist. In this paper we report on the use of Theory of Change (ToC) to plan the scale up of the World Health Organization’s flagship low intensity psychological intervention “Problem Management Plus” (PM+) for Syrian refugees in Turkey.Methods We conducted a one-day ToC workshop in Istanbul. ToC is a participatory planning process used in the development, implementation and evaluation of projects. It is similar to driver diagrams or logic models in that it offers a tool to visually present the components needed to reach a desired long-term outcome or impact. The overall aim of ToC is to understand the change process of a complex intervention and to map out causal pathways through which an intervention or strategy has an effect. Results Twenty-four stakeholders (including governmental officials, mental health providers, officials from international/national non-governmental organisations, conflict and health researchers) participated in the ToC workshop. A ToC map was produced identifying three key elements of scaling up (the resource team; the innovation and the health system; and the user organisation) which are represented in three distinct causal pathways. Context-specific barriers related to the health system and the political environment were identified, and possible strategies for overcoming these challenges were suggested. Conclusion ToC is a valuable methodology to develop an integrated framework for scaling up. The results highlight that the scaling up of PM+ for Syrian refugees in Turkey needs careful planning and investment from different stakeholders at the national level. Our paper provides a theoretical foundation of the scaling up of PM+, and exemplifies for the first time the use of ToC in planning the scaling up of an evidence-based psychological intervention in global mental health.

scholarly journals Disease burden and mental health system capacity: WHO Atlas study of 117 low- and middle-income countries

2012 ◽  
Vol 201 (6) ◽  
pp. 444-450 ◽  
Author(s):  
Ryan McBain ◽  
Carmel Salhi ◽  
Jodi E. Morris ◽  
Joshua A. Salomon ◽  
Theresa S. Betancourt
Keyword(s):  
Mental Health ◽  
Health System ◽  
Mental Health System ◽  
Disease Burden ◽  
Political Stability ◽  
System Capacity ◽  
World Health ◽  
Middle Income ◽  
Group 1 ◽  
Low And Middle Income

BackgroundTreatment coverage for mental disorders ranges from less than 10% to more than 90% across low- and middle-income (LAMI) countries. Studies have yet to examine whether the capacity of mental health systems might be adversely affected by the burdens of unrelated conditions such as HIV/AIDS.AimsTo examine whether the magnitude of disease burden from communicable, perinatal, maternal and nutritional conditions - commonly referred to as Group 1 diseases - is inversely associated with mental health system capacity in LAMI countries.MethodMultiple regression analyses were undertaken using data from 117 LAMI countries included in the 2011 World Health Organization (WHO) Mental Health Atlas. Capacity was defined in terms of human resources and infrastructure. Regressions controlled for effects of political stability, government health expenditures, income inequality and neuropsychiatric disease burden.ResultsHigher Group 1 disease burden was associated with fewer psychiatrists, psychologists and nurses in the mental health sector, as well as reduced numbers of out-patient facilities and psychiatric beds in mental hospitals and general hospitals (t= −2.06 to −7.68, P < 0.05).ConclusionsEvidence suggests that mental health system capacity in LAMI countries may be adversely affected by the magnitude of their Group 1 disease burden.

scholarly journals Protocol for a caregiver psychosocial support intervention for populations affected by displacement in Uganda

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Flora Cohen ◽  
Sabrina Hermosilla ◽  
Justin Knox ◽  
Gary Samuel Agaba ◽  
Grace Obalim ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Child Protection ◽  
Psychosocial Support ◽  
Scale Up ◽  
World Health ◽  
Health Concern ◽  
Quasi Experimental ◽  
Caregiver Mental Health ◽  
Health Organization

Abstract Background Child psychological distress in refugee settings is a significant public health concern, which is exacerbated by poor caregiver mental health and functioning. However, there are limited studies about effective interventions to improve caregiver mental health in support of child wellbeing. The objective of the current study is to evaluate the effectiveness and implementation of the Journey of Life (JoL) intervention to improve caregiver mental health in a refugee camp in Western Uganda. Methods A waitlist-control quasi-experimental design is being implemented in the Kiryandongo refugee settlement (intervention n = 600, control n = 600). Caregiver mental distress, measured using the Kessler-6, was selected as the primary outcome. Secondary outcomes include (a) functioning measured by the World Health Organization Disability Assessment Schedule, (b) social support measured by the Medical Outcomes Study Social Support Survey, and (c) caregiving behaviors according to the Parental Acceptance and Rejection Questionnaire and the Child Protection Index. The study aims to examine the implementation of the JoL intervention through qualitative assessments of intervention feasibility, adaptations, and reach. Discussion This trial will add much-needed evidence for the implementation of caregiver psychosocial programming within the humanitarian community. Findings will be disseminated amongst local, regional, and global actors in order to guide potential scale up within humanitarian settings. Trial registration Clinical Trials NCT04817098 (Registered: 3/24/21).

scholarly journals Together to make a difference in mental health in the Western Pacific Region

2014 ◽  
Vol 11 (1) ◽  
pp. 8-10
Author(s):  
Xiangdong Wang
Keyword(s):  
Mental Health ◽  
Disease Burden ◽  
Western Pacific ◽  
World Health ◽  
Pacific Region ◽  
Western Pacific Region ◽  
Mental Health Needs ◽  
Causes Of Disease ◽  
Health Organization ◽  
The Western Pacific

Mental disorders are among the leading causes of disease burden in the Western Pacific Region of the World Health Organization (WHO). Networking and partnership have been identified as the major components of key strategies to address challenges in meeting mental health needs in the region. This article provides a brief review of relevant initiatives collaboratively developed by the WHO, member states in the region and other partners.

scholarly journals Cyberchondria Amidst COVID-19 Pandemic: Challenges and Management Strategies

2021 ◽  
Vol 12 ◽  
Author(s):  
Rahul Varma ◽  
Sreeja Das ◽  
Tushar Singh
Keyword(s):  
Mental Health ◽  
Virus Disease ◽  
Management Strategies ◽  
Well Being ◽  
World Health ◽  
The Internet ◽  
Post Traumatic Stress ◽  
Related Information ◽  
Health Related ◽  
Health Organization

The corona-virus disease 2019 (COVID-19), first found in Wuhan, China in December 2019, has posed an inexplicable threat to the global community. After its inception, the virus proliferated rapidly, which led to the cause of millions of deaths, and having a detrimental effect on physical health, social lives, economic uncertainty, and mental health of people. The World Health Organization has reported that there are 111 million confirmed cases of COVID-19 and 2.45 million deaths due to COVID-19 worldwide. Indisputably, the present pandemic has contributed to the extensive psychological and environmental distress together with clinical depression, anxiety and post-traumatic stress disorder (PTSD), domestic violence, and unemployment. Due to the ambiguous nature of the pandemic, educational organizations, and outdoor activities are closed, thus burdening the mental health of younger populations. Children as well as youths are more glued to the Internet for their studies, online gaming, shopping, watching movies, and searching health-related information. Despite the advantages of using the Internet, it has some severe consequences too. Some people are repeatedly searching for physical and mental well-being related information without verifying credible sources, which, in turn, causes distress and anxiety. In such situations, individuals may end up contributing to an illness known as cyberchondria. In this paper, we have tried to highlight the problematic use of Internet for health-related searches and have outlined the management of such illness. We suggest two strategies: firstly, to reduce repeated online searches of health information and, secondly, to manage anxiety-augmenting thoughts that are triggered due to the maladaptive thoughts caused by the abstruse information.

The mental health of clean-up workers 18 years after the Chernobyl accident

2007 ◽  
Vol 38 (4) ◽  
pp. 481-488 ◽  
Author(s):  
K. Loganovsky ◽  
J. M. Havenaar ◽  
N. L. Tintle ◽  
L. T. Guey ◽  
R. Kotov ◽  
...  
Keyword(s):  
Mental Health ◽  
Chernobyl Accident ◽  
Suicide Ideation ◽  
Public Health Problem ◽  
Participation Rate ◽  
Composite International Diagnostic Interview ◽  
World Health ◽  
Exposure Level ◽  
Post Traumatic Stress

BackgroundThe psychological aftermath of the Chernobyl accident is regarded as the largest public health problem unleashed by the accident to date. Yet the mental health of the clean-up workers, who faced the greatest radiation exposure and threat to life, has not been systematically evaluated. This study describes the long-term psychological effects of Chernobyl in a sample of clean-up workers in Ukraine.MethodThe cohorts were 295 male clean-up workers sent to Chernobyl between 1986 and 1990 interviewed 18 years after the accident (71% participation rate) and 397 geographically matched controls interviewed as part of the Ukraine World Mental Health (WMS) Survey 16 years after the accident. The World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) was administered. We examined group differences in common psychiatric disorders, suicide ideation and severe headaches, differential effects of disorder on days lost from work, and in the clean-up workers, the relationship of exposure severity to disorder and current trauma and somatic symptoms. Analyses were adjusted for age in 1986 and mental health prior to the accident.ResultsRelatively more clean-up workers than controls experienced depression (18.0% v. 13.1%) and suicide ideation (9.2% v. 4.1%) after the accident. In the year preceding interview, the rates of depression (14.9% v. 7.1%), post-traumatic stress disorder (PTSD) (4.1% v. 1.0%) and headaches (69.2% v. 12.4%) were elevated. Affected workers lost more work days than affected controls. Exposure level was associated with current somatic and PTSD symptom severity.ConclusionsLong-term mental health consequences of Chernobyl were observed in clean-up workers.

scholarly journals Delivering maternal mental health through peer volunteers: a 5-year report

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Najia Atif ◽  
Amina Bibi ◽  
Anum Nisar ◽  
Shaffaq Zulfiqar ◽  
Ikhlaq Ahmed ◽  
...  
Keyword(s):  
Mental Health ◽  
Financial Incentives ◽  
Health Workers ◽  
Maternal Mental Health ◽  
Scale Up ◽  
Psychosocial Interventions ◽  
World Health ◽  
Research Attention ◽  
Peer Volunteers

Abstract Background Maternal depression affects one in five women in low-and middle income countries (LMIC) and has significant economic and social impacts. Evidence-based psychosocial interventions delivered by non-specialist health workers are recommended as first-line management of the condition, and recent studies on such interventions from LMIC show promising results. However, lack of human resource to deliver the interventions is a major bottle-neck to scale-up, and much research attention has been devoted to ‘task-sharing’ initiatives. A peer-delivered version of the World Health Organization’s Thinking Healthy Programme for perinatal depression in Pakistan and India showed clinical, functional and social benefits to women at 3 months postpartum. The programme has been iteratively adapted and continually delivered for 5 years in Pakistan. In this report, we describe the extended intervention and factors contributing to the peers’ continued motivation and retention, and suggest future directions to address scale-up challenges. Methods The study was conducted in rural Rawalpindi. We used mixed methods to evaluate the programme 5 years since its initiation. The competency of the peers in delivering the intervention was evaluated using a specially developed Quality and Competency Checklist, an observational tool used by trainers to rate a group session on key areas of competencies. In-depth interviews explored factors contributing to the peer volunteers’ continued motivation and retention, as well as the key challenges faced. Results Our key findings are that about 70% of the peer volunteers inducted 5 years ago continued to be part of the programme, retaining their competency in delivering the intervention, with only token financial incentives. Factors contributing to sustained motivation included altruistic aspirations, enhanced social standing in the community, personal benefits to their own mental health, and the possibility for other avenues of employment. Long-term challenges included demotivation due to lack of certainty about the programme’s future, increased requirement for financial incentivisation, the logistics of organising groups in the community, and resistance from some families to the need for ongoing care. Conclusions The programme, given the sustained motivation and competence of peer volunteers in delivering the intervention, has the potential for long-term sustainability in under-resourced settings and a candidate for scale-up.

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