scholarly journals Prevalence and Associated Factors of Metabolic Syndrome among Patients with Severe Mental Illness Attending a Tertiary Hospital in Southwest Uganda

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
David Collins Agaba ◽  
Richard Migisha ◽  
Rosemary Namayanja ◽  
Godfrey Katamba ◽  
Henry Mark Lugobe ◽  
...  
Keyword(s):  
Mental Health ◽  
Metabolic Syndrome ◽  
Mental Illness ◽  
Logistic Regression ◽  
Severe Mental Illness ◽  
Low Income ◽  
Associated Factors ◽  
Tertiary Hospital ◽  
Low Income Countries ◽  
Health Clinic

Globally, the prevalence of metabolic syndrome (MetS) and its components which are the major cardiovascular disease (CVD) risk factors, is higher among patients with severe mental illness (SMI) compared to the general population. This is mainly due to the deleterious lifestyles characterized by physical inactivity, excessive alcohol consumption, smoking, and unhealthy diets common among patients with SMI as well as due to cardiometabolic effects of psychotropic medications. Despite these conditions being highly prevalent among patients with SMI, little attention is given to these conditions during routine reviews in the mental health clinics in most low-income countries including Uganda. The main objective of this study was to determine the prevalence and associated factors of MetS among patients with SMI at Mbarara Regional Referral Hospital (MRRH), a tertiary hospital in southwestern Uganda. Through a cross-sectional study at the mental health clinic of the hospital, we recruited 304 patients with SMI and evaluated them for MetS using the National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III) criteria. We defined the prevalence of MetS as the proportion of patients meeting the NCEP ATP III criteria. We used logistic regression to evaluate associations between MetS and independent variables. We included a total of 302 (44.37% male, 55.63% female) patients with a diagnosis of SMI in the analysis. The prevalence of MetS was 23.51% (95% CI 18.84–28.71). At multivariable logistic regression, age >40 years and long duration of mental illness (>10 years) were significantly associated with MetS. The prevalence of MetS is high among patients with psychiatric disorders, and thus metabolic screening, especially among the high-risk groups, is critical.

scholarly journals Perceived Stigma Towards Mental Illness and Its Associated Factors among Community People of Pokhara Metropolitan, Kaski, Nepal

2020 ◽  
Vol 10 (2) ◽  
pp. 28-35
Author(s):  
Biddhya Bhattarai ◽  
Jenny Ojha
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Low Income ◽  
Associated Factors ◽  
Mental Health Problems ◽  
Public Health Problem ◽  
World Health ◽  
Low Income Countries ◽  
Perceived Stigma ◽  
Community People

Introduction: Mental illness is a major and neglected public health problem. People suffering from mental health problems are among the foremost stigmatized, discriminated, marginalized, disadvantaged and vulnerable members of our society. According to the World Health Organization, 450 million people are suffering from mental illness worldwide and around 80% of them live in middle and low-income countries. In spite of the high burden of mental disorders, globally, around 70% of people with mental illness do not receive any treatment, and evidence suggests that stigma plays a major role in treatment avoidance. The objective of this study is to assess the level of perceived stigma towards mental illness and its associated factors among community people of Pokhara Metropolitan. Methods: A community based descriptive cross-sectional study was conducted among the people of Pokhara Metropolitan. Systematic random sampling was employed for the selection of 292 participants. Face to face interview was conducted for the data collection using Community Attitude Towards Mental Illness (CAMI) scale. Chi square test was used to find the association between variables and stigma towards mental illness on different subscales of CAMI scale. Results: The overall prevalence of stigma towards mental illness was 72.9%. The prevalence of stigma was high under all the four domains of CAMI scale. Age, education, occupation and income were significantly associated with stigma score in all domains. Marital status had significant association to authoritarian as well as social restrictiveness domains score. However, sex and family history of mental illness was associated with Benevolence and community mental health ideology score respectively. Conclusion: The findings of the study depicted that stigma towards mental illness is high among the community people in all four subscales of CAMI scale. The study has revealed the stigma towards mental illness is  influenced by the various socio-demographic and socioeconomic factors. This study suggested that there is strong need to eliminate the stigma associated with mental illness to improve the mental health status of the region.

scholarly journals Mobile Health for All: Public-Private Partnerships Can Create a New Mental Health Landscape

2016 ◽  
Vol 3 (2) ◽  
pp. e26 ◽  
Author(s):  
Dror Ben-Zeev
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Mobile Phone ◽  
Mobile Phones ◽  
Mobile Technology ◽  
Low Income ◽  
Mental Health Problems ◽  
Assistance Program ◽  
The U.S

Research has already demonstrated that different mHealth approaches are feasible, acceptable, and clinically promising for people with mental health problems. With a robust evidence base just over the horizon, now is the time for policy makers, researchers, and the private sector to partner in preparation for the near future. The Lifeline Assistance Program is a useful model to draw from. Created in 1985 by the U.S. Federal Communications Commission (FCC), Lifeline is a nationwide program designed to help eligible low-income individuals obtain home phone and landline services so they can pursue employment, reach help in case of emergency, and access social services and healthcare. In 2005, recognizing the broad shift towards mobile technology and mobile-cellular infrastructure, the FCC expanded the program to include mobile phones and data plans. The FCC provides a base level of federal support, but individual states are responsible for regional implementation, including engagement of commercial mobile phone carriers. Given the high rates of disability and poverty among people with severe mental illness, many are eligible to benefit from Lifeline and research has shown that a large proportion does in fact use this program to obtain a mobile phone and data plan. In the singular area of mobile phone use, the gap between people with severe mental illness and the general population in the U.S. is vanishing. Strategic multi-partner programs will be able to grant access to mHealth for mental health programs to those who will not be able to afford them—arguably, the people who need them the most. Mobile technology manufacturing costs are dropping. Soon all mobile phones in the marketplace, including the more inexpensive devices that are made available through subsidy programs, will have “smart” capabilities (ie, internet connectivity and the capacity to host apps). Programs like Lifeline could be expanded to include mHealth resources that capitalize on “smart” functions, such as secure/encrypted clinical texting programs and mental health monitoring and illness-management apps. Mobile phone hardware and software development companies could be engaged to add mHealth programs as a standard component in the suite of tools that come installed on their mobile phones; thus, in addition to navigation apps, media players, and games, the new Android or iPhone could come with guided relaxation videos, medication reminder systems, and evidence-based self-monitoring and self-management tools. Telecommunication companies could be encouraged to offer mHealth options with their data plans. Operating system updates pushed out by the mobile carrier companies could come with optional mHealth applications for those who elect to download them. In the same manner in which the Lifeline Assistance Program has helped increase access to fundamental opportunities to so many low-income individuals, innovative multi-partner programs have the potential to put mHealth for mental health resources in the hands of millions in the years ahead.

Metabolic Syndrome Screening in People With Severe Mental Illness: Results From Two Spanish Community Mental Health Centers

2019 ◽  
Vol 26 (2) ◽  
pp. 162-171 ◽  
Author(s):  
Sara Fernández Guijarro ◽  
Carolina Miguel García ◽  
Edith Pomarol-Clotet ◽  
Elena Nunilón Egea López ◽  
Maria Dolors Burjales Martí ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Metabolic Syndrome ◽  
Mental Illness ◽  
Community Mental Health ◽  
Physical Health ◽  
Severe Mental Illness ◽  
Health Centers ◽  
Community Mental Health Centers ◽  
Mental Health Centers

BACKGROUND: The excess of mortality in people with severe mental illness is due to unnatural causes such as accidents or suicides and natural causes such as metabolic syndrome. The presence of modifiable risk factors like tobacco consumption increases cardiovascular and metabolic risk. AIMS: The purpose of this study was to identify the prevalence of metabolic syndrome and other cardiovascular risk factors in people with severe mental illness. This study also aimed to identify the prevalence of patients receiving treatment for any metabolic syndrome risk factor. METHOD: A cross-sectional descriptive study was performed. A total of 125 participants from two community mental health centers in Spain were recruited. RESULTS: More than half of the participants (58.4%) were active smokers. The prevalence of metabolic syndrome was 60%. A total of 16.8% received previous treatment for hypertension, 17.6% for hypertriglyceridemia, and 11.2% for diabetes. No differences were found between centers (22.7% vs. 18.7%, p = .9). CONCLUSIONS: The findings underscore the importance of monitoring the physical health of patients on antipsychotic therapy. The identification and management of cardiovascular and metabolic risks factors is an essential part of nursing care for people with severe mental illness. Mental health nurses are ideally positioned to carry out this task by performing physical health screening, health education, and lifestyle interventions.

scholarly journals Pathways Into and Out of Homelessness Among People with Severe Mental Illness in Rural Ethiopia: A Qualitative Study

2020 ◽  
Author(s):  
Caroline Smartt ◽  
Kaleab Ketema ◽  
Souci Frissa ◽  
Bethlehem Tekola ◽  
Rahel Birhane ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Severe Mental Illness ◽  
Low Income ◽  
Community Intervention ◽  
Social Needs ◽  
Rural Setting ◽  
Study Participants

Abstract Background: Little is known about the pathways followed into and out of homelessness among people with severe mental illness (SMI) living in rural, low-income country settings. Understanding these pathways is essential for the development of effective interventions to address homelessness and promote recovery. The aim of this study was to explore pathways into and out of homelessness in people with SMI in rural Ethiopia.Methods: In-depth interviews were conducted with 15 people with SMI who had experienced homelessness and 11 caregivers. Study participants were identified through a larger project implementing a multi-component district level plan to improve access to mental health care in primary care (PRIME). Thematic analysis was conducted using an inductive approach.Results: Study participants reported different patterns of homelessness, with some having experienced chronic and others an intermittent course. Periods of homelessness occurred when family resources were overwhelmed or not meeting the needs of the person with SMI. The most important pathways into homelessness were reported to result from family conflict and the worsening of mental ill health, interplaying with substance use in many cases. Participants also mentioned escape and/or wanting a change in environment, financial problems, and discrimination from the community as contributing to them leaving the home. Pathways out of homelessness included contact with (mental and physical) health care as a catalyst to the mobilization of other supports, family and community intervention, and self-initiated return.Conclusions: Homelessness in people with SMI in this rural setting reflected complex health and social needs that were not matched by adequate care and support. Interventions to prevent and tackle homelessness need to focus on increasing family support, and ensuring access to housing, mental health care and social support.

scholarly journals What is the experience of registered nurses in assessing people with severe mental illness for metabolic syndrome?

2021 ◽  
Vol 21 (8) ◽  
pp. 477-484
Author(s):  
Ruth Crawford ◽  
Sisilia Finau Peini ◽  
Teramira Christine Schutz
Keyword(s):  
Mental Health ◽  
Metabolic Syndrome ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Severe Mental Illness ◽  
Registered Nurses ◽  
Face To Face ◽  
Mental Health Settings ◽  
One Stop

Introduction: Metabolic Syndrome is a prevalent condition in New Zealand and worldwide, affecting adult populations, especially those who are in long-term  antipsychotic medications for severe mental illness. Registered nurses play a crucial role in improving the health of this population. Methods: Five registered nurses with at least two years of working experience in the mental health settings participated in this qualitative, exploratory study, underpinned by the Kakala Research Framework. Semi-structured face-to-face interviews with the participants were undertaken to gather research data and thematic analysis was used to find common themes. Findings: Registered nurses in mental health services are experiencing clinical and professional enablers as well as professional, organisational and systematic barriers in assessing people with severe mental illness for metabolic syndrome. Conclusion: Skilled registered nurses in mental health services are required to take the responsibility for providing a “one-stop-shop” for people with metabolic syndrome.

scholarly journals Rural vs urban residence and experience of discrimination among people with severe mental illnesses in Ethiopia

2019 ◽  
Author(s):  
Sarah Forthal ◽  
Abebaw Fekadu ◽  
Girmay Medhin ◽  
Medhin Selamu ◽  
Graham Thornicroft ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Low Income ◽  
Rural Areas ◽  
Negative Binomial ◽  
Mental Illnesses ◽  
Urban Setting ◽  
Low Income Countries ◽  
Urban Settings ◽  
Adjusted Risk

Abstract Background Few studies have addressed mental illness-related discrimination in low-income countries, where the mental health treatment gap is highest. We aimed to evaluate the experience of discrimination among persons with severe mental illnesses (SMI) in Ethiopia, a low-income, rapidly urbanizing African country, and hypothesised that experienced discrimination would be higher among those living in a rural compared to an urban setting. Methods The study was a cross-sectional survey of a community-ascertained sample of people with SMI who underwent confirmatory diagnostic interview. Experienced discrimination was measured using the Discrimination and Stigma Scale (DISC-12). Zero-inflated negative binomial regression was used to estimate the effect of place of residence (rural vs. urban) on discrimination, adjusted for potential confounders. Results Of the 300 study participants, 63.3% had experienced discrimination in the previous year, most commonly being avoided or shunned because of mental illness (38.5%). Urban residents were significantly more likely to have experienced unfair treatment from friends (χ2(1)=4.80; p=0.028), the police (χ2(1) =11.97; p=0.001), in keeping a job (χ2(1)=5.43; p=0.020), and in safety (χ2(1)=5.00; p=0.025), and had a significantly higher DISC-12 score than those living in rural areas (adjusted risk ratio: 1.66; 95% CI: 1.18, 2.33). Conclusions Persons with SMI living in urban settings report more experience of discrimination than their rural counterparts, which may reflect a downside of wider social opportunities in urban settings. Initiatives to expand access to mental health care should consider how social exclusion can be overcome in different settings.

scholarly journals The Burden of Mental Disorders in the Eastern Mediterranean Region, 1990–2013

2017 ◽  
Vol 41 (S1) ◽  
pp. S156-S157 ◽  
Author(s):  
R. Charara ◽  
A. Mokdad
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Disorders ◽  
Low Income ◽  
Mediterranean Region ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Low Income Countries ◽  
Years Of Life Lost ◽  
Life Years

The eastern Mediterranean region (EMR) is witnessing an increase in mental illness. With ongoing unrest, this is expected to rise. This is the first study to quantify the burden of mental disorders in the EMR. We used data from the global burden of disease study (GBD) 2013. DALYs (disability-adjusted life years) allow assessment of both premature mortality (years of life lost–YLLs) and nonfatal outcomes (years lived with disability–YLDs). DALYs are computed by adding YLLs and YLDs for each age-sex-country group. In 2013, mental disorders contributed to 5.6% of total disease burden in EMR (1894 DALYS/100,000 population): 2519 DALYS/100,000 (2590/100,000 males, 2426/100,000 females) in high-income countries, 1884 DALYS/100,000 (1618/100,000 males, 2157/100,000 females) in middle-income countries, 1607 DALYS/100,000 (1500/100,000 males, 1717/100,000 females) in low-income countries. Females had a greater proportion of burden due to mental disorders than did males of equivalent ages, except for those under 15 years. The highest proportion of DALYs occurred in the 25–49 age group. The burden of mental disorders in EMR increased from 1726 DALYs/100,000 in 1990 to 1912 DALYs/100,000 in 2013 (10.8% increase). Depressive disorders accounted for most DALYs, followed by anxiety disorders. Palestine had the largest burden of mental disorders. Nearly all EMR countries had a higher mental disorder burden compared to global level. Our findings call for EMR health ministries to increase provision of mental health services and to address stigma of mental illness. Our results showing the accelerating burden of mental health are alarming as the region is seeing an increased level of instability.

scholarly journals Stigma and discrimination limit access to mental health care

2008 ◽  
Vol 17 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Graham Thornicroft
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Low Income ◽  
Help Seeking ◽  
Mental Illnesses ◽  
Low Income Countries ◽  
Stigma And Discrimination ◽  
Epidemiological Surveys

AbstractThis editorial provides an overview of how far access to mental health care is limited by perceptions of stigma and anticipated discrimination. Globally over 70% of young people and adults with mental illness receive no treatment from healthcare staff. The rates of non-treatment are far higher in low income countries. Evidence from some descriptive studies and epidemiological surveys suggest that potent factors increasing the likelihood of treatment avoidance, or long delays before presenting for care include: (i) lack of knowledge about the features and treatability of mental illnesses; (ii) ignorance about how to access assessment and treatment; (iii) prejudice against people who have mental illness, and (iv) expectations of discrimination against people who have a diagnosis of mental illness. The associations between low rates of help seeking, and stigma and discrimination are as yet poorly understood and require more careful characterisation and analysis, providing the platform for more effective action to ensure that a greater proportion of people with mental illness are effectively treated in future.

scholarly journals Rural vs urban residence and experience of discrimination among people with severe mental illnesses in Ethiopia

2019 ◽  
Author(s):  
Sarah Forthal ◽  
Abebaw Fekadu ◽  
Girmay Medhin ◽  
Medhin Selamu ◽  
Graham Thornicroft ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Low Income ◽  
Rural Areas ◽  
Negative Binomial ◽  
Mental Illnesses ◽  
Low Income Countries ◽  
Cross Sectional Survey ◽  
Urban Settings ◽  
Adjusted Risk

Abstract Background Few studies have addressed mental illness-related discrimination in low-income countries, where the mental health treatment gap is highest. We aimed to evaluate the experience of discrimination among persons with severe mental illnesses (SMI) in Ethiopia, a low-income, rapidly urbanizing African country, and hypothesised that experienced discrimination would be higher among those living in a rural compared to an urban setting.Methods The study was a cross-sectional survey of a community-ascertained sample of people with SMI who underwent confirmatory diagnostic interview. Experienced discrimination was measured using the Discrimination and Stigma Scale (DISC-12). Zero-inflated negative binomial regression was used to estimate the effect of place of residence (rural vs. urban) on discrimination, adjusted for potential confounders.Results Of the 300 study participants, 63.3% had experienced discrimination in the previous year, most commonly being avoided or shunned because of mental illness (38.5%). Urban residents were significantly more likely to have experienced unfair treatment from friends (χ2(1)=4.80; p=0.028), the police (χ2(1) =11.97; p=0.001), in keeping a job (χ2(1)=5.43; p=0.020), and in safety (χ2(1)=5.00; p=0.025), and had a significantly higher DISC-12 score than those living in rural areas (adjusted risk ratio: 1.66; 95% CI: 1.18, 2.33).Conclusions Persons with SMI living in urban settings report more experience of discrimination than their rural counterparts, which may reflect a downside of wider social opportunities in urban settings. Initiatives to expand access to mental health care should consider how social exclusion can be overcome in different settings.

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