What role can a homoeopathic psychiatrist play in restoring mental health in an unequal world?

World Mental Health Day, observed on the 10 October, is an occasion for the mental health professionals to dedicate themselves to bringing succour to the numerous persons suffering from mental health disorders. The World Mental Health Federation has declared this year’s theme as ‘Mental Health in an Unequal world.’ The call is timely considering the distress wrought on different communities due to the pandemic and the social and economic distress which has affected all sections of the population, albeit with different intensities causing differing impacts. The article explores the theme in the historical context and outlines the various concerns which mental health professionals should concern themselves with. It is a common knowledge that they are in short supply all over the world. Homoeopaths, due to their approach to health, disease and individuals are uniquely equipped to fill this gap and thus make a difference. There are very few examples, at the institutional level, where community-based activities addressing the mental health issues have been successfully undertaken and have made an impact. The article draws on the almost two-decade-long experience of the Department of Homoeopathic Psychiatry, Dr. M. L. Dhawale Memorial Homoeopathic Institute in this area, thereby illustrating the possibility of incorporating similar practices in the District Mental Health Programme. Clinical activity needs to be reported in peer-reviewed journals and initiating research in priority areas would help homoeopathy to be recognised as a discipline which can be a part of Integrated Mental Health Care for mental disorders.

Childhood adversities and mental disorders in first-year college students: results from the World Mental Health International College Student Initiative

Background This study investigates associations of several dimensions of childhood adversities (CAs) with lifetime mental disorders, 12-month disorder persistence, and impairment among incoming college students. Methods Data come from the World Mental Health International College Student Initiative (WMH-ICS). Web-based surveys conducted in nine countries (n = 20 427) assessed lifetime and 12-month mental disorders, 12-month role impairment, and seven types of CAs occurring before the age of 18: parental psychopathology, emotional, physical, and sexual abuse, neglect, bullying victimization, and dating violence. Poisson regressions estimated associations using three dimensions of CA exposure: type, number, and frequency. Results Overall, 75.8% of students reported exposure to at least one CA. In multivariate regression models, lifetime onset and 12-month mood, anxiety, and substance use disorders were all associated with either the type, number, or frequency of CAs. In contrast, none of these associations was significant when predicting disorder persistence. Of the three CA dimensions examined, only frequency was associated with severe role impairment among students with 12-month disorders. Population-attributable risk simulations suggest that 18.7–57.5% of 12-month disorders and 16.3% of severe role impairment among those with disorders were associated with these CAs. Conclusion CAs are associated with an elevated risk of onset and impairment among 12-month cases of diverse mental disorders but are not involved in disorder persistence. Future research on the associations of CAs with psychopathology should include fine-grained assessments of CA exposure and attempt to trace out modifiable intervention targets linked to mechanisms of associations with lifetime psychopathology and burden of 12-month mental disorders.

Dr. Gordana Milavić on World Mental Health Day 2021

Dr. Gordana Milavić on World Mental Health Day 2021

Antidepressant use in low- middle- and high-income countries: a World Mental Health Surveys report

Background The most common treatment for major depressive disorder (MDD) is antidepressant medication (ADM). Results are reported on frequency of ADM use, reasons for use, and perceived effectiveness of use in general population surveys across 20 countries. Methods Face-to-face interviews with community samples totaling n = 49 919 respondents in the World Health Organization (WHO) World Mental Health (WMH) Surveys asked about ADM use anytime in the prior 12 months in conjunction with validated fully structured diagnostic interviews. Treatment questions were administered independently of diagnoses and asked of all respondents. Results 3.1% of respondents reported ADM use within the past 12 months. In high-income countries (HICs), depression (49.2%) and anxiety (36.4%) were the most common reasons for use. In low- and middle-income countries (LMICs), depression (38.4%) and sleep problems (31.9%) were the most common reasons for use. Prevalence of use was 2–4 times as high in HICs as LMICs across all examined diagnoses. Newer ADMs were proportionally used more often in HICs than LMICs. Across all conditions, ADMs were reported as very effective by 58.8% of users and somewhat effective by an additional 28.3% of users, with both proportions higher in LMICs than HICs. Neither ADM class nor reason for use was a significant predictor of perceived effectiveness. Conclusion ADMs are in widespread use and for a variety of conditions including but going beyond depression and anxiety. In a general population sample from multiple LMICs and HICs, ADMs were widely perceived to be either very or somewhat effective by the people who use them.