Global Mental Health最新文献

Evidence is scarce in terms of tracking the progress of implementation of mental healthcare plans and policies (MHPPs) in Europe, we aimed to map and analyze the content of MHPPs across the WHO European region. We collected data from the WHO Mental Health Atlas 2011, 2017 and 2020 to map the development of MHPPs in the region. We contacted 53 key informants from each country in the European region to triangulate the data from WHO Mental Health Atlases and to obtain access to the national mental health plans and policies. We analyzed the content of MHPPs against the four major objectives of the WHO Comprehensive Mental Health Action Plan, and we also focused on the specificity and measurability of their targets. The number and proportion of countries which have their own MHPPs has increased from 30 (52%) to 43 (91%) between 2011 and 2020. MHPPs are generally in line with the WHO policy, aiming to strengthen care in the community, expand mental health promotion and illness prevention activities, improve quality of care, increase intersectoral collaboration, build workforce and system capacity, and improve adherence to human rights. However, specific, and measurable targets as well as a description of concrete steps, responsibilities and funding sources are mostly missing. They often contain very little information systems, evidence and research, and mostly lack information on evaluating the implementation of MHPPs. Progress has been made in terms of the development of MHPPs in the WHO Europe. However, MHPPs are often lacking operationalization and appropriate data collection for evaluation. This is then reflected in missing evaluation plans, which in turn leads to lessons not being learned. To enhance the potential for knowledge generation and demonstration of impact, MHPPs should be more specific and contain measurable targets with allocated responsibilities and funding as well as evaluation plans.

Adolescence is a critical developmental period marked by significant changes, increasing the risk of mental health problems such as anxiety and depression. Understanding how youth engage with mental health resources is essential. This study explored the role of interpersonal relationships-including peer-to-peer, adult-youth, parent, teacher and mentor relationships, and interactions with mental health professionals-in shaping youth mental health engagement and identified factors influencing these relationships. Using a phenomenological qualitative design, youth researchers (YRs) and youth advisors (YAs) were engaged throughout the research process. Semi-structured interviews were conducted with South African youth aged 14-24 years. The study highlighted the significance of peer relationships, particularly relatability, as key in youth mental health support. Family relationships had a mixed role, with factors like lack of mental health literacy, age differences, and cultural norms hindering effective communication and support. By understanding the dynamics of these relationships, this study emphasizes the need for targeted interventions that harness social support. Enhancing the quality of relationships and promoting positive social bonds can protect against mental health problems. Addressing gaps in support by recognizing and supporting peer-to-peer engagement is essential. Findings provide valuable insights for designing strategies to promote mental well-being among youth, particularly in resource-constrained settings.

The Emotion Regulation Questionnaire-Short Form (ERQ-S) is a brief 6-item self-report measure of two emotion regulation strategies, cognitive reappraisal and expressive suppression. It is a short form of the most widely used emotion regulation measure in the field, but currently there are limited data on the performance of the ERQ-S. The aim of this study was to introduce a Polish version of the ERQ-S, examine its psychometric properties and provide Polish norms to aid score interpretation. Our sample was 574 Polish-speaking adults aged 18-69 from the general community in Poland. We examined the ERQ-S's factor structure and measurement invariance with confirmatory factor analysis. We assessed the concurrent validity of the questionnaire via relationships with psychopathology symptoms and well-being. As expected, the Polish version of the ERQ-S demonstrated strong factorial validity with a theoretically congruent 2-factor structure (cognitive reappraisal and expressive suppression factors), which was invariant across gender, age and education categories. The ERQ-S's concurrent validity and internal consistency reliability were good. As expected, cognitive reappraisal was significantly associated with lower psychopathology symptoms and higher well-being, whereas the opposite pattern was present for expressive suppression. Overall, the Polish version of the ERQ-S has strong psychometric properties and good clinical relevance.

This study aimed to assess feasibility, acceptability and potential for impact of FOotpaths foR Adolescent MAternal Mental HeAlth (FOR MAMA), a co-designed intervention for pregnant adolescents in Malawi. We used a mixed-methods interventional pre-post cohort design. We recruited pregnant adolescents from a rural health centre in Zomba district, Malawi, all of whom were offered a five-session psychosocial intervention delivered by community healthcare workers. Quantitative feasibility indicators related to participant enrolment, session attendance and intervention completion. Feasibility of intervention delivery was explored using in-depth semi-structured interviews with healthcare workers. Acceptability was investigated through in-depth semi-structured interviews with intervention participants and a service user satisfaction questionnaire. Intervention outcomes were assessed using standardised measures of common mental disorders, financial distress and poor mental health and perceived social support. 19 adolescents aged 15-19 years (mean=17.21, SD=1.18) started the intervention, with 18 (94.7%) completing the programme. Significant improvements (p<0.05) were reported across all outcome measures, with moderate to high pre-post effect sizes. Intervention participants reported high levels of service satisfaction, although healthcare workers (n = 6) reported that some feasibility challenges emerged during recruitment and delivery. The FOR MAMA intervention proved to be an acceptable and feasible psychosocial intervention for pregnant adolescents in Malawi.

Background: Childhood trauma (CT) increases rates of psychiatric disorders and symptoms, however, the lasting effect of CT into adulthood has little exploration using large-scale samples.

Objectives: This study estimated the prevalence of CT in a large sample of Chinese young adults, examining the risk factors of current psychological symptoms among those with CT experiences.

Methods: 117,769 college students were divided into CT and non-CT groups. The propensity score matching method balanced the confounding sociodemographic factors between the two groups, compared to 16 self-reported psychiatric disorders (e.g., depression, anxiety, eating disorder, obsessive-compulsive disorder, autism, social anxiety disorder, post-traumatic stress disorder), and seven current psychiatric symptoms. Hierarchical regression employed the significant risk factors of the seven current psychiatric symptoms.

Results: The prevalence of CT among young adults was 28.76% (95% CI: 28.47-29.04%). Youths with CT experiences reported higher psychiatric disorder rates and current symptom scores (P < 0.001). Sociodemographic factors (females, family disharmony, low socioeconomic status, poor relationship with parents, lower father's education level) and lifestyle factors (smoking status, alcohol consumption, lack of exercise) were significantly associated with current psychiatric symptoms.

Results: Public health departments and colleges should develop strategies to promote mental health among those who have experienced CT.

Research on adolescent mental health in low and middle-income countries cites the paucity of human resources and emphasises non-specialist worker (NSW)-led counselling intervention within school and health-system platforms. This pilot study aimed to evaluate the feasibility and acceptability of a transdiagnostic stepped care model, for delivering preventive psychological treatment to adolescents through NSWs in urban vulnerable community settings. Conducted in three such settlements in Mumbai and Thane districts of Maharashtra in India, this mixed-methods study engaged 500 young people, their parents and 52 NSWs. Quantitative data, obtained through monitoring indicators, fidelity checklists and the Strengths and Difficulties Questionnaire (SDQ), revealed key stressors for adolescents, including poverty, structural inequity, cultural conformity pressures, academic anxieties and communication gap within families. Post-intervention, adolescents exhibited an enhanced capacity for positive emotions and agency. The qualitative component, incorporating observations, focus group discussions (FGDs) and in-depth interviews (IDIs) with various stakeholders, highlighted reduced stigma around mental health, yet identified barriers like time commitment, lack of incentivisation for NSWs, lack of privacy in densely populated communities and societal stigma. This implementation research underscores that adolescent mental health stressors often originate from social determinants, exacerbated by insufficient awareness and stigma. Such stepped care models offer a pathway for communities to establish enduring support networks.

Mental health challenges are common following cancer diagnosis, negatively impacting treatment and quality of life for breast cancer (BC) patients. This pilot study provides an understanding of the impacts of BC diagnosis and care experiences on the mental health of patients seen at the Aga Khan University Hospital in Nairobi, Kenya. We conducted 40 in-depth interviews, including 10 women with newly diagnosed BC, 10 women with metastatic BC, 10 family members and 10 healthcare professionals. Data were transcribed, translated into English as needed and coded using Dedoose software. Following BC diagnosis, it was reported that patients faced various physical, social, psychological and spiritual factors affecting their mental health and quality of life. Our interviews with each group indicated that BC patients experienced feelings of stress, anxiety and depression related to treatments and accompanying side effects. Disclosure concerns, financial impacts, relationship strain and negative outlooks on life were common among BC patients. The findings indicate that BC diagnosis and care experiences influence mental health in this population. With this basis, understanding and addressing the mental health challenges of BC patients is crucial to improve mental health and quality of life.

Objective: To reveal the chain mediating roles of insomnia and anxiety between social support and PTSD in nursing staff under the stage of COVID-19 regular pandemic prevention and control in China.

Methods: A total of 784 nurses were recruited using the convenience sampling method in Jiangsu Province, China. Demographic questionnaire, Perceived Social Support Scale, Impact of Event Scale-Revised, Generalized Anxiety Disorder-7 and Insomnia Severity Index were applied to collect data.

Results: Social support, PTSD, insomnia and anxiety were significantly correlated with each other. Insomnia and anxiety acted as chain mediators between social support and PTSD.

Conclusion: Insufficient social support may trigger PTSD through the chain mediating effects of insomnia and anxiety in nursing staff under the stage of COVID-19 regular pandemic prevention and control. Measures focusing on social support, insomnia and anxiety should be taken to reduce or even prevent PTSD in nursing staff in Chinese hospitals in similar crises in the future.

The eastern Democratic Republic of Congo (DRC) has faced dual burdens of poor mental health and heightened levels of violence against women and children within the home. Interventions addressing family violence prevention may offer a path to mitigate mental distress within the eastern DRC. This exploratory analysis uses data from a pilot cluster randomized controlled trial conducted in North Kivu, DRC, assessing the impact of Safe at Home, a violence prevention intervention. Mental health was assessed at endline using the Patient Health Questionnaire-4. Statistical analyses employed multilevel linear regression. Assuming successful randomization, impact of the Safe at Home intervention on mental health differed by participant gender. Women enrolled in the Safe at Home intervention reported statistically significant decreases in mental distress symptoms [β (95%CI) = -1.01 (-1.85, -0.17)], whereas men enrolled in Safe at Home had similar scores in mental distress to the control group [β (95%CI) = -0.12 (-1.32, 1.06)]. Ultimately, this exploratory analysis provides evidence of the potential for a family violence prevention model to improve women's mental health in a low-resource, conflict-affected setting, although further research is needed to understand the impact on men's mental health.

The global health community has recognized that social determinants of health account for most of the inequities of health outcomes, including mental health outcomes, across and within countries. Strategies to overcome such inequities must focus on modifiable social factors. In this viewpoint, we argue for the preeminence of employment among social determinants of mental health for several reasons. People with mental health disabilities want to work, and a well-validated model of supported employment that is effective and cost-effective now exists. Employment leads to improvements in income, daily structure, self-esteem, social support, community integration and illness management, and people who are employed experience fewer emergencies and hospitalizations. Employment is empowering because people can use added income to activate their own choices regarding other social determinants. Supported employment actualizes the recovery paradigm: People who are employed in competitive jobs of their choice develop a meaningful functional life, increased self-esteem and new social supports. We provide examples of supported employment developments in diverse settings and discuss the implications of scaling up these services worldwide.