Global Mental Health最新文献

[This corrects the article DOI: 10.1017/gmh.2025.20.].

Parenting programs are effective ways to reduce child maltreatment and promote nurturing parent-child relationships. Yet, the potential of faith-based, positive parent programs, particularly those conducted globally at scale, remains underexplored. We conducted a pre-post and 6-month follow-up, single-group study of a faith- and community-based parenting program, Celebrating Families (CF), in 12 countries in sub-Saharan Africa, Central America and South East Asia. Using a train-the-trainers model, faith leaders delivered group-based parenting workshops over 3-5 days to a nonrandomized sample of 2201 caregivers across 12 countries. Data was collected at three time points. Shifts in caregiver attitudes and beliefs were assessed pre- and post, and harsh parenting behaviors were measured at pre- and 6-months after CF parent program implementation. Acceptability was demonstrated by high attendance and high satisfaction ratings from facilitators and caregivers. Trained faith and community leaders feasibly delivered the CF parent groups and were rated by caregivers to have strong teaching skills. Qualitative analysis of their feedback at 6-month follow-up highlighted barriers to implementation and areas for improvement. Results with those caregivers who completed the program suggest large to medium effect size improvements in caregiver attitudes around harsh discipline and nurturing parenting by country and change in reported use of harsh parenting behaviors at 6 months. Findings suggest that CF is a feasible and acceptable program with promising short-term effects for caregivers of children and adolescents in low- and middle-income countries.

Depression and anxiety are common mental health issues globally, yet limited research has focused on job seekers in Bangladesh. This study examines the prevalence and associated factors of depression and anxiety symptoms among Bangladeshi graduates seeking employment. A cross-sectional study was conducted among graduates from two public universities in Bangladesh, using face-to-face interviews and a semi-structured questionnaire. Data were collected between March and April 2024 through convenience sampling. Chi-square tests and logistic regression were used for analysis with SPSS software. Among the participants, 46.8% experienced depressive symptoms and 67.8% had anxiety symptoms, with 42.3% experiencing both. Factors associated with a reduced risk of depressive symptoms included being a first child (OR = 0.48, 95% CI: 0.25-0.93, p = 0.031) and exam satisfaction (OR = 0.22, 95% CI: 0.12-0.39, p < 0.001). Lower symptoms of anxiety were associated with being male (OR = 0.45, 95% CI: 0.25-0.80, p = 0.007), first-born status (OR = 0.45, 95% CI: 0.22-0.92, p = 0.030), financial contribution to family (OR = 0.40, 95% CI: 0.19-0.81, p = 0.011), over 12 months of preparation (OR = 0.37, 95% CI: 0.15-0.92, p = 0.034) and exam satisfaction (OR = 0.40, 95% CI: 0.22-0.71, p = 0.002). Intentionally unemployed participants had a higher risk of anxiety symptoms (OR = 1.70, 95% CI: 1.00-2.89, p = 0.046). This study reveals high rates of depressive and anxiety symptoms among job-seeking graduates in Bangladesh. Socio-demographic and job-related factors appear to significantly impact mental health, underscoring the need for a holistic approach to address these challenges. Targeted mental health interventions and increased public awareness are essential to support vulnerable groups in navigating the highly competitive job market.

Traditional faith healers (TFHs) are often consulted for serious mental illness (SMIs) in low- and middle-income countries (LMICs). Involvement of TFHs in mental healthcare could provide an opportunity for early identification and intervention to reduce the mental health treatment gap in LMICs. The aim of this study was to identify models of collaboration between TFHs and biomedical professionals, determine the outcomes of these collaborative models and identify any mechanisms (i.e., explanatory processes) or contextual moderators (i.e., barriers and facilitators) of these outcomes. A systematic scoping review of five electronic databases was performed from inception to March 2023 guided by consultation with local experts in Nigeria and Bangladesh. Data were extracted using a predefined data charting form and synthesised narratively. Six independent studies (eight articles) satisfied the inclusion criteria. Study locations included Ghana (n = 1), Nigeria (n = 1), Nigeria and Ghana (n = 1), India (n = 1), Hong Kong (n = 1) and South Africa (n = 1). We identified two main intervention typologies: (1) Western-based educational interventions for TFHs and (2) shared collaborative models between TFHs and biomedical professionals. Converging evidence from both typologies indicated that education for TFHs can help reduce harmful practices. Shared collaborative models led to significant improvements in psychiatric symptoms (in comparison to care as usual) and increases in referrals to biomedical care from TFHs. Proposed mechanisms underpinning outcomes included trust building and empowering TFHs by increasing awareness and knowledge of mental illness and human rights. Barriers to implementation were observed at the individual (e.g., suspicions of TFHs), relationship (e.g., reluctance of biomedical practitioners to equalise their status with TFHs) and service (e.g., lack of formal referral systems) levels. Research on collaborative models for mental healthcare is in its infancy. Preliminary findings are encouraging. To ensure effective collaboration, future programmes should incorporate active participation from community stakeholders (e.g., patients, caregivers, faith healers) and target barriers to implementation on multiple levels.

The Israeli escalation of violence and oppression in Gaza, particularly following the events of October 7, 2023, has deepened the trauma and exacerbated the already grievous conditions of dispossession and exploitation faced by Palestinians. The present exploratory work sought to analyze war-related traumatic experiences among Gazans following the recent Israeli genocide against Gazans. Thirty participants (mean age for males = 32.45 years, SD = 10.13; mean age for females = 30.28 years, SD = 9.15; range 19-57) were recruited via snowball sampling. Interviews were analyzed through thematic content analysis. Thematic content analysis of the interview transcripts led to the identification of five main themes: (1) challenges and difficulties faced Gazans, (2) traumatic experiences related to war, (3) feelings and emotions among Gazans living in refugee camps, (4) how do Gazans perceive the future and (5) survival coping employed by Gazans following the on-going genocide against the Gaza Strip. The findings of this study highlight the profound humanitarian crisis in Gaza, calling for urgent attention to the ongoing crisis in Gaza and advocating for comprehensive humanitarian support and psychological interventions to address the deep-seated trauma and help rebuild lives shattered by conflict.

Most people with mental illness in low and middle-income countries (LMICs) do not receive biomedical treatment, though many seek care from traditional healers and faith healers. We conducted a qualitative study in Buyende District, Uganda, using framework analysis. Data collection included interviews with 24 traditional healers, 20 faith healers, and 23 biomedical providers, plus 4 focus group discussions. Interviews explored treatment approaches, provider relationships, and collaboration potential until theoretical saturation was reached. Three main themes emerged: (1) Biomedical providers' perspectives on traditional and faith healers; (2) Traditional and faith healers' views on biomedical providers; and (3) Collaboration opportunities and barriers. Biomedical providers viewed faith healers positively but traditional healers as potentially harmful. Traditional and faith healers valued biomedical approaches while feeling variably accepted. Interest in collaboration existed across groups but was complicated by power dynamics, economic concerns, and differing mental illness conceptualizations. Traditional healers and faith healers routinely referred patients to biomedical providers, though reciprocal referrals were rare. The study reveals distinct dynamics among providers in rural Uganda, with historical colonial influences continuing to shape relationships and highlighting the need for integrated, contextually appropriate mental healthcare systems.

The objective of this study was to investigate the impact of common mental disorder (CMD; depression/anxiety) symptoms and risky substance use in people with epilepsy in Ethiopia (four districts) on quality of life (QoL) and functioning over 6 months. A prospective cohort study was carried out. Multivariable linear regression followed by structural equation modelling (SEM) was employed. In the multivariable regression model, neither CMD symptoms (β coef. = -0.37, 95% confidence interval [CI] -1.30, +0.55) nor moderate to high risk of alcohol use (β coef. = -0.70, 95% CI -9.20, +7.81) were significantly associated with a change in QoL. In SEM, the summative effect of CMD on QoL was significant (B = -0.27, 95% CI -0.48, -0.056). Change in functional disability was not significantly associated with common mental disorder (CMD) symptoms (β coef. = -0.03, 95% CI -0.48, +0.54) or with moderate to high risk of alcohol use (β coef. = -1.31, 95% CI -5.89, 3.26). In the SEM model, functional disability was predicted by both CMD symptoms (B = 0.24, 95% CI 0.06, 0.41) and seizure frequency (B = 0.67, 95% CI 0.46, 0.87). In this rural Ethiopian setting, co-morbid CMD symptoms and seizure frequency independently predicted functional disability in people with epilepsy.

Healthcare workers in Africa face considerable stress due to factors like long working hours, heavy workloads and limited resources, leading to psychological distress. Generally, countries in the global north have well-established policies and employee wellness programs for mental health compared to countries in the global south. This scoping review aimed to synthesize evidence from published and grey literature on workplace mental health promotion interventions targeting African healthcare workers using Social Ecological Model (SEM) and the Job Demands-Resources (JD-R) model as an underlying theoretical framework for analysis. Arksey and O'Malley framework for scoping reviews was used. The search was conducted across multiple databases. A total of 5590 results were retrieved from Ovid MEDLINE, Ovid Embase, Ovid PsycINFO, Cochrane Library, CINAHL, Scopus and Web of Science. Seventeen (17) studies from ten (10) African countries were included after title, abstract and full text screening. Thematic analysis identified 5 key themes namely training programs, counselling services, peer support programs, relaxation techniques and informational resources. In conclusion, even though limited workplace mental health interventions for healthcare professionals were identified in Africa, individual-level interventions have been notably substantial in comparison to organizational and policy-level initiatives. Moving forward, a multi-faceted approach unique to the African context is essential.

In this study, network analysis was conducted using an exploratory approach on the variables of self-efficacy, academic resilience (AR), cognitive test anxiety and academic achievement (ACH), which are frequently examined in educational research. Data were collected from a total of 828 Turkish secondary school adolescents (51.9% female), using three different self-reported scales for self-efficacy, AR and cognitive test anxiety, as well as an ACH scale. The data were analyzed using regularized partial correlation network analysis (EBICglasso). The results show that academic self-efficacy (ASE) stands out among the variables of the study and that there is a positive relationship between ASE and all other variables except cognitive test anxiety. Besides, increasing students' ASE and AR levels plays a notable role in increasing their ACH levels. By providing new evidence on the relationships among these variables, this study offers insights that may inspire educational policy interventions.

Interpersonal Psychotherapy (IPT) is an evidence-based treatment for adolescent depression. However, since it does not work for all adolescents in all settings, more research on its heterogeneous effects is needed. Using a realist approach, we aimed to generate hypotheses about mechanisms and contextual contingencies in adolescent group IPT in Nepal. We analysed 26 transcripts from qualitative interviews with IPT participants aged 13-19, facilitators, supervisors and trainers. We analysed data using the Framework Method. The qualitative analytical framework was based on the VICTORE checklist, a realist tool to explore intervention complexity. Sharing, problem-solving, giving and receiving support, managing emotions and negotiating emerged as mechanisms through which adolescents improved their depression. Participants perceived that girls and older adolescents benefitted most from IPT. Girls had less family support than boys and therefore benefitted most from the group support. Older adolescents found it easier than younger ones to share problems and manage emotions. Adolescents exposed to violence and parental alcoholism struggled to overcome problems without family and school support. We formulated hypotheses on group IPT mechanisms and contextual interpersonal and school-level factors. Research is needed to test these hypotheses to better understand for whom IPT works and in what circumstances.