Global Mental Health最新文献

Afro-Colombian adolescents in Tumaco face high mental-health risks due to armed conflict and structural marginalization. We tested the short-term efficacy of the 3C program to strengthen resilience, compassion, and prosocial behavior and to reduce anxiety, depression, and PTSD. Mixed-methods cluster RCT with concurrent triangulation; multilevel mixed-effects models with multiple imputation; assessments at baseline, 6, and 9 months. Resilience increased by 13.14 points at 6 months (large effect, d = 0.89) and remained elevated at 9 months. Anxiety and PTSD screenings were lower in the intervention group across follow-ups. Compassion and prosocial behavior improved at 6 months but attenuated by 9 months. Depression screenings decreased at 6 months and rebounded at 9 months. Qualitative data aligned with these patterns (students reported sustained use of stress-management skills and peer support). 3C demonstrated short-term efficacy for resilience, anxiety, and PTSD but showed limited durability for compassion, prosociality, and depression without ongoing reinforcement. The pattern of effect attenuation-particularly the complete depression rebound-indicates that 3C provides a foundational component requiring integration with booster sessions to sustain socioemotional gains.

Mental illness-related stigma acts as a critical barrier to care by fostering shame, fear of judgment and discrimination, which deters individuals from seeking help, delays treatment and worsens outcomes. This study aimed to investigate the forms, drivers and consequences of mental health-related stigma on help-seeking behavior. A cross-sectional study was conducted from November 2020 to March 2021. Data were collected from 419 participants using structured questionnaires, guided by the Health Stigma and Discrimination Framework and the Attitudes Towards Seeking Professional Psychological Help Scale for validation. Data were analyzed using Statistical Package for the Social Sciences version 22, employing descriptive statistics, chi-square tests and multinomial logistic regression. The average age of participants was 34.5 years. Findings revealed alarmingly high stigma: economic (76.8-80.2%), social (77.1-81.2%) and psychological (71.9-82.8%). Key drivers included stereotypes of dangerousness (58.7%) and systemic healthcare discrimination (65.6%). Multinomial regression confirmed that all stigma forms significantly reduced help-seeking odds. Structural barriers (odds ratio [OR] = 0.48) and internalized shame (OR = 0.53) were the strongest deterrents, with a multiplicative effect for combined economic and psychological stigma (OR = 0.41). This complex, multilayered barrier, driven by socio-cultural beliefs and structural failures, necessitates urgent, multifaceted interventions targeting public education, policy and self-stigma to improve mental health equity in rural Ghana.

The pervasive integration of digital media into daily life is reshaping how individuals encounter and internalize harmful contents. Unrestricted access exposes students to emotionally disruptive materials, including depictions of violence, substance use, and harassment, raising concerns about its impact on well-being. This study examines a serial mediation model linking antisocial media exposure to subjective well-being (SWB) through school-based victimization as sequential pathways. Using data from 326 high school students in Nigeria, we applied partial least squares structural equation modeling to test hypothesized relationships. Results indicate that antisocial media exposure was not directly associated with SWB but significantly predicted experiences of teacher and peer victimization. Peer victimization mediated the relationship between antisocial media exposure and SWB (β = -0.023, 95% CI: [-0.054, -0.004], p < 0.05). Furthermore, antisocial media exposure increased the likelihood of teacher victimization, which facilitated peer victimization, ultimately compromising SWB (β = -0.030, 95% CI: [-0.058, -0.011], p < 0.05). Effects varied by gender and academic level, underscoring intersectional risks linked to media exposure. Findings highlight the need for targeted interventions addressing both teacher and peer victimization in resource-constrained educational contexts.

The Russia-Ukraine war generates fear, depression, loneliness, burnout and substance misuse among civilians. Our study examines mental health among Ukrainian university female students during 3 years of war. A total of 3,467 students were surveyed on three occasions: August to October 2022 (T1, n = 1,416), March to July 2023 (T2, n = 747) and September to November 2024 (T3, n = 1,304). The respondent's average age was 19.3 years, 25.3% identified as secular and 36.9% were married/partnered. The respondents included 81.2% who were not relocated, 10.7% who were internally displaced and 8.1% who were refugees. Valid and reliable survey instruments were used to gather data. One-way analysis of variance (ANOVA) shows a significant decrease in fear of war, depression and burnout in 2023 compared to 2022; however, there was a marked increase in 2024. Regardless of the survey period, one-way ANOVA shows a significant difference in fear of war and burnout scores associated with depression and loneliness levels. Stepwise regression analysis shows fear of war, depression and loneliness associated with burnout. This study provides usable information for mental health services planning and intervention purposes associated with young women affected by war in Ukraine. Additionally, it has relevance for training to address client and service personnel needs, for academic curriculum development and course instruction, and as a reference source for mental health personnel addressing student needs.

International migrant workers (IMWs) may face insecure work and housing, limited access to healthcare and increased risk of psychological problems. Two scalable, evidence-based interventions to support individuals experiencing psychological distress are Doing What Matters in Times of Stress (DWM) and Problem Management Plus (PM+). This study aimed to explore IMWs' problems, daily functioning and help-seeking behaviour, to inform cultural adaptation of the DWM/PM+ stepped-care intervention in the Netherlands. Following the Design, Implementation, Monitoring, and Evaluation (DIME) model, we conducted various qualitative interviews and a focus group discussion with IMWs (n = 30) and professionals (n = 18). Data were analysed thematically, and findings informed adaptations. Participants described problems related to work, housing, administration, finances, healthcare access and the COVID-19 pandemic. Daily routines focused on practical needs. Help-seeking was hindered by stigma, fear of job loss, low trust and reliance on informal or cross-border healthcare. Based on these results, the intervention was adapted to the needs of Polish IMWs in the Netherlands, regarding content and examples, which were tailored to their context; the intervention was offered remotely and collaboration with employers was avoided. These findings highlight the structural vulnerabilities of IMWs and demonstrate how qualitative insights can guide the cultural adaptation of a psychological intervention.

Suicide is a significant global mental health issue and a leading cause of death, with over half a million lives lost annually. The majority of suicide deaths occur in low- and middle-income countries (LMICs), yet there are limited data on suicidal behavior in these regions, particularly in Ethiopia. Given the rising trends of mental health issues worldwide and the alarming rate of suicide in LMICs, this research addresses a critical gap in knowledge regarding suicidal behavior in Eastern Ethiopia, which is essential to inform local public health strategies. Therefore, the study aimed to assess the prevalence and associated factors of suicidal ideation and attempts among adults in the Kersa, Haramaya and Harar Health and Demographic Surveillance System in Eastern Ethiopia in 2022. A community-based cross-sectional study was conducted among 1,411 participants selected using a multistage sampling technique. Binary logistic regression was employed to identify factors associated with suicidal ideation and attempts. The findings revealed that 9.8% and 6.2% of participants reported suicidal ideation and attempts, respectively. A history of mental illness [adjusted odds ratio (AOR) = 6.82, 95% confidence interval (CI): 4.63-10.05] and khat use (AOR = 2.34, 95% CI: 1.48-3.69) were factors significantly associated with suicidal ideation. Similarly, rural residence (AOR = 4.32, 95% CI: 2.17-7.58), a history of mental illness (AOR = 6.02, 95% CI: 3.78-9.60) and khat use (AOR = 2.23, 95% CI: 1.29-3.85) were strongly associated with suicide attempts (p < 0.05). The study highlights that nearly one in 10 individuals in the community experienced suicidal ideation or attempts, underscoring the urgent need for attention to these mental health concerns. In conclusion, suicidal ideation and attempts are prevalent in Eastern Ethiopia and are significantly associated with mental illness, khat use and rural residence. Early screening, detection and management of suicidal behavior at the community level are recommended to address this pressing public health issue.

Due to an increased awareness of the prevalence and impact of trauma, "trauma-informed care" (TIC) was developed as an organisational framework aiming to centre the needs of survivors of trauma. TIC proposes that organisations can reduce trauma exposure by embedding specific principles (e.g., safety and trust) at every level of an organisation, improving the organisation for both service users and providers. Recent reviews of TIC implementation efforts have demonstrated its use in diverse settings; however, studies are overwhelmingly situated in high-income, predominantly English-speaking countries. Rather than reflecting a lack of TIC efforts in low- and middle-income countries (LMICs), these findings may be a result of the newness of the term TIC. To create a more inclusive evidence map, the current review captures efforts conducted in LMICs that may or may not use the label of TIC but align with the organisational approaches and key principles of TIC. A search of four databases and review of relevant references yielded 3,091 results, of which 255 met the inclusion criteria. Implementation efforts took place across 39 LMICs. The vast majority included involvement of another country, most commonly the United States. Approximately 90% of efforts were implemented within medical settings, and 69% focused on the TIC principle of cultural, historical and gender issues. The results of the current review have both theoretical and applied implications for TIC research. They query how and by whom TIC is conceptualised and defined, and how TIC aligns with other global research approaches. Results also highlight the need for organisational TIC interventions to conduct comprehensive baseline assessments of current efforts before implementing new efforts to avoid unintentional duplication. As the adoption of TIC frameworks becomes more widespread, it is imperative to increase research efforts aimed at developing a more thorough and inclusive definition of TIC.

The ENHANCE non-inferiority trial that took place in a deprived setting in Pakistan demonstrated that a technology-assisted digital adaptation of the Technology Assisted Thinking Healthy Programme (THP-TAP) was no different than the face-to-face THP in improving symptoms of perinatal depression. The present study examines the mechanisms through which THP-TAP improved symptoms of perinatal depression (or not) compared to the face-to-face THP. We applied a counterfactual-based approach to mediation - particularly interventional effects - to decompose the total effect of the THP-TAP intervention on symptoms of perinatal depression into the following pre-specified indirect effects: number of sessions attended; behavioural activation; perceived social support; problem-solving and cognitive-restructuring skills; and peer empathy. Mediators were assessed at 3 months post-partum, and depressive symptoms were measured at 6 months using the Patient Health Questionnaire-9 (PHQ-9). Perceived social support in THP-TAP arm mediated an improvement in symptoms of perinatal depression compared to the standard face-to-face THP group (adjusted mean difference in PHQ-9 scores attributable to perceived social support in the technology-assisted digital adaptation of the THP group compared to the World Health Organisation THP group: -0.072, bias-corrected 95% confidence interval: -0.170, -0.018). There was no difference to support the indirect effects for all other mediators. Even in the absence of treatment superiority, our findings suggest that levels of perceived social support were an important feature of the THP-TAP intervention, which resulted in improved symptoms of perinatal depression. From a practical perspective, these findings highlight the importance of social connectedness as a mechanism of change, demonstrating that peer-delivered digital psychosocial interventions can successfully cultivate this relational component.

This study examined the psychological impact of the Jet Set nightclub collapse in Santo Domingo, Dominican Republic, on April 8, 2025. Through a comprehensive approach, the research aimed to assess emotional symptoms in the immediate aftermath of the disaster. A prospective cross-sectional design was applied with a purposive sample of 1,034 adults who completed an online survey between April 9 and 15. Standardized instruments were used to evaluate post-traumatic stress disorder (PTSD), depression, anxiety, perceived social support and emotion regulation strategies. The study had three main objectives: (a) to estimate the prevalence of clinically significant emotional symptoms; (b) to analyze symptom variation according to trauma exposure level (direct, intermediate or vicarious); and (c) to explore sociodemographic and psychological predictors through multiple regression models. Results showed prevalence rates of 14.1% for PTSD, 27.9% for depression and 21.7% for anxiety. Higher symptom severity was observed among participants with direct exposure. Emotion suppression was consistently associated with greater psychological distress, while perceived social support was a protective factor against depression and anxiety. Female gender and younger age also emerged as significant predictors. These findings highlight the importance of considering both individual and contextual factors in post-disaster mental health responses and provide regionally relevant evidence to inform culturally sensitive interventions.

Suicide remains one of the leading causes of death globally, with growing evidence that humanitarian emergencies and fragile states, most of which unfold in low- to middle-income countries (LMICs), are associated with elevated risk of suicide. However, the few suicide-targeted interventions for use in humanitarian contexts remain both sparse and fragmented. This scoping review aims to identify and synthesise evidence from suicide and self-harm prevention interventions implemented in all types of humanitarian settings, globally, that have been evaluated for their effectiveness in improving suicide and self-harm-related outcomes. We systematically searched eight electronic databases, including two grey literature databases, and relevant organisational websites for records published through November 2024 and in any language. Screening was done using the Covidence platform, with each record independently screened by two reviewers. Among other preselected inclusion criteria, studies must have conducted a quantitative evaluation of the effectiveness of an intervention on improving suicide and self-harm-related outcomes during a humanitarian crisis to be included for data extraction. Data extraction and quality assessment were both conducted by two authors. In all, 6,209 records were screened at the title and abstract phase; 104 were included for full text screening; and 23 studies were included for data extraction. Most studies were conducted during the coronavirus disease 2019 pandemic (COVID-19), and in high-income countries. Evaluated interventions encompassed various approaches, including psychotherapeutic, practical, and pharmacological assistance, often employing multiple components. The majority targeted the general population, were delivered via remote modalities and relied on mental health specialists for their administration. Overall, 15 (65.2%) interventions were associated with statistically significant positive effects on suicide and or self-harm-related outcomes. Promising approaches include cognitive behavioural therapy-based text services, skills-building programmes, and strategies that foster supportive environments for high-risk individuals. These findings highlight both promising approaches and critical gaps in suicide prevention efforts in humanitarian settings. The limited evidence base - particularly in LMICs and with particularly at-risk populations - alongside the increasing frequency of humanitarian crises, underscores the urgent need for future implementation and associated research of suicide and self-harm prevention initiatives within humanitarian contexts.