Global Mental Health最新文献

Urban refugees in low- and middle-income countries (LMICs) often face housing insecurity, undermining their ability to achieve self-reliance and well-being. Few studies have evaluated the impact of housing interventions in these contexts. This study offers preliminary evidence on the effectiveness of a 9-month rental assistance program targeting female-headed Venezuelan migrant households in Colombia. Using pre-post data from 517 participants, we assessed changes over time in household-level self-reliance, domains of self-reliance, subjective well-being and perceived agency. We also employed ordinary least squares regression and fixed-effects models to estimate changes in self-reliance and the relationship between self-reliance, psychosocial and housing outcomes. Our analysis found significant improvements in overall self-reliance, well-being and agency after controlling for observed individual and household characteristics. Increases were observed across almost all domains of self-reliance. Fixed-effects models also found that subjective well-being, perceived agency and select housing conditions were positively associated with self-reliance. Rental support appears to promote both material and psychosocial recovery for displaced households by alleviating financial stress and enabling forward-looking behaviors. However, the impact of housing quality dimensions varies, and the sustainability of outcomes remains uncertain. Future evaluations should incorporate longitudinal designs and control groups to inform holistic refugee housing strategies.

Most individuals with mental disorders reside in low- and middle-income countries (LMICs), where care is often provided by family members. However, Family Interventions for psychosis (FIp) are rarely adapted for LMIC contexts. Using a validated cultural adaptation framework, we adapted Psychosis Recovery by Enabling Adult Carers at Home (Psychosis REACH) - an intervention designed for delivery outside of clinical settings - and evaluated the adapted version (Ca-REACH) among families affiliated with a mental health rehabilitation clubhouse in Lahore, Pakistan. A Fountain House clinician delivered Ca-REACH to 40 caregivers of individuals with psychosis through eight in-person group sessions. Feasibility was demonstrated across multiple process indicators: all 40 caregiver-resident dyads consented (100% recruitment), caregiver retention was high, session attendance averaged 96.5% and assessments were completed at baseline, post-intervention and 4-month follow-up. Data completeness among residents was 85%. Perceived feasibility, acceptability and appropriateness (FIM, AIM, IAM) all exceeded the benchmark score of 4.0 (M = 4.42-4.79). Caregivers demonstrated significant improvements in anxiety and psychological well-being, with marginal reductions in depression. Residents showed significant improvements in PANSS general and total symptom scores. Findings support the acceptability and promise of Ca-REACH as a feasible, culturally responsive, community-delivered FIp in a low-resource setting.

Alcohol and Substance Use (ASU) and mental ill-health among youths is today a global public health concern especially among the urban poor. This pilot study examined the prevalence, patterns and mental health associations of ASU among youths in urban slums. Baseline cross-section data were collected from 94 participants aged 15-24 in two informal settlements in Nairobi. Descriptive statistics analyzed demographic, substance use and mental health variables. Bivariate analyses of associations between ASU scores, sociodemographic factors and mental health symptoms were done. Seventy-eight per cent of participants reported having used alcohol in the preceding 3 months, while 68% and 35% respectively reported cannabis and tobacco use. Concerning frequency of use, 43% used alcohol while 47% used cannabis frequently. Alcohol use was associated with age, depressive symptoms and socio-economic independence. Tobacco use was more common among participants with depression, anxiety and low education levels. Cannabis use was higher in participants living independently, with depression, anxiety and stress and in men. In conclusion the study found prevalent ASU associated with multiple sociodemographic and psychological vulnerabilities. These findings may reflect sample characteristics not generalizable to the population, but they provide preliminary evidence for the need of future studies of integrated preventive interventions.

There is limited post-pandemic youth mental health data in low- and middle-income countries. This study describes the prevalence of suicidal ideation, suicidal attempt, and self-harm since the COVID-19 pandemic among young Filipino adolescents. Adolescents aged 13-16 years old from public and private high schools in Cavite, Philippines were recruited for a cross-sectional school survey conducted from May 2023 to February 2024. Suicidal behaviours and self-harm since the pandemic were determined using a self-administered questionnaire alongside sociodemographics and internalising and externalising symptoms. Of the 1,229 13-16-year-olds who completed the survey, 54.0% experienced suicidal ideation, 24.2% attempted suicide, and 34.2 % reported self-harm between 30 January 2020 and the date when they completed the survey. The prevalence of suicide attempts was higher among females (29.6%) than males (13.1%). Parental absence was associated with suicidal attempts (ARRR=2.93) and self-harm and/or suicidal ideation (ARRR=2.00) while living with either the biological mother or father was moderated by gender. Internalising and externalising symptom scores increased the risk for both outcomes by ≥15%. This study revealed a high prevalence of suicidal and self-harming behaviours among young adolescents in the Philippines. This calls for action to implement population-based strategies in suicide prevention, early screening, and cross-sectoral intervention.

Background: Conflict-affected Palestinian communities experience profound mental health challenges. This systematic review assesses the evidence for mental health interventions in these contexts, focusing on the theoretical alignment of narrative therapy with cultural assets like sumud (steadfastness) and hikaye (storytelling).

Methods: Following PRISMA guidelines, we searched nine databases and grey literature up to December 2023. We included studies on mental health interventions for conflictaffected Palestinians, with a primary focus on narrative therapy and a secondary analysis of other approaches.

Results: Of 847 records screened for narrative therapy, no studies met the inclusion criteria. A broader search identified 23 intervention studies, revealing a predominant focus on cognitive-behavioral therapy (CBT; n = 11) and Narrative Exposure Therapy (n = 4), with limited therapeutic diversity. Analysis showed insufficient Palestinian researcher leadership and superficial cultural adaptation of interventions.

Conclusions: This review reveals a dual gap: a complete absence of narrative therapy research despite its theoretical relevance, and a broader pattern of limited intervention diversity. The predominance of Western-centric models reflects systemic biases in research funding. Addressing this requires community-led participatory research, shifts in funding priorities, and investment in culturally-grounded methodologies.

This article assesses a 10-month co-created universal school-based mental health (SBMH) promotion initiative for adolescents (10-19). The study combined quantitative and qualitative components. Pre- and post-intervention surveys were conducted in four schools in Tanzania (n = 400 baseline, 488 endline, with 100 intervention participants at both) and eight schools in Vietnam (n = 1,036 baseline, 893 endline and 436 in panel). In each country, ~90 qualitative interactions (interviews and focus groups) were held at baseline and endline with adolescents, parents, teachers and service providers (total = ~180). In Tanzania, multivariate analysis indicated significant gains among intervention participants relative to peers. Emotional literacy rose 9.5% (p = 0.007; d = 0.57). Attitudes toward help-seeking (p = 0.021; d = 0.50) and prosocial behaviors (p = 0.043, d = 0.38) also improved Active coping increased 15.6% (p = 0.006; d = 0.55). In Vietnam, emotional literacy increased 5.3% (p = 0.012, η ² = .019), and positively, emotion-focused coping declined 14.4% (p = 0.032, η ² = .015). Qualitative evidence reinforces these findings, and suggested spillover effects for nonparticipants. Overall results indicate that co-created universal SBMH initiatives can improve adolescent well-being and offer viable alternatives to limited adolescent-focused mental health services in LMICs.

This study aimed to determine the prevalence and associated factors of depressive symptoms among adolescents in Can Tho City, Vietnam. A cross-sectional study was conducted with 1,054 students aged 15-18 years, recruited from eight high schools using one-off anonymous questionnaires. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale Revised - Vietnamese version. The Self-esteem Scale of Vietnamese Adolescents, the Crandell Cognitions Inventory-Short form scale, the School Connectedness Scale and the Educational Stress Scale for Adolescents were used to assess self-esteem, cognitive distortion, school connectedness and educational stress, respectively. Univariate analyses explored the relationships between sociodemographic variables and depressive symptoms. Pearson correlations were calculated for the associations between variables. Multiple regression was used to adjust for the factors that contributed to depressive symptoms in adolescents. The findings revealed that 37.4% of adolescents in Can Tho City, Vietnam, experienced depressive symptoms. Factors influencing depression in adolescents include cognitive distortions, academic pressure, exposure to interpersonal violence, consumption of alcohol and smoking, family history of depression, family incarceration and experiences of digital sexual violence. These results underscore the urgent need for a multilevel and multidimensional intervention strategy involving parents, educators, mental health professionals and policymakers to promote early identification, provide support and enhance mental health literacy among adolescents.

The global mental health (GMH) field aims to equitably improve mental health and well-being everywhere. This article reviews persistent common challenges hindering sustained, high-quality delivery of mental health and psychosocial support (MHPSS). Our focus is on programming that is funded or implemented by external organizations, typically universities or international non-governmental organizations from high-income countries. It is a consensus statement of MHPSS practitioners, programmers and researchers working for these organizations and some who are locally based who observe these programs in action. We comment on progress to date, barriers and recommendations for change and the importance of promoting sustained integration of MHPSS into health and social service systems through a comprehensive, recovery-oriented system of care. We call for prioritizing often-neglected issues (e.g., stigma, severe mental health conditions and neurodevelopmental conditions), strengthening workforce training and supervision and monitoring and evaluation systems to ensure program quality. The continued dominance of the Global North in shaping GMH programming priorities remains a concern. We advocate for a greater involvement of local workers and communities in agenda-setting for programs, culturally grounded implementation and long-term capacity building. Evidence-based practices must be met with contextual relevance, and comprehensive guidelines for sustained support are needed for development settings. For persistent funding challenges, we recommend clearer funder objectives, investment in in-house mental health expertise and funder coordination with prioritization of complementary programming. These recommendations are essential to realizing equitable, comprehensive, evidence-based and contextually grounded GMH programming.

Youth who are lesbian, gay, bisexual, transgender, queer or questioning, and other diverse sexual and gender identities (LGBTQ+) experience disproportionately high rates of suicidal thoughts and behaviors compared to heterosexual and cisgender peers, yet many face barriers to care. Data came from a national online survey of 18,663 LGBTQ+ youth aged 13-24 years in the United States (September-December 2023). Analyses focused on participants who reported wanting mental health care in the past year and assessed access, barriers, service modalities and suicidal ideation/attempts. Half of LGBTQ+ youth who wanted mental health care did not receive it. The most common barrier was fear of talking about mental health concerns (42%). Among those who received care, one-on-one therapy was most common (69% in-person and 53% online). Suicidal ideation was lower among youth in therapy (46% in-person and 40% online) compared to those using crisis lines (75%). After adjusting for demographics, hotline use remained strongly associated with elevated risk: adjusted odds ratio (aOR) = 3.77 (95% confidence interval [CI]: 3.11-4.56) for suicidal ideation; aOR = 3.21 (95% CI: 2.62-3.94) for attempts. Despite strong willingness to seek care, structural and identity-related barriers leave many needs unmet. Expanding culturally competent services is essential to reducing suicide risk.

Psychological distress can occur even without a depression diagnosis. Many older adults have functional limitations that hinder daily activities, yet their emotional needs often go unrecognized. This study examined whether functional impairment is associated with psychological distress in older adults and whether this relationship varies by depression-diagnosis status. Data came from the 2023 Behavioral Risk Factor Surveillance System for U.S. adults aged 65 and older (N = 95,325). Functional impairment was defined as having 14 or more days in the past month when poor health limited usual activities. Psychological distress was measured by days of poor mental health and a binary indicator of high distress. Survey-weighted regression analyses tested main and interaction effects of functional impairment and depression diagnosis while adjusting for sociodemographic and behavioral factors. Functional impairment was linked to greater distress. Predicted estimates showed the highest distress among those with both impairment and a depression diagnosis (about 11 poor mental health days). Those with impairment only averaged about 6 days, those with a diagnosis only about 8, and those with neither condition about 3. Functional impairment may reveal hidden distress in older adults without diagnosed depression. Adding physical-function indicators to screening could help identify vulnerable individuals earlier.