Global Mental Health最新文献

Despite significant advancements in the development of psychotropic medications, increasing adherence rates remain a challenge in the treatment and management of psychiatric disorders. The purpose of this study is to qualitatively explore the challenges underlying medication adherence and strategies to improve it among adolescents with psychiatric disorders in Malaysia. This qualitative research design presents results from 17 semi-structured interviews with adolescent psychiatric patients, aged 11 to 19 years old, from public hospitals across Peninsular Malaysia. The data collected from interviews were transcribed and processed through thematic analysis using the NVivo 11 software. A total of three main themes concerning medication adherence were identified: (1) challenges; (2) coping strategies and (3) protective factors. In this study, thirteen subthemes emerge as challenges underlying medication adherence experienced by adolescent psychiatric patients. The coping strategies identified in this study fall under three broad subthemes which are problem-focused strategies, emotion-focused strategies and maladaptive strategies. This study also highlights social support and positive medicinal effects as protective factors for non-adherence issues in adolescent psychiatric patients. In conclusion, this study supports the notion that adherence is a multi-factorial phenomenon. This study can inform future development of interventions and targeted health promotion programmes in enhancing adherence.

Background: Psychodrama (PD), supported by extensive global research, is increasingly becoming a vital method for alleviating psychological symptoms and promoting mental well-being in diverse populations across China. However, comprehensive evidence based on rigorous interventions is currently lacking.

Methods: This article systematically reviews the literature on randomized controlled experimental intervention studies of PD in the Chinese Mainland from 1982 to 2023.

Findings: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework, this article included seven studies (N = 332, 25 effect sizes). The results demonstrate that PD interventions have a promotional effect (standardized mean difference SMD = 0.768, 95% CI [0.591, 0.946]) across different age groups and settings in randomized controlled trial interventions. In accordance with previous literature, we categorized the effect sizes into two major groups: illness reduction (IR) and health promotion (HP). Subgroup analysis based on these two categories revealed consistent findings. In the IR category, the overall effect size was notably significant (SMD = -0.711, 95% CI [-0.976, -0.446]), and in the HP category, the overall effect was also highly significant (SMD = 0.889, 95% CI [0.705, 1.074]). This finding aligns with previous research in other nations, supporting the significant effectiveness of PD as a counseling method in alleviating psychological illnesses and promoting mental health within the Chinese context.

Conclusion: PD serves not only as a therapeutic tool but also as a preventive and developmental intervention. Moving forward, there is a call for increased emphasis on standardized and randomized controlled experimental studies to further the advancement of PD within China.

Background: In Colombia, over 9 million people have been impacted by armed conflict, creating a significant need for mental health services. This study aimed to culturally adapt and pilot test the Youth Readiness Intervention (YRI), an evidence-based transdiagnostic mental health intervention, for conflict-affected Colombian youth aged 18-28 years.

Methods: The eight phases of the Assessment, Decision, Administration, Production, Topical Experts, Integration, Training, and Testing (ADAPT-ITT) framework were used to culturally adapt the YRI for conflict-affected Colombian youth. The Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies (FRAME-IS) was used to track the adaptations made. Qualitative and quantitative data were gathered and analyzed throughout the adaptation process.

Results: Data from the Assessment phase demonstrated a high need for mental health interventions among conflict-affected youth. The Testing phase revealed significant improvements in emotion regulation and functional impairment, suggesting the YRI is a promising intervention among conflict-affected Colombian youth. Qualitative data confirmed the intervention's acceptability among youth and mental health providers.

Conclusions: The YRI was successfully adapted for conflict-affected Colombian youth. Future studies using randomized designs are needed to test the effectiveness of the YRI for improving mental health among larger samples of Colombian conflict-affected youth.

Earthquakes and other disasters caused by natural hazards have a significant impact on the mental health and well-being of children and adolescents. This study aimed to investigate the psychological symptoms, suicide probability, and future expectations among adolescents affected by the Kahramanmaraş-centered earthquake in Türkiye. A total of 704 individuals participated in the study. We conducted a cross-sectional study using the Brief Symptom Inventory, Suicide Probability Scale and Future Expectation Scale. The mean age of participants was 15.27 ± 1.39. Participants lost up to 10 of their relatives and up to 4 of their nuclear families due to the earthquake. The study showed a strong positive correlation between psychological symptoms and suicide probability and a strong negative correlation between psychological symptoms and future expectations among adolescents. Additionally, losing family members or relatives was associated with increased psychological problems. Earthquake-related issues such as lack of food, shelter and security, and education disruption should be addressed to mitigate the mental health impact of the disaster. Additionally, mental health and psychosocial support services should be made available for adolescents and their families in the earthquake-affected regions.

[This corrects the article DOI: 10.1017/gmh.2023.89.].

Background: There is a strong link between trauma exposure and serious mental health conditions (SMHCs), such as schizophrenia and bipolar disorder. The majority of research in the field has focused on childhood trauma as a risk factor for developing an SMHC and on samples from high-income countries. There is less research on having an SMHC as a risk factor for exposure to traumatic events, and particularly on populations in low- and middle-income countries (LMICs).This scoping review aimed to synthesize the nature and extent of research on traumatic events that adults with SMHCs face in LMICs. It was conducted across five databases: PubMed, Embase, PsycINFO, Web of Science Core Collection and Africa-Wide Information/NiPad in December 2023 and by hand searching citation lists.

Findings: The database search returned 4,111 articles. After removing duplicates and following a rigorous screening process, 51 articles met criteria for inclusion. There was one case study, one mixed methods study, 12 qualitative studies and 37 quantitative studies. Ten countries were represented, with the most studies from India (n = 19), Ethiopia (n = 9) and China (n = 6). Schizophrenia was the most studied type of SMHC. Of the trauma exposures, more than 76% were on interpersonal violence, such as sexual and physical violence. Of the studies on interpersonal violence, more than 23% were on physical restraint (e.g., shackling) in the community or in hospital settings. There were no studies on man-made or natural disasters.

Implications: Much of our data in this population are informed by a small subset of countries and by certain types of interpersonal violence. Future research should aim to expand to additional countries in LMICs. Additional qualitative research would likely identify and contextualize other trauma types among adults with SMHCs in LMICs.

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.

Youth in sub-Saharan Africa (SSA) face limited access to professional mental health resources. A comprehensive assessment of the prevalence of mental disorders would build an understanding of the scope of the need. We conducted systematic searches in PsycInfo, Pubmed, AfriBib and Africa Journals Online to identify prevalence rates for five disorders (anxiety, depression, conduct disorder, attention problems and post-traumatic stress) among SSA youth with a mean age of less than 19 years. We calculated a random-effects pooled prevalence for each disorder and assessed possible moderators. The meta-analysis included 63 studies with 55,071 participants. We found the following pooled prevalence rates: 12.53% post-traumatic stress disorder (PTSD), 15.27% depression, 6.55% attention-deficit hyperactivity disorder, 11.78% anxiety and 9.76% conduct disorder. We found high heterogeneity across the studies, which may have resulted from differences in samples or measurement tools. Reported prevalence rates were not explained by the sample (i.e., special or general population), but whether the psychometric tool was validated for SSA youth affected the reported prevalence of PTSD and anxiety. In a meta-regression, prevalence rates were associated with the disorder type, with a higher prevalence of depression and PTSD. We found the mean age significantly moderated the prevalence in univariate meta-regression, with increased age correlated with greater prevalence. Our findings suggest there is a need to explore reasons for varying prevalence rates further and to develop interventions that support youth mental health in SSA, particularly interventions for depression and PTSD. Limitations included a lack of standardization in psychometric tools and limited reporting on research methods, which influenced quality rating. Importantly, the search only considered studies published in English and was conducted 2 years ago. Although recent estimates reported slightly higher than our prevalence estimates, these reviews together highlight the prevalence and importance of youth mental health difficulties in SSA.

Studies indicate a high burden of mental health disorders among female sex workers (FSWs) in low- and middle-income countries (LMICs). Despite available data on suicidal ideation and suicide attempts among FSWs, little is known about suicide deaths in this hard-to-reach population. This study aims to examine the extent to which suicide is a cause of maternal mortality among FSWs, the contexts in which suicides occur, and the methods used. From January to October 2019, the Community Knowledge Approach method for identifying cause-specific deaths in communities was employed across eight LMICs (Angola, Brazil, the Democratic Republic of the Congo (DRC), India, Indonesia, Kenya, Nigeria, and South Africa). A total of one thousand two hundred eighty FSWs provided detailed reports on two thousand one hundred twelve FSW deaths in the preceding 5 years, including 288 (13.6%) suicides, 178 (61.8%) of which were maternal. Of these maternal suicides, 57.9% occurred during pregnancy (antepartum), 20.2% within two months of delivery (puerperium), and 21.9% in the 2-12 months following delivery (postpartum). The highest proportion of suicides occurred in Nigeria, Kenya, and DRC in sub-Saharan Africa. A total of 504 children lost their mothers to suicide. Further research is needed to identify interventions for suicide risk among FSW mothers.