Global Mental Health最新文献

The Syrian government's violent suppression of pro-democracy protests in March 2011 sparked a civil war that resulted in the deaths of hundreds of thousands of people and the displacement of millions. This study focuses on the emotional achievement of 357 Syrian primary and secondary school students who have moved to Türkiye and are under temporary protection. The researchers used the achievement emotion scale to collect data. They conducted a t-test, analysis of variance, correlation analysis and multiple linear regression to examine the sociodemographic factors affecting students' achievement emotions. The results revealed that boy students experienced more negative achievement emotions than girl students, and that the longer the students have been in temporary protection, the more their positive achievement emotions have decreased. The ongoing war in Syria has dire consequences for school-age children who have been forced to flee their homes.

Improving social and emotional well-being (SEWB) for Aboriginal and Torres Strait Islander peoples is central to achieving health equity in Australia. Aboriginal Community Controlled Health Services (ACCHS) deliver SEWB programmes that are culturally grounded and community-led. While service design and delivery have been explored, less is known about how Aboriginal peoples' perceptions of self-efficacy influence their SEWB help-seeking behaviours and self-management. This study re-analysed 22 one-on-one interviews with Aboriginal community members from the Kimberley region of Western Australia. In this context, self-efficacy is understood as an individual's belief in their ability to support their own SEWB, shaping their motivation, persistence and responses to challenges. The findings highlight the importance of family, culture and connection to Country as critical enablers of self-efficacy. The concept of 'strength', grounded in cultural identity, relationships, and personal growth, emerged as an important foundation for SEWB self-management. The study affirms that self-efficacy can be developed over time through mastery experiences, vicarious learning, verbal encouragement, and emotional regulation. It concludes that culturally safe services and environments that nurture self-efficacy are essential to improving SEWB outcomes.

For nearly three decades, the Democratic Republic of the Congo has endured armed conflict that has devastated its population, leaving a staggering number of survivors of sexual violence. This article draws on over a decade of clinical, academic and field experience to explore the psychosocial and public health challenges of caring for these survivors. Despite the high prevalence of post-traumatic disorders - often severe and complex - the mental health system remains gravely under-resourced. The article examines gaps in mental health services, highlights the clinical intricacies of trauma resulting from rape (including complex PTSD and dissociation) and critiques the uncritical export of Western therapeutic models to African contexts. Emphasizing the need for culturally grounded, integrative care, the author advocates for community-based, trauma-informed, inclusive and context-sensitive approaches that bridge clinical science and local healing traditions. This holistic vision is essential for restoring dignity and mental health to survivors and for building a resilient public health infrastructure in the DRC.

Despite reductions in cardiovascular, cancer, and infectious disease, comparable public-health improvements in mental health have not materialized. Global dissemination of trainings and programs have not translated into reduced burden of mental health conditions. Detection in primary care remains uncommon, sustained delivery of psychological services is difficult, few governments prioritize mental health, and reliable data are scarce. A largely unexamined factor is how we talk about suicide. How suicide is discussed shapes whether primary care workers feel able to engage, what organizations incorporate psychosocial programs, and whether mental-health data are accurate and representative. Drawing on three decades of work, this Perspectives piece argues that protocol-heavy, medico-legal framing, such as rigid confidentiality scripts, liability fears, and technical checklists, pulls attention away from the feelings involved in sitting with a person who expresses suicidal thoughts. Logistical, legal, and clinical pushback reflects fear and powerlessness in the face of suicidality. I advocate for making deliberate space for emotional processing by inviting helpers to notice their own reactions, collaborating with people with lived experience of suicidality, and learning from those bereaved by suicide. An empathy-guided approach to suicide can strengthen trainings, program adoption, data quality, and, most importantly, ensure people in distress are not left alone.

Geographic information systems (GIS) are computer-based spatial mapping tools widely used in public health to examine service availability and access disparities and healthcare utilization. While GIS has supported evidence-based health planning in various domains, its application in mental healthcare service delivery remains underexplored. Our scoping review aimed to address this gap by exploring the scope and type of GIS usage in studying three dimensions of mental health (MH) service delivery (availability, accessibility and utilization), across all geographical locations, settings and populations. We conducted a scoping review following the Joanna Briggs Institute methodology. We included peer-reviewed English-language studies using GIS to examine service delivery (availability, accessibility or utilization) for any MH condition diagnosed through standardized criteria or validated tools. Seven databases were searched (Medical Literature Analysis and Retrieval System Online [MEDLINE], PsycINFO, Excerpta Medica Database [Embase], Global Health, Cumulative Index to Nursing and Allied Health Literature [CINAHL], Cochrane Central Register of Controlled Trials [CENTRAL] and Web of Science) between January and April 2024. This review included 58 studies predominantly from high-income countries. A wide range of GIS methods were employed across studies, including hotspot analysis, network analysis and spatial analysis. Six studies explored availability, generally through measures like distribution of facilities across a population, and resource availability within 5-10-mile network buffers. Forty-six studies explored the spatial accessibility of MH services and substance-use treatment facilities using GIS. Six studies examined service utilization patterns. Equity emerged as a recurring theme across all three dimensions. GIS has the potential to emerge as a powerful tool in MH research, particularly in mapping disparities, informing service delivery and identifying high-risk zones. Expanding GIS use in trial design, implementation science and policy advocacy could help bridge critical gaps in MH service delivery, ensuring more equitable and data-driven decision-making.

Although virtual reality (VR) programs are being developed by marginalized groups', a systemic power imbalance still exists. Marginalized groups have a place in digital wellbeing and can lead initiatives to access resources that they desire. To better support these efforts and mobilize knowledge among marginalized stakeholders, we conducted a scoping review of the use of VR for wellbeing. Adopting an equity lens that considers the experiences of intersectional marginalization, our aim was to identify VR programs, their targets, outcomes and equity-related facilitators and barriers. In May 2023, we conducted a comprehensive literature search of MEDLINE, PsycINFO, Embase and Web of Science databases and grey literature for virtual reality and marginalized populations. Eligible research articles since the inception of the databases were those that met our predefined criteria of VR, marginalized populations and wellbeing. We included 38 studies and charted preregistered variables using narrative synthesis, descriptive statistics, and a logic model. The populations were often intersectionally marginalized--primarily individuals with disabilities, underrepresented sexualities and genders, and marginalized older individuals in high-income countries on Turtle Island (North America). The most common race categories were Black or African American (26%) and European or White (53%), but other sociodemographic characteristics were underreported. VR offered diverse support, including social, mental, physical and cultural. We report program outcomes for several subgroups; though heterogeneous, most studies reported improved wellbeing outcomes. VR's flexibility created informal, flexible spaces, with peer support that contributed to mental and social wellbeing. Several factors could hinder marginalized groups' ability to access and participate, such as the lack of free programs, data and program ownership, and intersectional data analyses. This topic reflects a growing literature, with half of the publications being in 2022 or 2023. Many of these studies have limitations like small sample sizes and a lack of mixed-methods or practical significance analyses. Moving forward, researchers should apply more open-access and inclusive practices in their designs and recruitment processes to widen equitable access to marginalized stakeholders. Nevertheless, many marginalized populations created VR programs and benefited from them, contributing to a rebalancing of power over wellbeing.

Sensory Over-Responsivity Disorder (SORD) is characterized by extreme sensitivity to everyday sensory input, which can interfere with children's emotional, behavioral and social development. Despite growing interest, limited research has explored its developmental effects in the absence of other psychiatric diagnoses. This study investigated self-regulation and related clinical features in preschool children with SORD who did not meet diagnostic criteria for autism spectrum disorder, attention-deficit/hyperactivity disorder (ADHD), or obsessive-compulsive disorder. The sample included 15 children with SORD and 15 typically developing controls, matched by age and gender. Diagnoses were made using the Preschool Age Psychiatric Assessment, and comorbidities were excluded using Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood: Revised Edition criteria. Self-regulation was assessed through the Head-Toes-Knees-Shoulders-Revised task. While no significant differences were found in autistic traits, repetitive behaviors or executive functioning, children with SORD demonstrated significantly poorer self-regulation (p < .001). Poorer self-regulation was strongly associated with greater SORD severity, elevated ADHD symptoms, lower social interaction and increased emotional and sensory reactivity. These findings suggest that self-regulation difficulties are a core feature of SORD, even in the absence of comorbid psychiatric disorders. Early identification and interventions targeting self-regulation may help improve long-term outcomes for children affected by SORD.

A burgeoning body of evidence suggests a higher prevalence of nonsuicidal self-injury (NSSI) behaviors among adolescents. This study aimed to examine the comorbid internalizing symptoms and suicidal behaviors, along with associations between dissociative experiences and suicide risk in adolescents attending a psychiatric outpatient unit in Ankara, Türkiye. The study included 81 adolescents aged 12-18 years, who engaged in NSSI and sought treatment at a psychiatric outpatient clinic. Psychiatric evaluations were conducted through semi-structured clinical interviews. NSSI behaviors were assessed using the Inventory of Statements About Self-Injury, and suicide risk was measured using the Suicide Probability Scale. Additionally, internalizing symptoms and dissociative experiences were evaluated using the Revised Children's Anxiety and Depression Scale-Child Version and the Adolescent Dissociative Experiences Scale, respectively. Moderate to high correlations were found among suicide risk, dissociation, NSSI severity, anxiety and internalizing scores. Mediation analysis revealed that NSSI significantly mediated the relationship between dissociation and suicide risk. These findings indicate that assessing both dissociation and NSSI could provide valuable insights into comprehending and addressing adolescent suicide, thereby facilitating the development of targeted interventions to mitigate the effects of dissociative experiences.

Background. Despite the growing recognition of adolescent suicide as a pressing concern, traditional methods for identifying suicide risk often fail to capture the complex interplay of socio-ecological and psychological factors. The advent of machine learning (ML) offers a transformative opportunity to improve suicide risk prediction and intervention strategies. Objective. This study aims to utilize ML techniques to analyze socio-ecological and psychological risk factors to predict suicide ideation, plans and attempts among a nationally representative sample of Ghanaian adolescents. Methods. A cross-sectional survey was conducted with 1,703 adolescents aged 12-18 years across Ghana measuring psychological factors (depression symptoms, anxiety symptoms etc) and socio-ecological factors (bullying, parental support etc) using validated measures. Descriptive statistics were conducted and random forest and logistic regression models were employed for suicide risk prediction, i.e., 'ideation, plans and attempts'. Model performance was evaluated using accuracy, sensitivity, specificity and feature importance analysis. Results. Psychological factors such as depression symptoms (r = .42, p < .01), anxiety (r = .38, p < .01) and perceived stress (r = .35, p < .01) were the strongest predictors of suicide ideation, plans and attempts, while parental support emerged as a significant protective factor (r = -.34, p < .01). The random forest model demonstrated good predictive performance (accuracy = 78.3%, AUC = 0.81). Gender differences were observed. Conclusions. This study is the first to apply ML techniques to a nationally representative dataset of Ghanaian adolescents for suicide risk prediction, i.e., 'ideation, plans and attempts'. The findings highlight the potential of ML to provide precise tools for early identification of at-risk individuals.

The mental health (MH) of adolescents in low- and middle-income countries (LMIC), particularly those in rural areas, has historically been neglected in research and services, despite the documented burden MH problems represent among these populations. Settings where MH stigma is high require strategic research methods. Photovoice is a promising method for MH research in contexts of high stigma, but studies examining its acceptability with rural adolescents in LMIC remain scarce. We explored the acceptability of photovoice for MH research through perspectives of adolescents from rural Mexico who participated in a photovoice project focused on factors affecting their MH. Adolescents (n = 40) participated in focus groups where they discussed what they learned through the MH photovoice project, and the aspects of the method they perceived to be valuable. Focus groups transcripts were thematically analyzed. Participants' satisfaction with the MH photovoice project was tied to: (1) learning about the meaning, nature, and experiences of MH; (2) enjoying relationships, novelty, and fun; and (3) wishing for more time, more play, and continuity. Photovoice is an acceptable method for MH research among rural adolescents in LMIC, sparking reflection and collective dialog that can lead to the development of local initiatives.