Global Mental Health最新文献

This study investigates the epidemiology of adolescent suicide in India, addressing the limited research on the subject. Data on adolescent suicide (14-17 years) by sex and state were obtained from the National Crimes Records Bureau for 2014-2019, which included acquiring unpublished data from 2016 to 2019. Crude suicide rates for the period 2014-2019 were calculated by sex and state. Rate ratios (RRs) by sex and state were also calculated to assess changes over time, comparing suicide rates from 2017-2019 to 2014-2016. Female adolescent suicide rates, which ranged between 9.04 and 8.10 per 100,000 population, were consistently higher than male adolescent suicide rates, which ranged between 8.47 and 6.24 per 100,000 population. Compared to the first half of the study period (2014-2016), adolescent suicide rates significantly increased between 2017 and 2019 among less developed states (RRs = 1.06, 95% uncertainty interval [UI] = 1.03-1.09) and among females in these states (RRs = 1.09, 95% UI = 1.05-1.14). Male suicide rates aligned with global averages, while female rates were two to six times higher than in high-income and Southeast Asian countries. Findings highlight the urgent need for comprehensive surveillance and targeted suicide prevention strategies to address this critical public health issue.

Mental health is a global priority, fundamental to the health and development of all nations. The contribution of mental disorders to the global burden of disease is widely recognized; however, a significant care gap exists, particularly in the context of low-and middle-income countries. In India, for instance, there are 0.3 psychiatrists per 1,00,000 population. To address this severe shortage of mental health professionals and resources globally, the World Health Organization has suggested the adoption of a community-based mental health care approach, where the locus of services shifts from institutional care to local communities. Over the last five decades in India, diverse approaches to mental health care have emerged because of the interaction of dominant discourses on community-based mental health care with various socio-cultural contexts. In addition to the government-run mental health program and programs run by medical colleges, civil society organizations have increasingly contributed to this space. Although studies have assessed individual interventions, there exists a need to map these interventions and synthesize the approaches for service delivery to inform public health practice in India and in low-and middle-income countries at large. This narrative review attempts to map and synthesize insights from community-based mental health interventions in India implemented across diverse contexts. We searched peer-reviewed journal articles and book chapters published in the English language between 2010 and 2023. We present the synthesis of approaches used in 41 community-based mental health interventions, where we unpack key intervention components and processes adopted for primary prevention and promotion; identification and case detection; treatment and care, and rehabilitation in the community. This review presents key recommendations for practitioners about the role of community, the diversity and commonalities in various approaches across contexts, the roles of various actors in service delivery, and the shared values guiding the conceptualization and implementation of community-based mental health interventions in India.

[This corrects the article DOI: 10.1017/gmh.2025.10011.].

The global prevalence of mental health disorders among youths aged 15 to 24 is a significant public health concern. This systematic review aimed to explore global strategies for promoting mental well-being and addressing mental health challenges within this demographic, as defined by the World Health Organization. A comprehensive search of electronic scientific databases was conducted on November 1, 2023, yielding 43 studies with a total of 29,581 participants published between 2008 and 2023 that examined mental health interventions targeting youth. This review identified heterogeneity across multiple dimensions including modes and modalities of intervention delivery, conceptualisations of mental health, measurement tools and implementation settings. Digital/ technology-based interventions were prevalent in high-income countries, whereas physical interventions were more commonly employed across all income groups, especially where technological infrastructure was limited. Cognitive-behavioural therapy, psychoeducation and mindfulness-based interventions dominated the intervention modalities, likely due to their structured formats, scalability and broad applicability across a range of settings and mental health conditions. However, limited evidence of cultural adaptation in the reviewed interventions highlights the need for more inclusive and context-sensitive approaches. Schools were the most frequent delivery setting; however, reliance on educational platforms risks excluding out-of-school and marginalised youth. Conceptually, the reviewed interventions reflected both disorder-specific (diagnostic) and transdiagnostic understandings of mental health, affirming a spectrum-based view that integrates symptom reduction with well-being enhancement. This dual lens supports emerging frameworks such as the Hierarchical Taxonomy of Psychopathology (HiTOP). Measurement heterogeneity mirrored conceptual diversity, with both standardised and context-specific tools used to assess outcomes. This diversity highlighted the urgent need for culturally relevant, flexible and multi-modal interventions that span diverse settings and conceptualisations to equitably support youth mental health worldwide.

Adverse childhood experiences (ACEs) are widely associated with mental health disorders, such as depression, post-traumatic stress disorder (PTSD), and suicidality. Resilience plays a role in mediation and moderation of these associations, yet there is limited data from Kenya on this. This cross-sectional study examined the role of resilience in the relationship between ACEs and mental health outcomes among 1,972 participants aged 14-25 years in the Nairobi Metropolitan area. Participants completed the Trauma and Distress Scale (ACEs), Patient Health Questionnaire-9 (depression), Columbia-Suicide Severity Rating Scale (suicidality), Harvard Trauma Questionnaire (PTSD), and Adult Resilience Measure-Revised (resilience). Analyses of moderation and mediation using Hayes Process Macro indicated that resilience moderated the association between ACEs with PTSD and depression, with minimal effect on suicidality. It also moderated specific associations, including emotional/physical neglect on ideation, physical abuse on lifetime behavior (p = 0.0479), and total ACEs on recent behavior (p = 0.0514). Resilience also partially mediated the effects of ACEs on PTSD and depression, and fully mediated suicidality for specific ACE domains (emotional neglect, physical neglect, and physical abuse on suicidal ideation and all ACEs on recent suicidal behaviors). Building resilience mitigates the effects of ACEs on depression, PTSD, and suicidality among Kenyan youth.

Storm Daniel struck northeastern Libya on September 10, 2023, causing severe infrastructure damage and significant human loss. Derna was the most affected city, with the University of Derna suffering extensive damage and the tragic loss of 37 medical students. Medical students face unique psychological and academic stressors, and tend to have higher rates of psychiatric disorders compared to their peers of the same age. This is the first study to investigate the storm's psychological impact on medical students at the University of Derna. The study has a cross-sectional design and lasted from February 1 to March 1, 2024. We used the Generalized Anxiety Disorder-7 (GAD-7) to assess anxiety and the Patient Health Questionnaire-9 (PHQ-9) to assess depression, along with sociodemographic questions in our questionnaire. We included only active students enrolled in the 7-year undergraduate program at the University of Derna. Statistical tests such as the chi-square test and binary logistic regression were used in the analysis. About 225 students completed the survey. The means and standard deviations for GAD-7 and PHQ-9 scores were 9.2 (3.9) and 10.8 (5.0), respectively. The prevalence of anxiety was 42.2% for cases classified as moderate and severe (cut-off ≥10). Depression had a prevalence of 51.1% for cases classified as moderate, moderately severe and severe (cut-off ≥ 10). Suicidal ideation was reported at a rate of 48.9% for "several days" or more and at 16.5% for "more than half of the days" and "nearly every day." Internal displacement following the storm was significantly associated with both anxiety (p = 0.033) and depression (p = 0.003). However, age, gender, year of study, monthly allowance and residence status (living with family or alone) did not show a statistically significant association with either anxiety or depression (p > 0.05 for all variables). Logistic regression analysis identified gender as the only significant predictor of anxiety (p = 0.041) and internal displacement as the sole significant predictor of depression (p = 0.023). Medical students at the University of Derna reported high rates of anxiety, depression and suicidal ideation following Storm Daniel. Internal displacement was significantly associated with both anxiety and depression. These results highlight the need for targeted interventions to address medical students' mental health challenges and improve their overall well-being.

Negative symptoms in schizophrenia are critical to functional outcomes but remain difficult to assess reliably. The Brief Negative Symptom Scale (BNSS) was developed to address these challenges, though no validation exists in Romanian-speaking populations. To validate the BNSS in a Romanian clinical sample, explore its psychometric properties and compare BNSS-based and PANSS-based classifications of severe negative symptoms. Forty-seven inpatients with schizophrenia were assessed using Romanian versions of the BNSS, PANSS, CDSS and AIMS. Psychometric analyses included internal consistency, inter-rater reliability, factor analysis and correlation-based validity. Two classification schemes, moderate-severe negative symptoms, measured by BNSS (BNSS-MS), and predominant negative symptoms, measured by PANSS (PANSS-PNS), were compared. The BNSS showed excellent internal consistency (α = .94) and inter-rater reliability (ICC = .98). A five-factor structure was confirmed. BNSS total scores correlated strongly with PANSS negative (ρ = .90), but not with positive, depressive, or motor symptoms. Blunted affect emerged as the most prominent subscale. The BNSS-MS group captured more severe cases than PANSS-PNS and showed greater symptom burden and higher distress scores. The Romanian BNSS is valid and sensitive for detecting negative symptoms, outperforming PANSS in identifying clinically significant subgroups.

The growing burden of mental, neurological and substance use (MNS) disorders in low-resource settings has prompted efforts to integrate mental health into primary health care (PHC). This study evaluated the implementation and outcomes of a large-scale mhGAP training initiative under the Mental Health in Primary Care (MeHPriC) program in Lagos State, Nigeria. A total of 852 PHC workers from 57 facilities completed a 5-day mhGAP training and a 1-day refresher session. Using a pre-post mixed-methods design, we assessed changes in knowledge, stigma, clinical practice and self-efficacy, with follow-up at five months. Quantitative findings revealed significant improvements in knowledge and attitudes, with enhanced clinical practice reported by 69.1% of participants. Supervision, knowledge gains and self-efficacy emerged as predictors of improved practice. Qualitative data, analyzed using the Consolidated Framework for Implementation Research (CFIR), highlighted increased confidence, reduced stigma and the enabling role of supervision and peer support, alongside persistent barriers such as medication stock-outs and limited referral networks. The study offers robust evidence for the effectiveness of task-sharing approaches when supported by contextual adaptation and system-level readiness. The MeHPriC model demonstrates that government-led mhGAP scale-up in PHC is both feasible and impactful, offering a replicable pathway for mental health integration in other LMICs.

Syrian refugees in Türkiye show a high prevalence of mental health problems but encounter barriers to accessing mental health services. Group Problem Management Plus (gPM+), developed by the World Health Organization, is a low-intensity psychological intervention delivered by nonspecialist facilitators. This qualitative process evaluation explores the acceptability, feasibility and perceived effectiveness of gPM+ for Syrian refugees resettled in Türkiye, as well as facilitating factors and barriers to its implementation. Twenty-three semi-structured interviews were conducted with gPM+ participants, facilitators, drop-outs, relatives of participants and key informants. Findings showed that gPM+ was well-received for its group-based format, which participants felt fostered social support, and for its content, which they reported may have led to improvements in coping skills and family relationships. Facilitators viewed the intervention as feasible to implement. However, barriers such as participants' economic struggles, practical challenges (e.g., childcare and transportation difficulties) and low mental health literacy impeded engagement. Adapting gPM+ to address social determinants like poverty may be beneficial. The need for booster sessions was emphasized to maintain long-term change and provide deeper learning of the strategies. For sustainable scaling up gPM+ within primary health care, key informants highlighted the importance of training and supervising nonprofessional facilitators and securing governmental support.

Background: This study investigates the links between dietary diversity, food insecurity and mental health (depression and anxiety) in adolescents from rural Pakistan. Adolescence is a critical time for developing mental health disorders, yet limited research exists on these issues in low- and middle-income countries (LMICs).

Methods: The study included 1,396 adolescents (ages 9-15) and assessed their mental health, nutrition and maternal well-being. Depression and anxiety were measured using standardized questionnaires, while dietary diversity and food insecurity were evaluated through household assessments. Incidence rate ratios assessed the relationship between nutrition and mental health.

Results: Results showed that 8.1% of boys and 10.2% of girls experienced depression, with anxiety rates ranging from 5.8% to 39.1%. Adolescents from households with higher dietary diversity had lower symptoms of depression and anxiety (IRRs:0.91-0.96), while those with higher food insecurity had increased symptoms (IRRs:1.24-1.86). Folate deficiency was associated with depressive symptoms, particularly in boys. Maternal mental health was observed to mediate the relationship between food insecurity and adolescent depression and anxiety.

Conclusions: The study highlights that improving maternal mental health and addressing nutritional deficiencies, particularly folate, may benefit adolescent well-being. Further research in other LMICs is needed to explore these associations and their mechanisms.