Global Mental Health最新文献

Optimising knowledge mobilisation in low- and middle-income countries (LMICs) could prove beneficial for improving mental health care, alleviating the global burden of high prevalence mental health problems and reducing inequalities. This review aimed to systematically review and synthesise the evidence on knowledge mobilisation for mental health improvement in LMICs, identifying barriers and facilitators and recommendations to guide progress. Four electronic databases were searched from inception to March 2024 using free text syntax combining synonyms of knowledge mobilisation, mental health and LMICs. Articles were eligible for inclusion if they were peer reviewed, on the topic of mental health and included evaluation data on knowledge mobilisation undertaken in LMICs. Included studies were quality assessed using the mixed-methods appraisal tool, and data extracted and synthesised narratively, complemented with the use of the framework for knowledge mobilisers and thematic analysis. Seventy-eight studies met the inclusion criteria. Successful knowledge mobilisation within resource-constrained settings was supported by several key facilitators. These include promoting community participation, engaging local stakeholders from the start and maintaining that engagement and building trust through equitable, long-term partnerships. Using structured frameworks helps guide systematic involvement, while fostering local ownership and leadership ensures sustainability and relevance. Knowledge mobilisation in low-resource settings faced several barriers, including limited logistical and financial resources, low literacy levels and a general lack of awareness about psychological interventions. A lack of mental health-specific training and language or translation difficulties further hindered efforts to effectively mobilise and implement mental health knowledge. Future knowledge mobilisation efforts could be strengthened by fostering sustained, trust-based collaborations among stakeholders and engaging policymakers early to ensure optimal alignment and buy-in. Emphasising local beliefs and attitudes is crucial, as is creating inclusive, participatory environments that encourage broad community involvement. Employing culturally responsive, community-driven frameworks can enhance relevance and impact, while rigorous evaluation of mobilisation strategies is critical to guide future research investment and resource allocation. Mobilising mental health knowledge in LMIC shares principles with mobilising other types of knowledge but differs in focus, stakeholders and challenges due to the stigma of mental health problems, its complexity, cultural sensitivity, misconceptions and resistance.

The mental health of Sri Lankan adolescents is of growing concern, given the decades of internal conflict and socio-political instability in Sri Lanka. This aims were to examine the prevalence and determinants of symptoms of common mental health problems (MHP) experienced by school-going adolescents in Sri Lanka. A cross-sectional survey was conducted among school-going adolescents in grades 10-12/13 from seven schools in Gampaha District, Sri Lanka. Depressive/psychological distress symptoms measured using the PHQ-9 /K10, were analysed using mean scale scoring. Psychosocial determinants were measured using JVQ/PBI/AESI/study-specific questions. Associations between MHPs and psychosocial determinants were examined using multiple linear regression models. 24.11% of 1,045 adolescents who completed the surveys reported clinically significant symptoms of depression, and 60.10% reported psychological distress. Higher age, being female, lesser physical activity, smoking, daily social media use, violent victimisation, not living with both birth parents, having ≥2 siblings, low maternal/paternal education, having an overprotective paternal figure, increased academic stress and rural living were associated with higher MHPs. We identified a high prevalence of MHPs among Sri Lankan adolescents, which was multifactorially determined. Modifiable risk factors addressed through public health policies, research and programmes, as well as less-modifiable risk factors addressed through national-level policy changes, are all essential to addressing mental health burdens in this population.

While the links between extreme weather events and mental health have received growing attention, little is known about how climate change impacts adolescent mental health in low- and middle-income climate-affected settings. To address this gap, we conducted a multi-method qualitative study exploring how young adolescents (YAs) aged 10-14 years experience climate-related stressors across six regions in Kenya. Guided by the resource insecurity framework, we thematically analyzed Elder focus groups, YA walk-along interviews and YA participatory mapping workshops. Our findings revealed that food, water and sanitation insecurity contribute to psychological distress, including symptoms of depression and suicidality, and heighten concerns of community violence (e.g., assault, fighting). Water insecurity, particularly the time and distance required for collection, disrupted school attendance, while resource borrowing generated feelings of shame. Food insecurity and larger contexts of poverty were associated with substance use as a coping mechanism, which in turn contributed to school dropout, crime and gang involvement. Poverty also led some youth to run away from home. These findings highlight the urgent need for climate-informed mental health interventions that address co-occurring resource insecurities. To advance adolescent mental health and well-being in climate-affected settings, policy responses must be targeted and multilevel, engaging families, communities and institutions.

An increasing number of studies have sought to explore the applicability of scalable mental health interventions to bridge the adolescent mental health treatment gap. This study aimed to adapt the World Health Organization's mental health intervention Early Adolescent Skills for Emotion (EASE) for urban communities in New York City (NYC). Following the mental health Cultural Adaptation and Contextualization for Implementation framework and in collaboration with three Brooklyn community-based organizations and the NYC Mayor's Office of Community Mental Health, the intervention was intensively workshopped through eight weekly sessions with adolescents (n = 18) and caregivers (n = 12). Documentation of the process followed the Reporting Cultural Adaptation in Psychological Trials criteria. Surface adaptations involved revising the storybook to reflect key challenges faced by adolescents and caregivers of these communities, such as social media usage, economic stressors, and racial diversity. Deep adaptations addressed cultural concepts of distress by incorporating topics such as identity exploration, socioemotional learning, and the mind-body connection. Feedback from stakeholders indicated that the basic components of EASE are relevant for members in their communities, but additional changes would foster greater engagement and community building. These findings will inform upcoming program implementation across NYC and may guide adaptation work in other contexts.

Understanding and responding to patient expectations is crucial for providing high-quality, person-centred mental healthcare, but remains underexplored in humanitarian settings. This study examines the preferences and experiences of Syrian mental health and psychosocial support (MHPSS) service users in Northwest Syria and Türkiye. We conducted structured interviews with 378 displaced Syrians (55% female, mean age: 31 years). Participants completed the Client Satisfaction Questionnaire-8 and responded to nine open-ended questions. An abductive qualitative content analysis guided by the World Health Organization's health system responsiveness framework was used to interpret their accounts. Participants most frequently described the importance of time and understanding (62%), dignity (43%), confidentiality (36%) and continuity of care (31%), with notable variation by gender. Interpersonal aspects of care were crucial for building trust and sustaining service engagement. Service-level factors, such as adequate time with practitioners and integrated and coordinated care, ensured high-quality support in a context of ongoing conflict, displacement and poverty. These findings underscore the importance of embedding person-centred approaches in MHPSS service design and delivery. As efforts to rebuild Syria's health system begin, prioritising service user experiences could improve the quality of care and restore health system trust and legitimacy.

This study examined the role of coping resources - self-efficacy (problem-focused) and emotion regulation (emotion-focused) - in supporting mental health and social functioning among refugees in a transit setting in Indonesia. Using a latent profile analysis approach with 1,214 participants, three distinct coping profiles were identified: high coping resources, high emotion-focused coping resource, and low coping resources. Results showed that high coping resources were associated with better mental health and social functioning outcomes. Emotion-focused coping resources were more strongly associated with better mental health, while problem-focused coping resources were closely linked to social functioning. This study highlighted the importance of coping flexibility and offers practical implications for strength-based interventions in transit displacement settings.

Background: The Venezuelan migrant crisis is the largest forced displacement in the Western Hemisphere. Venezuelan migrants face numerous challenges during the migration and resettlement process, negatively impacting their mental and physical health. Migrants who are caregivers face additional vulnerabilities and health needs, particularly women of reproductive age. However, there is limited research on the mental health of this population, including predictors of mental health conditions.

Methods: We combined two datasets, including 1,124 quantitative telephone surveys and 28 qualitative semistructured interviews with female Venezuelan migrant caregivers in Colombia - the primary destination for Venezuelan migrants globally - to characterize the prevalence of psychological distress and symptoms of depression and anxiety, key predictors of illness, and experiences with the healthcare system, using a convergent parallel design.

Results: We found that a high number of respondents experienced symptoms of moderate-to-severe distress (63%), depression (18%) and anxiety (28%). Across datasets, financial stressors, experiences of discrimination, family separation experiences and history with other health and chronic diseases significantly worsened mental health. Both datasets also showed the protective impacts of social support and mental healthcare from informal sources.

Conclusion: This study highlights the critical mental healthcare needs of female Venezuelan migrant caregivers residing in Colombia.

This study aimed to adapt and validate the Mental Health Support Scale (MHSS) for Chile and Argentina, hypothesising that it would correlate positively with mental health literacy, negatively with stigma measures, and differ by mental health first aid (MHFA) training history. The MHSS involves the 'Intended' scale (assessing intended support) and the 'Provided' scale (evaluating actual help), capturing recommended and not-recommended actions. The scales were translated into Spanish, piloted with 17 adults to explore cultural relevance, and validated with 554 Chilean and Argentinian adults using concurrent measures of stigma, social distance and mental health literacy. Factor analysis of the MHSS-Intended identified a recommended factor (16 items) and a not-recommended factor (5 items). The recommended factor correlated positively with mental health literacy (r = 0.19) and negatively with weak-not-sick stigma (r = -0.16) and social distance (r = -0.16). Support scores significantly discriminated between participants with and without MHFA training (recommended d = 0.99, not-recommended d = 1.35) and within participants pre- and post-MHFA training (recommended d = 0.90, not recommend d = 0.47). Overall, the adapted MHSS demonstrates acceptable psychometric properties and is a promising tool for evaluating mental health first aid support in Chile and Argentina.

This study aimed to perform a cross-country validation of the Arabic version of the World Health Organization 5-item (WHO-5) Well-Being Index, in terms of factor structure, composite reliability, cross-gender measurement invariance and concurrent validity. We carried out a cross-sectional, web-based study on a total of 3,247 young adults (aged 18-35 years) from six Arab countries (Tunisia, Lebanon, Egypt, Jordan, Morocco and Kuwait). Confirmatory Factor Analysis showed that the one-factor model demonstrated acceptable fit across all six countries. In addition, the Arabic WHO-5 Well-Being Index yielded high reliability coefficients in samples from each country (McDonald's ω and Cronbach's α = .92-.96), across genders (ω = .95 in men and .94 in women) and age groups (ω = .94/α = .94 in participants aged ≤25 years and ω =.96/α =.96 in those aged ≥26 years). Multi-group analyses demonstrated that configural, metric and scalar invariance were supported across gender, countries and age groups. Regarding concurrent validity, WHO-5 Well-being scores were strongly and significantly inversely correlated with depression, anxiety, stress, suicidal ideation and insomnia severity. This study provides a brief, valid and reliable Arabic version of the WHO-5 Well-Being Index that can be applied cross-nationally among Arabic-speaking young adult populations for screening and research purposes.

We aimed to compare the concordance between the Montreal Cognitive Assessment (MoCA) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), as cognitive screening tools to detect mild cognitive impairment (MCI) in a South African adult community sample (N = 370). The MoCA showed acceptable internal consistency, agreement with the RBANS and good criterion-related validity. The MoCA demonstrated fair performance, compared to the RBANS, for predicting MCI, with AUCs of 0.711 (English) and 0782 (Afrikaans). Using the recommended cut-off score of 26/30, the MoCA showed high sensitivity but low specificity. Sensitivity and specificity were optimal when the cut-off scores were lowered to 25/30 (English) and 24/30 (Afrikaans). MoCA scores were significantly associated with language, sex, age and education. While these findings demonstrate applicability of the MoCA in screening for and identifying mild cognitive difficulty in this population, our findings suggest that modifications are needed to improve differentiating between normal aging and MCI. Until a culturally adapted version of the MoCA is developed and validated for this population we suggest lowering the cut-off score to 25/30 (English) and 24/30 (Afrikaans) to reduce false positive NCD diagnoses. Demographic factors (age, sex, language and education) also need to be considered.