SSM. Mental health最新文献

This review synthesises the evidence base for promoting and maintaining attendance in mental health and health interventions for children and adolescents in low- and middle-income countries (LMIC) and identifies strategies that can be employed for mental health interventions in those contexts. This is achieved through systematically searching relevant peer-reviewed literature in PubMed, Embase, PsychINFO and Global Health. Retrieved studies are screened by title and abstract, and subsequently the relevant papers undergo a full-text screening. The quality of the included studies is assessed using validated quality appraisal tools, namely the JBI Critical Appraisal Checklist and the Mixed Methods Appraisal Tool, and key data is extracted from each of the included studies. Fifteen studies from twelve different countries meet the eligibility criteria. The mean age of the participants in each study falls between 9 and 18 years. Only one study focuses on a mental health intervention, while the majority test strategies for health interventions. Six distinct categories of attendance promotion strategies are identified: (i) service improvement, (ii) health education and (iii) peer-support are the three most utilised strategies, followed by (iv) community engagement, (v) counselling, and (vi) cash-based approaches. Ten out of the fifteen studies (66.7%) yield statistically significant results for the improvement of attendance outcomes, one (6.7%) does not find any statistical significance and four (26.7%) do not test effectiveness of the strategies. While these results highlight a need for further studies with rigorous methodologies focusing on testing the effectiveness of strategies, service improvement and community engagement were noted as particularly effective. The findings identify several promising strategies from the global health literature, which can be translated to mental health interventions for children and adolescents in LMICs. Nevertheless, further research is necessary to establish their appropriateness in addressing the barriers to attendance in mental health interventions.

Background

While growing evidence has documented risks and resilience to HIV and poor sexual and reproductive health (SRH) among young women, young mothers’ abilities to respond to and overcome challenges have been understudied. Developing appropriate methodologies to measure resilience in the context of HIV, especially among young mothers, is a critical first step to filling this gap. We aimed to improve the relevance, and comprehensibility of an open-access resilience measure for use among young mothers living in HIV-endemic communities in South Africa. This paper summarizes a two-stage study that was carried out in the Eastern Cape, South Africa.

Methods

First, n = 9 cognitive interviews were conducted to inform the adaptation of the Child and Youth Resilience Measure Revised (CYRM-R) for use among young mothers (n = 7 living with HIV). The adapted measure was applied in remote interviews with 892 adolescent mothers during the COVID-19 pandemic (December 2021–April 2023). We investigated the basic psychometric properties of the adapted measure using STATA16.

Results

Cognitive interviews offered unique perspectives on how to modify items in English and isiXhosa, including items that had similar understandings and responses, with new probes and additional key words added to seven items. Participants' understanding of item wording and the translation of items resulted in word changes or substitution to maximise participants’ understanding of eight out of 17 items. The utilization of vignettes proved to be useful in engaging participants to reflect on their experiences. The revised scale had moderate psychometric properties. The EFA confirmed a two-factor structure, and the internal consistency of the CYRM-R was moderate (α = 0.75; ω = 0.75).

Conclusion

Cognitive interviews supported the adaptation of a resilience measure for adolescent mothers affected by HIV in South Africa. Initial psychometric properties highlight possible further adaptations needed, potentially due to the unique population of adolescent mothers.

Aim

To describe the perceptions and experiences of key stakeholders to understand the use of telehealth in community mental health centers (CMHCs) during the COVID-19 pandemic in Lima and Callao, Peru.

Methods

A qualitative study was carried out in four CMHCs in Lima and Callao, Peru. Forty-nine individual semi-structured interviews were conducted between September 2021 and March 2022, considering CMHCs' users and their relatives, health and administrative workers, directors, as well as local and national policymakers. Data was analyzed using thematic analysis.

Results

Regarding the transition from in-person care to telehealth, CMHCs' directors and workers identified some of the regulations issued by the Government during the pandemic, such as the continuity of care through telehealth, especially for pregnant women and for people with comorbidities related to COVID-19. Regarding benefits, workers and users indicated that it allowed better communication, such as constant follow-ups. Directors and workers recognized that Google Drive facilitated access to user information, since they did not have an electronic medical record. Additionally, workers said they used social media to share educational information on mental health, and explained that some new users began their treatment this way. Regarding difficulties, participants reported a lack of devices and poor internet connection in CMHCs. Users mentioned that scheduling an appointment was difficult because the phone lines were usually saturated, and they could not find available appointments.

Conclusion

Although the pandemic forced an immediate and disruptive change towards telehealth, CMHCs were able to adapt most of their services. This study reports the adaptations made by CMHCs to move from in-person to remote care, identifying the benefits and challenges faced, information that can be used for the nationwide implementation of telehealth in CMHCs. We recommend ensuring technological equipment and internet connection and adapt the telehealth system to make it responsive to the routine practices of CMHCs.

Introduction

Adolescence is a critical time for mental health promotion and prevention and establishing healthy behaviours. Implementing universal, school-based psychosocial interventions can improve short- and long-term health trajectories for adolescents. While these interventions may offer important opportunities for fostering skills and relationships, few school-based interventions have been developed for and tested in low- and middle-income countries (LMICs) where adolescent mental health needs may be significant and under-served. This manuscript details the development of a multi-component, universal school-based intervention, Health Action in ScHools for a Thriving Adolescent Generation (HASHTAG), for adolescents aged 12–15 years in Nepal and South Africa.

Methods and results

We describe HASHTAG's development over four phases, combining methods and results as each phase was iteratively conducted between 2018 and 2021. Phase 1 included a systematic review and components analysis, building from WHO guidelines for adolescent mental health. Seven components were strongly supported by the evidence: emotional regulation, stress management, mindfulness, problem-solving, interpersonal skills, assertiveness training, and alcohol and drug education. Phase 2 encompassed site selection, theory of change development, and formative research engagements; research teams in each site engaged adolescents and key adult stakeholders to identify priorities for intervention. Stakeholders voiced preferences for external facilitators and key content and delivery for intervention sessions. These findings informed Phase 3, a draft manual of HASHTAG, including a whole-school component, called Thriving Environment in Schools, and a classroom-based, six-session component, Thrive Together. In Phase 4, participants engaged in consultative workshops to review and contextualise content by country, preparing HASHTAG for implementation in a feasibility trial. Minor adaptations were made in Nepal, including using school nurses and adjusting take-home materials; both country's workshops identified practical considerations for implementing activities.

Conclusions

HASHTAG was designed around core evidence-based components to increase translatability across LMICs, while enabling country-specific tailoring to enhance feasibility. Future research will test whether this multi-component, whole-school approach can improve adolescent mental health.

Objectives

Informed by the Medical Research Council's process evaluation framework (Moore et al., 2015), this study explored the experiences of a newly developed brief compassion-focused intervention for trainee mental health professionals (tMHPs).

Design

A qualitative approach was taken, using semi-structured interviews analysed with thematic analysis (Braun and Clarke, 2006).

Method

The intervention was developed and planned in collaboration with key stakeholders. The intervention was piloted by delivering it to tMHPs at course centres in England as part of their core teaching programme. Qualitative methods were employed to explore the experiences of the intervention using in-depth semi-structured interviews (n = 19).

Results

Whilst several suggested improvements were recommended by participants, the experience of the intervention was generally good. Participants reported finding the intervention helpful and described positive changes they subsequently noticed in themselves and their work. Factors facilitating engagement with and implementation of the intervention, such as interactive and experiential content, were discussed as improving experience. Conversely, contextual factors, such as multiple demands and levels of support, were most consistently spoken about as preventing participants from being able to make use of the intervention.

Conclusions

The brief compassion-focused intervention was largely perceived to be helpful and valuable. However, some aspects of the intervention and the context in which it was delivered were discussed as creating barriers to engagement and implementation, thereby impacting experience. These findings have several clinical implications and highlight areas for further research.

Background

Psychiatric patients are vulnerable to disruptions caused by the Corona Virus Disease 2019 (COVID-19) pandemic. This study aimed to investigate the effects of the pandemic on mental health symptoms and suicidality among these patients during lockdowns.

Methods

This repeated cross-sectional study utilized data from “Psychological distress and Coping in Patients in Community Mental Health Centers during COVID-19 pandemic (PsyCo-COVID-19) " study, conducted in two phases between June–July 2020 and March–April 2021. It included 261 participants from six Community Mental Health Centers (CMHCs) who completed a digital questionnaire, including Norwegian version of Mini International Neuropsychiatric Interview Plus (M.I.N.I. Plus), Hopkins Symptoms Checklist (HSCL-25), Post-traumatic Stress Disorder Checklist (PCL-5).

Results

A higher percentage of patients reported PTSD during the second phase of lockdown (47.4%) compared to the first phase of lockdown (33.7%). A third of participants (33.7%) reported high levels of suicidality. Moderate to severe effects of pandemic on mental health were associated with a significantly higher risk of suicide (AOR = 3.12; 95% CI: 1.50, 6.48; p = 0.0001), while having children (AOR = 0.35; 95% CI: 0.16, 0.76; p = 0.008) and being employed (AOR = 0.44; 95% CI: 0.23, 0.84; p = 0.013) were protective factors. Non-Norwegian background was associated with a higher risk of suicide (AOR = 2.59; 95% CI: 1.08, 6.19; p = 0.032).

Conclusion

High prevalence of suicidality was found among patients in CMHCs in Norway, with a significant association with self-reported worsening of mental health. PTSD and suicidality increased significantly during the second phase of lockdown, emphasizing the lasting impact of the pandemic on mental health. Targeted interventions and support services are needed for psychiatric patients during times of increased stress and uncertainty. Healthcare providers should be aware of the increased risk of suicide and provide appropriate support and interventions to prevent adverse outcomes.