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Challenges and priorities for global mental health in the Sustainable Development Goals (SDG) era

ACADEMY OF MEDICAL SCIENCES
June 2018

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Published in 2011, the Grand Challenges in Global Mental Health initiative provided a framework to guide the research needed to improve treatment and prevention of mental health disorders and expand access to mental health services. At the Academy’s workshop on global mental health participants reflected on progress since 2011, focusing on specific life-course stages, and identified priorities for research in treatment and prevention, as well as enduring challenges and emerging opportunities

International Humanitarian Law (IHL) and Persons with Disabilities

INTERNATIONAL COMMITTEE OF THE RED CROSS (ICRC)
October 2017

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"International humanitarian law (IHL) is a set of rules that, in times of armed conflict, seeks – for humanitarian reasons – to protect persons who are not, or are no longer directly participating in hostilities, and to restrict means and methods of warfare. IHL requires parties to armed conflicts to afford special respect and protection to persons with disabilities and helps ensure their inclusion. A number of weapons-related treaties aims to prevent certain disabilities from occurring by prohibiting the use of particular weapons and reducing the dangers they pose. They also seek to ensure that victims receive appropriate assistance"

Mental health assessments in refugees and asylum seekers: evaluation of a tablet-assisted screening software

MORINA, Naser
et al
October 2017

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Mental health problems resulting from persecution and forced migration are very common among refugees and asylum seekers and evolve into a major public health challenge. Language barriers often prevent timely access to appropriate health care, leading to chronic trajectories and abortive social integration. Tools for multilingual screening and assessment could be of great benefit for this particularly vulnerable population as well as for policy makers. This study aimed at testing the reliability, feasibility and usability of the Multi-Adaptive Psychological Screening Software (MAPSS), a newly developed Audio Computer-Assisted Self-Interview Software (ACASI) for touchscreen devices, for screening purposes in a clinical setting. In a randomized cross-over design including both MAPSS and paper-pencil clinician-administered interviews, 30 treatment-seeking refugees completed clinical measures and a feasibility questionnaire to rate the user interface of MAPSS. Five professionals performed given tasks in MAPSS and completed usability questionnaires for the administration interface.

Conflict and Health 2017 11:18

https://doi.org/10.1186/s13031-017-0120-2

Everywhere the bombing followed us. Forced displacement and the use of explosive weapons in populated areas. Perspectives of Syrian women refugees in Lebanon

BEAUJOLAIS, Aurelie
September 2017

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Based on a survey of 205 Syrian refugees in Lebanon and in-depth interviews with 14 Syrian women refugees originally from different towns and cities in Syria, and additional research, this study confirms that the use of explosive weapons in populated areas drives multiple forced displacements and induces a pattern of displacement that increases the vulnerability of civilians. Quantitative data collected during the survey confirms the correlation between multiple forced displacements and the use of the explosive weapons, as almost half of all respondents had been internally displaced prior to seeking external refuge in Lebanon, with an average of 3 internal displacements within their own city. The women interviewed highlighted the deprivation induced by forced displacement. The study also reflects the considerable harm caused by the use of explosive weapons in populated areas in terms of socio-economic vulnerability, linked to the loss of livelihood and the disruption of civilian infrastructure, as well as the long-term impact on mental health. Dire social impacts were emphasised by respondents, namely aid dependence and new restrictions encountered by people living with disabilities, along with a loss of personal dignity, as well as the loss of education for Syrian children

 

Better understanding of youth mental health

The Lancet
April 2017

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Mental health issues are the leading cause of disability in adolescents aged 15–19 years in all the world's regions, contributing 45% of their overall burden of disease. Early intervention to prevent mental health disorders is crucial to suicide prevention and to improve lifelong wellbeing. In April 2017, Mission Australia, in association with the Black Dog Institute (a research institute based in New South Wales) published the 5th Youth Mental Health Report. A survey of 21 000 Australian adolescents recorded 22·8% of young Australians meeting the criteria for probable serious mental illness (PSMI), as assessed by the Kessler 6 measure of non-specific psychological distress. Adolescent girls were almost twice as likely than boys to meet the criteria for PSMI. A significantly higher proportion of Aboriginal and Torres Strait Islander responders met the criteria for PSMI (31·6%)  than non-Aboriginal and Torres Strait Islanders.


DOI: http://dx.doi.org/10.1016/S0140-6736(17)31140-6

Vol. 389, No. 10080, p1670, 29 April 2017

 

Improving mental health and related service environments and promoting community inclusion WHO QualityRights training to act, unite and empower for mental health (Pilot version)

FUNK, Michelle
DREW, Natalie
2017

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This document provides training and guidance on the key standards related to the physical and social environment within mental health and related services that need to be met to promote good outcomes, independent living and community inclusion. Service assessment and improvement tools are provided. Training tools (core and advanced) and guidance tools are introduced. Guidance is given for facilitators and learning objectives, resources and outcomes are provided for three topics: What makes a good environment?; The right to an adequate standard of living in mental health and related services; and Living independently and being included in your community.

Mental health and human rights : Report of the United Nations High Commissioner for Human Rights

OFFICE OF THE HIGH COMMISIONER FOR HUMAN RIGHTS
January 2017

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"The present report, mandated by the Human Rights Council in resolution 32/18, identifies some of the major challenges faced by users of mental health services, persons with mental health conditions and persons with psychosocial disabilities. These include stigma and discrimination, violations of economic, social and other rights and the denial of autonomy and legal capacity.

In the report, the High Commissioner recommends a number of policy shifts, which would support the full realisation of the human rights of those populations, such as the systematic inclusion of human rights in policy and the recognition of the individual’s autonomy, agency and dignity. Such changes cover measures to improve the quality of mental health service delivery, to put an end to involuntary treatment and institutionalisation and to create a legal and policy environment that is conducive to the realisation of the human rights of persons with mental health conditions and psychosocial disabilities"

A/HRC/34/32

Human Rights Council, Thirty-fourth session, 27 February-24 March 2017

Mental health and trauma in asylum seekers landing in Sicily in 2015: a descriptive study of neglected invisible wounds

CREPET, Anna
RITA, Francesco
REID, Anthony
et al
January 2017

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Abstract

 

Background

 

In 2015, Italy was the second most common point of entry for asylum seekers into Europe after Greece. The vast majority embarked from war-torn Libya; 80,000 people claimed asylum that year. Their medical conditions were assessed on arrival but their mental health needs were not addressed in any way, despite the likelihood of serious trauma before and during migration. Médecins sans Frontières (MSF), in agreement with the Italian Ministry of Health, provided mental health (MH) assessment and care for recently-landed asylum seekers in Sicily. This study documents mental health conditions, potentially traumatic events and post-migratory living difficulties experienced by asylum seekers in the MSF programme in 2014–15.

 

Methods

 

All asylum seekers transiting the 15 MSF-supported centres were invited to a psycho-educational session. A team of psychologists and cultural mediators then provided assessment and care for those identified with MH conditions. Potentially traumatic events experienced before and during the journey, as well as post-migratory living difficulties, were recorded. All those diagnosed with MH conditions from October 2014 to December 2015 were included in the study.

 

Results

 

Among 385 individuals who presented themselves for a MH screening during the study period, 193 (50%) were identified and diagnosed with MH conditions. Most were young, West African males who had left their home-countries more than a year prior to arrival. The most common MH conditions were post traumatic stress disorder (31%) and depression (20%). Potentially traumatic events were experienced frequently in the home country (60%) and during migration (89%). Being in a combat situation or at risk of death, having witnessed violence or death and having been in detention were the main traumas. Lack of activities, worries about home, loneliness and fear of being sent home were the main difficulties at the AS centres.

 

Conclusion

 

MH conditions, potentially traumatic events and post-migratory living difficulties are commonly experienced by recently-arrived ASs, this study suggests that mental health and psychosocial support and improved living circumstances should be integrated into European medical and social services provided by authorities in order to fulfil their humanitarian responsibility and reduce the burden of assimilation on receiving countries.

 

Keywords

 

Immigration Asylum seekers Refugee Mental health Italy Europe Traumatic event Operational research

Mental health and trauma in asylum seekers landing in Sicily in 2015: a descriptive study of neglected invisible wounds

CREPET, Anna
RITA, Francesco
REID, Anthony
et al
January 2017

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While the medical conditions of newly migrated asylum seekers to Sicily were being addressed, the mental health of those who may have experienced trauma before, during, or after their migration was not addressed. "Médecins sans Frontières (MSF), in agreement with the Italian Ministry of Health, provided mental health (MH) assessment and care for recently-landed asylum seekers in Sicily. This study documents mental health conditions, potentially traumatic events and post-migratory living difficulties experienced by asylum seekers in the MSF programme in 2014–15." 

Partnerships in mental healthcare service delivery in low-resource settings: developing an innovative network in rural Nepal

ACHARYA, Bibhav
MARU, Duncan
SCHWARZ, Ryan
et al
January 2017

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"Mental illnesses are the largest contributors to the global burden of non-communicable diseases. However, there is extremely limited access to high quality, culturally-sensitive, and contextually-appropriate mental healthcare services. This situation persists despite the availability of interventions with proven efficacy to improve patient outcomes. A partnerships network is necessary for successful program adaptation and implementation."

WHO: New QualityRights guidance and training tools (pilot version)

WHO
2017

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"As part of the QualityRights Initiative, WHO has developed a comprehensive package of training and guidance modules. The modules can be used to build capacity among mental health practitioners, people with psychosocial, intellectual and cognitive disabilities, people using mental health services, families, care partners and other supporters, NGOs, DPOs and others on how to implement a human rights and recovery approach in the area of mental health in line with the UN Convention on the Rights of Persons with Disabilities and other international human rights standards".

 

The core mental health and human rights modules are:

Understanding human rights 
(WHO/MSD/MHP/17.1)
Promoting human rights in mental health 
(WHO/MSD/MHP/17.2)
Improving mental health and related service environments and promoting community inclusion 
(WHO/MSD/MHP/17.3)
Realising recovery and the right to health in mental health and related services 
(WHO/MSD/MHP/17.4)
Protecting the right to legal capacity in mental health and related services 
(WHO/MSD/MHP/17.5)
Creating mental health and related services free from coercion, violence and abuse
(WHO/MSD/MHP/17.6)

 

Further to these, there are 4 advanced modules, 2 service improvement tools and 4 guidance tools

 

The burden of mental disorders in the eastern Mediterranean region, 1990-2013

CHARARA, Raghid
et al
January 2017

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The Eastern Mediterranean Region (EMR) is witnessing an increase in chronic disorders, including mental illness. With ongoing unrest, this is expected to rise. This is the first study to quantify the burden of mental disorders in the EMR. Data was used from the Global Burden of Disease study (GBD) 2013. DALYs (disability-adjusted life years) allow assessment of both premature mortality (years of life lost–YLLs) and nonfatal outcomes (years lived with disability–YLDs). DALYs are computed by adding YLLs and YLDs for each age-sex-country group.

 

https://doi.org/10.1371/journal.pone.0169575

Mad studies: Intersections with disability studies, social work, and mental health

INTERSECTIONALITIES, A GLOBAL JOURNAL OF SOCIAL WORK, ANALYSIS,RESEARCH, POLITY AND PRACTICE
December 2016

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A special issue of the online journal "Intersectionalities - A Global Journal of Social Work Analysis, Research, Polity, and Practice", Vol 5, No.3 (2016) providing 10 articles on the theme of Mad studies. Titles of papers included are: 

Doing Mad Studies: Making (Non)sense Together; 

An Introduction to Anti-Black Sanism; 

Why Mad Studies Needs Survivor Research and Survivor Research Needs Mad Studies; 

Recovery-as-Policy as a Form of Neoliberal State Making; 

“About Nothing Without Us”: A Comparative Analysis of Autonomous Organizing Among People Who Use Drugs and Psychiatrized Groups in Canada; 

Too Young to Be Mad: Disabling Encounters with 'Normal' from the Perspectives of Psychiatrized Youth; 

Relocating Mad_Trans Re_presentations Within an Intersectional Framework; 

A Desire to be ‘Normal’? A Discursive and Intersectional Analysis of ‘Penetration Disorder’; 

Racialized Communities, Producing Madness and Dangerousness; 

Psy-Times: The Psycho-Politics of Resilience in University Student Life

Not forgetting severe mental disorders in humanitarian emergencies: a descriptive study from the Philippines

WEINTRAUB, Ana Cecilia Andrade de Moraes
et al
November 2016

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"In response to the Typhoon Haiyan in the Philippines, Médecins Sans Frontières-Operational Centre Brussels (MSF-OCB) decided to concentrate its efforts in the severely affected area of Guiuan and its four surrounding municipalities. The MSF-OCB intervention included a comprehensive approach to mental health, including care for people with pre-existing and post-disaster severe mental disorders. Based on this experience of providing MH care in the first five months after Typhoon Haiyan, we report on the monthly volume of MH activities and beneficiaries; sociodemographic and care seeking characteristics of beneficiaries receiving MH counselling/care, stratified by the severity of their condition; profile and outcomes of patients with severe mental disorders; prescribing practice of psychotropic medication; and main factors facilitating the identification and management of individuals with severe mental disorders"

International Health, Vol.8, No.5, pp. 336-344

Doi: 10.1093/inthealth/ihw032

Innovations In Dementia

ROUTLEDGE, Martin
SANDERSON, Helen
BAILEY, Gill
October 2016

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This book offers concrete ideas and examples to those interested in driving a radically different approach to supporting people with dementia and their families. "We have explored a number of approaches with people who have been leading their development. We have been keen to look at both approaches that emerge from working directly to improve support for people with dementia and others that have different roots, but we think are potentially very transferable. None of the approaches is yet being used at any significant scale". Discussions and examples are all UK based. There is an introduction detailing current problems and issues with care and support for people with dementia. 10 approaches are described for housing and support, 4 concerned with enabling people to have good days and 7 associated with enabling people to connect with their community. 

Disability, family and identity

SCHNEIDER, Cort
October 2016

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Many people with disabilities struggle with issues that relate to identity development.  Many people with disabilities find it difficult to develop a positive sense of self. There is also no question that familial relationships play a significant part in the process of identity construction for people with disabilities. Thus, it is important to examine how family relationships influence the process of identitydevelopment for people with disabilities. Conversely, it relevant to explore how a person’s identity development can impact his or her relationship with family members. This article employs an autoethnographic approach to research in order to examine issues that relate to disability, identity and family. It elucidates the complex nature of family scripts and identity. In addition this paper contends that the process that an individual goes through in order to “come to terms” with a disabled identity, can transform the relationships that an individual has with various family members.

 

Considering Disability, Vol.1, Issue 3&4

DOI: 10.17774/CDJ1.32016.2.20575874

Dignity in mental health : Psychology & mental health first aid for all

WORLD FEDERATION FOR MENTAL HEALTH (WFMH)
October 2016

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‘Dignity in Mental Health-Psychological & Mental Health First Aid for All’ is designed to enable us to contribute to the goal of taking mental health out of the shadows so that people in general feel more confident in tackling the stigma, isolation and discrimination that continues to plague people with mental health conditions, their families and carers. Key messages concerning Mental Health First Aid include: all members of the public can learn basic skills to help people with mental health problems; we need to aim to have large numbers of people trained throughout the world to be able to provide mental health first aid; parity is needed with the provision of physical first aid.

Improving Ghana’s mental healthcare through task-shifting-psychiatrists and health policy directors perceptions about government’s commitment and the role of community mental health workers

AGYAPONG, Vincent
et al
October 2016

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The aim of this study was to examine the perceptions of psychiatrists and health policy directors about the policy to expand mental health care delivery in Ghana through a system of task-shifting from psychiatrists to community mental health workers (CMHWs). A self-administered semi-structured questionnaire was developed and administered to 11 psychiatrists and 29 health policy directors. Key informant interviews were also held with five psychiatrists and four health policy directors. .

Globalization and Health (2016) 12:57

DOI 10.1186/s12992-016-0199-z

The promise and the reality: a mental health workforce perspective on technology-enhanced youth mental health service delivery

ORLOWSKI, Simone
LAWN, Sharon
MATTHEWS, Ben
et al
October 2016

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Digital technologies show promise for reversing poor engagement of youth (16–24 years) with mental health services. In particular, mobile and internet based applications with communication capabilities can augment face-to-face mental health service provision. Results of in-depth qualitative data drawn from various stakeholders involved in provision of youth mental health services in one Australian rural region are described. Data were obtained using focus groups and semi-structured interviews with regional youth mental health clinicians, youth workers and support/management staff and analysed via inductive thematic analysis. Six main themes were identified: young people in a digital age, personal connection, power and vulnerability, professional identity, individual factors and organisational legitimacy. 

 

DOI: 10.1186/s12913-016-1790-y

Mental health and psychosocial support for South Sudanese refugees in northern Uganda: a needs and resource assessment

ADAKU, Alex
et al
September 2016

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Since December 2013, an armed conflict in South Sudan has resulted in the displacement of over 2.2 million people, more than 270,000 of whom were, at the time of the research, in refugee settlements located throughout Uganda. A mental health and psychosocial support (MHPSS)​MHPSS needs and resource assessment was carried out in Rhino Camp refugee settlement in northern Uganda, between June and August 2014 following World Health Organization (WHO) and United Nations High Commissioner for Refugees (UNHCR) guidelines for MHPSS needs assessments in humanitarian settings. The assessment used a range of methodologies including: 1) a desk (literature) review to understand the context for mental health service provision; 2) an analysis of data from existing health information systems (HIS); 3) an assessment of the current infrastructure for service provision using a shortened version of a Who does What Where until When (4Ws); and 4) semi-structured individual and group interviews (total n = 86) with key informants (n = 13) and general community members (individual interviews n = 28, four focus groups with n = 45).

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