scholarly journals Evaluation of an anti-stigma intervention for Mexican psychiatric trainees

2022 ◽  
Vol 8 (1) ◽  
Author(s):  
Emmeline Lagunes-Cordoba ◽  
Ruth Alcala-Lozano ◽  
Roberto Lagunes-Cordoba ◽  
Ana Fresan-Orellana ◽  
Manuela Jarrett ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Negative Attitudes ◽  
Middle Income ◽  
Self Reflection ◽  
Middle Income Countries ◽  
People With Mental Illness ◽  
Related Stigma ◽  
Health Related ◽  
The Impact

Abstract Background There is research evidence regarding the presence of stigmatising attitudes in psychiatrists towards people with mental illness, but a lack of studies and interventions focused on this issue in low and middle-income countries. Aims To assess the feasibility of implementing an anti-stigma intervention for Mexican psychiatric trainees, and its potential effects. Methods This study comprised a pre-post design with outcome measures compared between baseline and 3-month follow-up. Quantitative outcome measures were used to evaluate the potential effects of the intervention, whilst the process evaluation required the collection and analysis of both quantitative and qualitative data. Results Twenty-nine trainees (25% of those invited) participated in the intervention, of whom 18 also participated in the follow-up assessment. Outcome measures showed the intervention had moderately large effects on reducing stereotypes and the influence of other co-workers on trainees’ own attitudes. The main mechanisms of impact identified were recognition of negative attitudes in oneself and colleagues, self-reflection about the impact of stigma, one’s own negative attitudes and recognition of one’s ability to make change. Participants accepted and were satisfied with the intervention, which many considered should be part of their routine training. However, trainees’ work overload and lack of support from the host organisation were identified as barriers to implement the intervention. Conclusions A brief anti-stigma intervention for Mexican psychiatric trainees is feasible, potentially effective, well accepted and was considered necessary by participants. This study also suggests mechanisms of impact and mediators should be considered for developing further interventions, contributing to reducing the damaging effects that mental health-related stigma has on people’s lives.

scholarly journals A scoping review of health-related stigma outcomes for high-burden diseases in low- and middle-income countries

BMC Medicine ◽  
2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Jeremy C. Kane ◽  
Melissa A. Elafros ◽  
Sarah M. Murray ◽  
Ellen M. H. Mitchell ◽  
Jura L. Augustinavicius ◽  
...  
Keyword(s):  
Scoping Review ◽  
Middle Income ◽  
High Burden ◽  
Middle Income Countries ◽  
Related Stigma ◽  
Health Related ◽  
Low And Middle Income

scholarly journals 407 - Living through the pandemic as an older person: Long-term psychological impacts in low- and middle-income countries

2021 ◽  
Vol 33 (S1) ◽  
pp. 33-33
Author(s):  
Clarissa Giebel ◽  
Bwire Ivan ◽  
Maria Isabel Zuluaga ◽  
Suresh Kumar ◽  
Mark Gabbay ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Well Being ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health And Social Care ◽  
The Impact ◽  
Low And Middle Income

Background:The pandemic has put a huge strain on people’s mental health, with varying restrictions affecting people’s lives. Little is known how the pandemic affects older adults’ mental health, particularly those living in low- and middle-income countries (LMICs) where restrictions are affecting people’s access to basic necessities. Thus, the aim of this 3-country study was to understand the long- term impacts of the pandemic on the mental well-being of older adults with and without dementia in LMICs.Methods:We are collecting 30 baseline and 15 follow-up interviews with older adults (aged 60+), people with dementia, and family carers in Colombia, India, and Uganda, as well as a baseline and follow-up focus group with health and social are professionals in each country. Interviews are conducted remotely over the phone due to pandemic restrictions, with data collection taking place between March and July 2021. Transcripts are translated into English before being analysed using thematic analysis.Results:To date, we have completed close to 90 baseline interviews and 3 focus groups with health and social care professionals. Analysis is ongoing, but findings are capturing the detrimental second wave in India and follow-up interviews will capture the longitudinal impacts on mental health.Conclusions:Whilst vaccines are starting to be rolled out in LMICs, albeit at different rates, the virus will likely take much longer to be somewhat managed in LMICs. This leaves more room for people’s physical as well as mental health to be impacted by the restrictions, and with often limited mental health service coverage, it is all the more important o understand the impact of the pandemic on older people’s mental health.

Tobacco addiction

2020 ◽  
pp. 546-554
Author(s):  
Marcus Munafo ◽  
Meryem Grabski
Keyword(s):  
Tobacco Use ◽  
Global Economy ◽  
Middle Income ◽  
Middle Income Countries ◽  
People With Mental Illness ◽  
Tobacco Addiction ◽  
Global Concern ◽  
Policy Measures ◽  
The Impact

Tobacco use is a global concern, due to the associated health risks and the impact of the health consequences of tobacco use on the global economy. It is responsible for over 5 million deaths per year, and even though smoking rates have declined in many high-income countries, they are expected to continue to increase in many low- and middle-income countries. The focus of this chapter is on the epidemiology of tobacco addiction and its biological underpinnings, including the role of genetic influences. The importance of non-nicotine factors in tobacco use is discussed, as well as the use of tobacco in people with mental illness. Finally, currently available treatments for smoking cessation, as well as current policy measures to prevent and decrease tobacco use, are also discussed.

scholarly journals Reducing mental health-related stigma among medical and nursing students in low- and middle-income countries: a systematic review

2019 ◽  
Vol 29 ◽  
Author(s):  
E. Heim ◽  
C. Henderson ◽  
B. A. Kohrt ◽  
M. Koschorke ◽  
M. Milenova ◽  
...  
Keyword(s):  
Mental Health ◽  
Nursing Students ◽  
Cultural Adaptation ◽  
Methodological Quality ◽  
Outcome Measure ◽  
Middle Income ◽  
Professional Students ◽  
Middle Income Countries ◽  
Related Stigma ◽  
Health Related

Abstract Aims This systematic review compiled evidence on interventions to reduce mental health-related stigma among medical and nursing students in low- and middle-income countries (LMICs). Primary outcomes were stigmatising attitudes and discriminatory behaviours. Methods Data collection included two strategies. First, previous systematic reviews were searched for studies that met the inclusion criteria of the current review. Second, a new search was done, covering the time since the previous reviews, i.e. January 2013 to May 2017. Five search concepts were combined in order to capture relevant literature: stigma, mental health, intervention, professional students in medicine and nursing, and LMICs. A qualitative analysis of all included full texts was done with the software MAXQDA. Full texts were analysed with regard to the content of interventions, didactic methods, mental disorders, cultural adaptation, type of outcome measure and primary outcomes. Furthermore, a methodological quality assessment was undertaken. Results A total of nine studies from six countries (Brazil, China, Malaysia, Nigeria, Somaliland and Turkey) were included. All studies reported significant results in at least one outcome measure. However, from the available literature, it is difficult to draw conclusions on the most effective interventions. No meta-analysis could be calculated due to the large heterogeneity of intervention content, evaluation design and outcome measures. Studies with contact interventions (either face-to-face or video) demonstrated attitudinal change. There was a clear lack of studies focusing on discriminatory behaviours. Accordingly, training of specific communication and clinical skills was lacking in most studies, with the exception of one study that showed a positive effect of training interview skills on attitudes. Methods for cultural adaptation of interventions were rarely documented. The methodological quality of most studies was relatively low, with the exception of two studies. Conclusions There is an increase in studies on anti-stigma interventions among professional students in LMICs. Some of these studies used contact interventions and showed positive effects. A stronger focus on clinical and communication skills and behaviour-related outcomes is needed in future studies.

scholarly journals Care for elderly people with mental illness: a global problem

2010 ◽  
Vol 7 (2) ◽  
pp. 29-30 ◽  
Author(s):  
David Skuse
Keyword(s):  
Mental Illness ◽  
The Elderly ◽  
Western Hemisphere ◽  
Elderly Persons ◽  
Middle Income ◽  
Middle Income Countries ◽  
Care Services ◽  
People With Mental Illness ◽  
Health And Social Care ◽  
The Impact

As the median age of populations around the world increases, due to the provision of better diets and better medical care, the number of elderly persons vulnerable to mental illness will inevitably increase too. We are not good at providing high-quality geriatric care, even in high-income countries. For example, Age Concern (a UK-based charity) states on its website: ‘Health and social care services have made some progress in tackling age discrimination, but older people still report feeling that they have had second class treatment and care simply because of their age’ (www.ageconcern.org.uk/AgeConcern/ageism-in-healthcare.asp). How much worse these matters are in low- and middle-income countries is the subject of our theme in this issue. We have drawn articles from three distinct geographic regions: India, Africa and South-East Asia. We often assume that cultural factors in lower-income areas lead to greater respect for, and better care of, the elderly than we experience in many parts of the Western hemisphere. This appears to be a misapprehension, and attitudes towards the elderly are changing as the impact of industrialisation increases.

scholarly journals Neurosurgeons’ experiences of conducting and disseminating clinical research in low-income and middle-income countries: a reflexive thematic analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e051806
Author(s):  
Charlotte Jane Whiffin ◽  
Brandon George Smith ◽  
Ignatius N Esene ◽  
Claire Karekezi ◽  
Tom Bashford ◽  
...  
Keyword(s):  
Clinical Research ◽  
Thematic Analysis ◽  
Low Income ◽  
Demographic Data ◽  
Middle Income ◽  
Survey Tool ◽  
Middle Income Countries ◽  
Specific Effects ◽  
The Impact

ObjectivesLow-income and-middle-income countries (LMICs) are increasing investment in research and development, yet there remains a paucity of neurotrauma research published by those in LMICs. The aim of this study was to understand neurosurgeons’ experiences of, aspirations for, and ability to conduct and disseminate clinical research in LMICs.DesignThis was a two-stage inductive qualitative study situated within the naturalistic paradigm. This study committed to an interpretivist way of knowing (epistemology), and considered reality subjective and multiple (ontology). Data collection used online methods and included a web-based survey tool for demographic data, an asynchronous online focus group and follow-up semistructured interviews. Data were analysed using Braun and Clarke’s Reflexive Thematic Analysis supported by NVivo V.12.SettingLMICs.ParticipantsIn April–July 2020, 26 neurosurgeons from 11 LMICs participated in this study (n=24 in the focus groups, n=20 in follow-up interviews).ResultsThe analysis gave rise to five themes: The local landscape; creating capacity; reach and impact; collaborative inquiry; growth and sustainability. Each theme contained an inhibitor and stimulus to neurosurgeons conducting and disseminating clinical research, interpreted as ‘the neurosurgical research potential in LMICs’. Mentorship, education, infrastructure, impact and engagement were identified as specific accelerators. Whereas lack of generalisability, absence of dissemination and dissemination without peer review may desensitise the impact of research conducted by neurosurgeons.ConclusionThe geographical, political and population complexities make research endeavour challenging for neurosurgeons in LMICs. Yet in spite of, and because of, these complexities LMICs provide rich opportunities to advance global neurosurgery. More studies are required to evaluate the specific effects of accelerators of research conducted by neurosurgeons and to understand the effects of desensitisers on high-quality, high-impact clinical research.

scholarly journals Reducing mental health-related stigma in primary health care settings in low- and middle-income countries: a systematic review

2018 ◽  
Vol 29 ◽  
Author(s):  
E. Heim ◽  
B. A. Kohrt ◽  
M. Koschorke ◽  
M. Milenova ◽  
G. Thornicroft
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Cultural Adaptation ◽  
Risk Of Bias ◽  
Middle Income ◽  
Training Interventions ◽  
Middle Income Countries ◽  
Primary Health ◽  
Related Stigma ◽  
Health Related

Abstract Aims This systematic review compiled evidence on interventions to reduce mental health-related stigma in primary health care (PHC) in low- and middle-income countries (LMICs). Studies targeting PHC staff (including non-professionals) were included. Primary outcomes were stigmatising attitudes and discriminatory behaviours. Methods Data collection included two strategies. First, previous systematic reviews were searched for studies that met the inclusion criteria of the current review. Second, a new search was done, covering the time since the previous reviews, i.e. January 2013 to May 2017. Five search concepts were combined in order to capture relevant literature: stigma, mental health, intervention, PHC staff and LMICs. A qualitative analysis of all included full-texts was done with software MAXQDA. Full-texts were analysed with regards to the content of interventions, didactic methods, mental disorders, cultural adaptation, type of outcome measure and primary outcomes. Furthermore, a risk of bias assessment was undertaken. Results A total of 18 studies were included. Risk of bias was rated as high in most included studies. Only six studies had tested their intervention against a control condition, two of which had used random allocation. Most frequently used interventions were lectures providing theoretical information. Many studies also used interactive methods (N = 9), discussed case studies (N = 8) or used role plays (N = 5). Three studies reported that they had used clinical practice and supervision. Results of these studies were mixed. No or little effects were found for brief training interventions (e.g. 1 h to 1 day). Longer training interventions with more sophisticated didactic methods produced statistically significant changes in validated stigma questionnaires. These results have to be interpreted with caution due to risk of bias. Methods for cultural adaptation of interventions were rarely documented. Conclusions More rigorous trials are needed in LMICs to test interventions that target discriminatory behaviours in relationship with patients. Cultural adaptation of stigma interventions and structural/institutional factors should be more explicitly addressed in such trials.

scholarly journals Neighborhood Violence Impacts Disease Control and Surveillance: Case Study of Cali, Colombia from 2014 to 2016

2018 ◽  
Vol 15 (10) ◽  
pp. 2144 ◽  
Author(s):  
Amy Krystosik ◽  
Andrew Curtis ◽  
A. LaBeaud ◽  
Diana Dávalos ◽  
Robinson Pacheco ◽  
...  
Keyword(s):  
Preventive Health Services ◽  
Middle Income ◽  
Vector Borne Diseases ◽  
Middle Income Countries ◽  
Increased Risk ◽  
Health Related ◽  
Vector Borne ◽  
Arboviral Transmission ◽  
The Impact

Arboviruses are responsible for a large burden of disease globally and are thus subject to intense epidemiological scrutiny. However, a variable notably absent from most epidemiological analyses has been the impact of violence on arboviral transmission and surveillance. Violence impedes surveillance and delivery of health and preventative services and affects an individual’s health-related behaviors when survival takes priority. Moreover, low and middle-income countries bear a disproportionately high burden of violence and related health outcomes, including vector borne diseases. To better understand the epidemiology of arboviral outbreaks in Cali, Colombia, we georeferenced chikungunya (CHIKV), dengue (DENV), and Zika (ZIKV) viral cases from The National System of Surveillance in Public Health between October 2014 and April 2016. We extracted homicide data from the municipal monthly reports and kernel density of homicide distribution from IdeasPaz. Crucially, an overall higher risk of homicide is associated with increased risk of reported DENV, lower rates of acute testing, and higher rates of lab versus clinical discordance. In the context of high violence as a potential barrier to access to preventive health services, a community approach to improve health and peace should be considered.

scholarly journals Mexican Psychiatric Trainees’ Attitudes Towards People with Mental Illness: A Qualitative Study

2021 ◽  
Author(s):  
Emmeline Lagunes-Cordoba ◽  
Roberto Lagunes-Cordoba ◽  
Ana Fresan-Orellana ◽  
Jorge Gonzalez-Olvera ◽  
Manuela Jarrett ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Borderline Personality ◽  
Mental Health Stigma ◽  
Service Users ◽  
Negative Attitudes ◽  
Individual Interviews ◽  
People With Mental Illness ◽  
Related Stigma ◽  
Health Related

AbstractDespite their training, psychiatrists have been found to have negative attitudes towards people with mental illness, including the patients they treat. Similarly, studies focused on service users have identified psychiatrists as a source of stigma. Even though negative attitudes in psychiatrists have been identified in different countries and settings, in Mexico the attitudes of these professionals have never been assessed. Because of this, we invited psychiatric trainees from a hospital in Mexico to participate in individual interviews to describe their opinions regarding mental health-related stigma, to evaluate their attitudes towards people with mental illness and to identify factors that could be influencing their attitudes. Interviews were audio recorded, transcribed and analysed using thematic analysis. A total of 29 trainees participated in the study. The results suggested that trainees recognised psychiatrists can have negative attitudes towards people with mental illness, such as poor empathy, judgement and labelling, and mainly towards patients considered difficult and with borderline personality disorder. Participants recognised these attitudes can influence their relationship with patients, and considered it is necessary to develop interventions to improve their own attitudes and reduce mental health stigma. From this study we concluded Mexican psychiatrists are not free from stigma towards people with mental illness. However, Mexican psychiatric trainees are interested in improving their attitudes and reactions towards their patients.

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