P.4.16 Cannabis use and subclinical psychotic symptoms: is the public mental health at risk?

The COVID-19 pandemic heralded challenges that were both significant and unfamiliar, placing inordinate burdens on health care systems, economies, and the collective psyche of citizens. The pandemic underscored the tenuous intersections between public mental health care, politics, economics, and psychosocial capital. In South Africa, the inadequacies of the public health system have been laid bare, and the disproportionate privileges of the private health care system exposed. This article critically considers government responses to the COVID-19 pandemic, the psychosocial correlates of lockdown, politics, corruption, and public mental health policy in South Africa.

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Psychosocial and pharmacological treatments for cannabis use disorder and mental health comorbidities: a narrative review

Psychological Medicine ◽

10.1017/s0033291720005449 ◽

2021 ◽

pp. 1-12

Author(s):

Rachel Lees ◽

Lindsey A. Hines ◽

Deepak Cyril D'Souza ◽

George Stothart ◽

Marta Di Forti ◽

...

Keyword(s):

Mental Health ◽

Clinical Decision Making ◽

Treatment Compliance ◽

Narrative Review ◽

Cannabis Use ◽

Psychotic Symptoms ◽

Motivational Enhancement Therapy ◽

Cannabis Use Disorder ◽

Pharmacological Treatments ◽

Health Comorbidities

Abstract Cannabis is the most widely used illicit drug worldwide, and it is estimated that up to 30% of people who use cannabis will develop a cannabis use disorder (CUD). Demand for treatment of CUD is increasing in almost every region of the world and cannabis use is highly comorbid with mental disorders, where sustained use can reduce treatment compliance and increase risk of relapse. In this narrative review, we outline evidence for psychosocial and pharmacological treatment strategies for CUD, both alone and when comorbid with psychosis, anxiety or depression. Psychosocial treatments such as cognitive behavioural therapy, motivational enhancement therapy and contingency management are currently the most effective strategy for treating CUD but are of limited benefit when comorbid with psychosis. Pharmacological treatments targeting the endocannabinoid system have the potential to reduce cannabis withdrawal and cannabis use in CUD. Mental health comorbidities including anxiety, depression and psychosis hinder effective treatment and should be addressed in treatment provision and clinical decision making to reduce the global burden of CUDs. Antipsychotic medication may decrease cannabis use and cannabis craving as well as psychotic symptoms in patients with CUD and psychosis. Targeted treatments for anxiety and depression when comorbid with CUD are feasible.

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Public mental health services in Mumbai

International Psychiatry ◽

10.1192/s1749367600006056 ◽

2010 ◽

Vol 7 (4) ◽

pp. 97-99

Author(s):

Ajanta Akhuly ◽

Mrinmoyi Kulkarni

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Public Mental Health ◽

Publicly Funded ◽

Special Significance ◽

The Public ◽

Migrant Populations ◽

Public Mental Health Services ◽

The World

Mumbai, India's largest city, also has the distinction of being the most populous city in the world. The association between urbanisation and mental illness has been widely documented (Harpham & Blue, 1995, especially pp. 41–60). Mumbai is characterised by dense slums housing large migrant populations facing stressful lives. The state of publicly funded mental health facilities in Mumbai has special significance in this context, since they are the only resource available to a large economic ally vulnerable section of the population. The objective of the present study was to evaluate the public mental health services in Mumbai and to identify areas for improvement.

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