scholarly journals Improving mental health among people living with HIV: a review of intervention trials in low- and middle-income countries

2015 ◽  
Vol 2 ◽  
Author(s):  
K. J. Sikkema ◽  
A. C. Dennis ◽  
M. H. Watt ◽  
K. W. Choi ◽  
T. T. Yemeke ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Intervention ◽  
Health Interventions ◽  
People Living With Hiv ◽  
Mental Health Intervention ◽  
Middle Income ◽  
Middle Income Countries ◽  
Mental Health Interventions ◽  
Intervention Trials ◽  
Living With Hiv

People living with HIV (PLWH) experience greater psychological distress than the general population. Evidence from high-incomes countries suggests that psychological interventions for PLWH can improve mental health symptoms, quality of life, and HIV care engagement. However, little is known about the effectiveness of mental health interventions for PLWH in low- and middle-income countries (LMICs), where the large majority of PLWH reside. This systematized review aims to synthesize findings from mental health intervention trials with PLWH in LMICs to inform the delivery of mental health services in these settings. A systematic search strategy was undertaken to identify peer-reviewed published papers of intervention trials addressing negative psychological states or disorders (e.g. depression, anxiety) among PLWH in LMIC settings. Search results were assessed against pre-established inclusion and exclusion criteria. Data from papers meeting criteria were extracted for synthesis. Twenty-six papers, published between 2000 and 2014, describing 22 unique interventions were identified. Trials were implemented in sub-Saharan Africa (n = 13), Asia (n = 7), and the Middle East (n = 2), and addressed mental health using a variety of approaches, including cognitive-behavioral (n = 18), family-level (n = 2), and pharmacological (n = 2) treatments. Four randomized controlled trials reported significant intervention effects in mental health outcomes, and 11 preliminary studies demonstrated promising findings. Among the limited mental health intervention trials with PLWH in LMICs, few demonstrated efficacy. Mental health interventions for PLWH in LMICs must be further developed and adapted for resource-limited settings to improve effectiveness.

scholarly journals Employees’ Perspectives on the Facilitators and Barriers to Engaging With Digital Mental Health Interventions in the Workplace: Qualitative Study

2018 ◽  
Vol 5 (1) ◽  
pp. e8 ◽  
Author(s):  
Stephany Carolan ◽  
Richard O de Visser
Keyword(s):  
Mental Health ◽  
Controlled Trial ◽  
Health Intervention ◽  
Health Interventions ◽  
Mental Health Intervention ◽  
Depression And Anxiety ◽  
Occupational Setting ◽  
Mental Health Interventions ◽  
Facilitators And Barriers ◽  
Workplace Setting

Background Prevalence rates of work-related stress, depression, and anxiety are high, resulting in reduced productivity and increased absenteeism. There is evidence that these conditions can be successfully treated in the workplace, but take-up of psychological treatments among workers is low. Digital mental health interventions delivered in the workplace may be one way to address this imbalance, but although there is evidence that digital mental health is effective at treating stress, depression, and anxiety in the workplace, uptake of and engagement with these interventions remains a concern. Additionally, there is little research on the appropriateness of the workplace for delivering these interventions or on what the facilitators and barriers to engagement with digital mental health interventions in an occupational setting might be. Objective The aim of this research was to get a better understanding of the facilitators and barriers to engaging with digital mental health interventions in the workplace. Methods Semistructured interviews were held with 18 participants who had access to an occupational digital mental health intervention as part of a randomized controlled trial. The interviews were transcribed, and thematic analysis was used to develop an understanding of the data. Results Digital mental health interventions were described by interviewees as convenient, flexible, and anonymous; these attributes were seen as being both facilitators and barriers to engagement in a workplace setting. Convenience and flexibility could increase the opportunities to engage with digital mental health, but in a workplace setting they could also result in difficulty in prioritizing time and ensuring a temporal and spatial separation between work and therapy. The anonymity of the Internet could encourage use, but that benefit may be lost for people who work in open-plan offices. Other facilitators to engagement included interactive and interesting content and design features such as progress trackers and reminders to log in. The main barrier to engagement was the lack of time. The perfect digital mental health intervention was described as a website that combined a short interactive course that was accessed alongside time-unlimited information and advice that was regularly updated and could be dipped in and out of. Participants also wanted access to e-coaching support. Conclusions Occupational digital mental health interventions may have an important role in delivering health care support to employees. Although the advantages of digital mental health interventions are clear, they do not always fully translate to interventions delivered in an occupational setting and further work is required to identify ways of minimizing potential barriers to access and engagement. Trial Registration ClinicalTrials.gov: NCT02729987; https://clinicaltrials.gov/ct2/show/NCT02729987?term=NCT02729987& rank=1 (Archived at WebCite at http://www.webcitation.org/6wZJge9rt)

scholarly journals Employees� Perspectives on the Facilitators and Barriers to Engaging With Digital Mental Health Interventions in the Workplace: Qualitative Study (Preprint)

2017 ◽  
Author(s):  
Stephany Carolan ◽  
Richard O de Visser
Keyword(s):  
Mental Health ◽  
Controlled Trial ◽  
Health Intervention ◽  
Health Interventions ◽  
Mental Health Intervention ◽  
Depression And Anxiety ◽  
Occupational Setting ◽  
Mental Health Interventions ◽  
Facilitators And Barriers ◽  
Workplace Setting

BACKGROUND Prevalence rates of work-related stress, depression, and anxiety are high, resulting in reduced productivity and increased absenteeism. There is evidence that these conditions can be successfully treated in the workplace, but take-up of psychological treatments among workers is low. Digital mental health interventions delivered in the workplace may be one way to address this imbalance, but although there is evidence that digital mental health is effective at treating stress, depression, and anxiety in the workplace, uptake of and engagement with these interventions remains a concern. Additionally, there is little research on the appropriateness of the workplace for delivering these interventions or on what the facilitators and barriers to engagement with digital mental health interventions in an occupational setting might be. OBJECTIVE The aim of this research was to get a better understanding of the facilitators and barriers to engaging with digital mental health interventions in the workplace. METHODS Semistructured interviews were held with 18 participants who had access to an occupational digital mental health intervention as part of a randomized controlled trial. The interviews were transcribed, and thematic analysis was used to develop an understanding of the data. RESULTS Digital mental health interventions were described by interviewees as convenient, flexible, and anonymous; these attributes were seen as being both facilitators and barriers to engagement in a workplace setting. Convenience and flexibility could increase the opportunities to engage with digital mental health, but in a workplace setting they could also result in difficulty in prioritizing time and ensuring a temporal and spatial separation between work and therapy. The anonymity of the Internet could encourage use, but that benefit may be lost for people who work in open-plan offices. Other facilitators to engagement included interactive and interesting content and design features such as progress trackers and reminders to log in. The main barrier to engagement was the lack of time. The perfect digital mental health intervention was described as a website that combined a short interactive course that was accessed alongside time-unlimited information and advice that was regularly updated and could be dipped in and out of. Participants also wanted access to e-coaching support. CONCLUSIONS Occupational digital mental health interventions may have an important role in delivering health care support to employees. Although the advantages of digital mental health interventions are clear, they do not always fully translate to interventions delivered in an occupational setting and further work is required to identify ways of minimizing potential barriers to access and engagement. CLINICALTRIAL ClinicalTrials.gov: NCT02729987; https://clinicaltrials.gov/ct2/show/NCT02729987?term=NCT02729987& rank=1 (Archived at WebCite at http://www.webcitation.org/6wZJge9rt)

Heeding the Call of an Innovative Paradigm for Mental Health Interventions in Low- and Middle-income Countries

2021 ◽  
Author(s):  
Arlene G. MacDougall ◽  
Rosemary Lysaght ◽  
Regina Casey ◽  
Marlene Janzen Le Ber ◽  
Victoria Mutiso ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Interventions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Mental Health Interventions ◽  
Low And Middle Income

scholarly journals Evidence on Digital Mental Health Interventions for Adolescents and Young People: Systematic Overview

10.2196/25847 ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. e25847
Author(s):  
Susanna Lehtimaki ◽  
Jana Martic ◽  
Brian Wahl ◽  
Katherine T Foster ◽  
Nina Schwalbe
Keyword(s):  
Mental Health ◽  
Cost Effectiveness ◽  
Young People ◽  
Digital Health ◽  
Health Interventions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Mental Health Interventions ◽  
Meta Analyses ◽  
Low And Middle Income

Background An estimated 1 in 5 adolescents experience a mental health disorder each year; yet because of barriers to accessing and seeking care, most remain undiagnosed and untreated. Furthermore, the early emergence of psychopathology contributes to a lifelong course of challenges across a broad set of functional domains, so addressing this early in the life course is essential. With increasing digital connectivity, including in low- and middle-income countries, digital health technologies are considered promising for addressing mental health among adolescents and young people. In recent years, a growing number of digital health interventions, including more than 2 million web-based mental health apps, have been developed to address a range of mental health issues. Objective This review aims to synthesize the current evidence on digital health interventions targeting adolescents and young people with mental health conditions, aged between 10-24 years, with a focus on effectiveness, cost-effectiveness, and generalizability to low-resource settings (eg, low- and middle-income countries). Methods We searched MEDLINE, PubMed, PsycINFO, and Cochrane databases between January 2010 and June 2020 for systematic reviews and meta-analyses on digital mental health interventions targeting adolescents and young people aged between 10-24 years. Two authors independently screened the studies, extracted data, and assessed the quality of the reviews. Results In this systematic overview, we included 18 systematic reviews and meta-analyses. We found evidence on the effectiveness of computerized cognitive behavioral therapy on anxiety and depression, whereas the effectiveness of other digital mental health interventions remains inconclusive. Interventions with an in-person element with a professional, peer, or parent were associated with greater effectiveness, adherence, and lower dropout than fully automatized or self-administered interventions. Despite the proposed utility of digital interventions for increasing accessibility of treatment across settings, no study has reported sample-specific metrics of social context (eg, socioeconomic background) or focused on low-resource settings. Conclusions Although digital interventions for mental health can be effective for both supplementing and supplanting traditional mental health treatment, only a small proportion of existing digital platforms are evidence based. Furthermore, their cost-effectiveness and effectiveness, including in low- and middle-income countries, have been understudied. Widespread adoption and scale-up of digital mental health interventions, especially in settings with limited resources for health, will require more rigorous and consistent demonstrations of effectiveness and cost-effectiveness vis-à-vis the type of service provided, target population, and the current standard of care.

scholarly journals Mental disorder and mental health interventions for children and youth: the cases of non-suicidal self-harm and unruly behaviour A philosophical inquiry

2021 ◽  
Author(s):  
Snita Ahir-Knight
Keyword(s):  
Mental Health ◽  
Mental Disorder ◽  
Interesting Case ◽  
Health Intervention ◽  
Health Interventions ◽  
Children And Youth ◽  
Mental Health Intervention ◽  
Mental Health Interventions ◽  
Self Harm ◽  
Outcomes For Children

<p><b>Thesis abstract </b></p><p> </p><p>This dissertation is a contribution to the philosophy of mental disorder with a focus on children and youth and questions about what interventions they need. </p><p>I start by asking whether non-suicidal self-harm in youth is a mental disorder. Non-suicidal self-harm involves someone causing themselves harm with no intent to try to kill themselves. Young people cutting themselves alone and when with peers may be viewed as destructive, abnormal and irrational. Yet, I argue that non-suicidal self-harm in youth is never a mental disorder in its own right. Although non-suicidal self-harm in youth is not a disordered behaviour, that does not imply that it never merits intervention. </p><p>This leads to the question of what criteria should be applied when deciding whether to offer mental health interventions. I claim that whether one has a mental disorder should not determine whether one is offered a mental health intervention. The argument is made through considering the cases of non-suicidal self-harm in youth and unruly behaviour in children and youth. Unruly behaviour includes a wailing toddler, a child deliberately breaking items and a youth crossing police lines when protesting. </p><p>Unruly behaviour is another interesting case. In some instances, there is a high likelihood of negative outcomes for some children and youth who are behaving in an unruly way. However, unruly behaviour may also be part of a passing phase and helpful for development. Furthermore, in some cases, unruly behaviour may be praiseworthy, and encouraging unruliness may advance an individual’s welfare. The case of unruly behaviour, then, raises the question of when mental health clinicians should intervene. </p><p>The cases of non-suicidal self-harm and unruly behaviour help make my central claims. I say that behaviours and thoughts that are usually part of a passing phase and produce goods appropriate to that phase of life are not mental disorders; that managing life in the best way one can with the abilities available at a particular stage of life is not disordered; and, furthermore, that whether one has a mental disorder should not determine whether one is offered a mental health intervention. Finally, I say that, rather than depending on whether a person has a mental disorder, interventions should be offered only when they will advance the welfare of the service user. </p><p>My dissertation will appeal to philosophers. I also hope that youth, parents, teachers, clinicians, policy makers and similar will be interested in the contents. This is because important practical questions are asked that challenge common views, and that guide policies and clinical practice to improve the welfare and service outcomes for children and youth. </p>

scholarly journals How does context influence the delivery of mental health interventions for asylum seekers and refugees in low- and middle-income countries? A qualitative systematic review

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Sohail Jannesari ◽  
Claudia Lotito ◽  
Giulia Turrini ◽  
Siân Oram ◽  
Corrado Barbui
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Asylum Seekers ◽  
Health Interventions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Qualitative Systematic Review ◽  
Mental Health Interventions ◽  
Refugees And Asylum Seekers ◽  
Low And Middle Income

Abstract Background Low- and middle-income countries (LMICs) host the majority of the world’s refugees. Evidence suggests that refugees and asylum seekers have high mental health needs compared to the host country population. However, they face many social, economic and culture barriers to receiving mental health care and benefitting from mental health interventions. This paper examines how these contextual factors affect the implementation of mental health interventions for refugees and asylum seekers in LMICs. Methods We conducted a qualitative systematic review searching 11 databases and 24 relevant government and non-governmental organisation (NGO) websites. We spoke with academic experts and NGO professionals for recommendations, and conducted forwards and backwards citation tracking. Results From 2055 records in abstract and title screening, and then 99 in full-text screening, 18 eligible studies were identified. Qualitative thematic synthesis was conducted on eligible papers. Three main thematic clusters were identified around: (1) support during a time of pressure and insecurity, and the need for intervention flexibility through facilitator and participant autonomy; (2) different cultural conceptions of mental health, and how interventions negotiated these differences; and (3) the importance of facilitator skills, knowledge, characteristics and relationships to intervention implementation. Conclusion Evidence suggests that intervention coordinators and developers should continue to: (1) think broadly about the range of social influences on mental health, addressing structural issues where possible; (2) offer flexibility with intervention style, content and timings; and (3) encourage building research capacity in LMICs while acknowledging pre-existing mental health knowledge and practice.

cThe Cultural Adaptation of Step-by-Step: An intervention to address depression among Chinese young adults (Preprint)

2020 ◽  
Author(s):  
Hao Fong Sit ◽  
Rui Ling ◽  
Agnes Iok Fong Lam ◽  
Wen Chen ◽  
Brian Hall
Keyword(s):  
Mental Health ◽  
Young Adults ◽  
Cultural Adaptation ◽  
Ecological Validity ◽  
Health Intervention ◽  
Health Interventions ◽  
Content Adaptation ◽  
Mental Health Intervention ◽  
Mental Health Interventions ◽  
Chinese Young Adults

BACKGROUND Digital mental health interventions leverage digital communication technology to address the mental health needs of populations. Culturally adapting interventions can lead to a successful scalable mental health intervention implementation, and cultural adaptation of digital mental health interventions is a critical component to implementing interventions at scale within contexts where mental health services are not well supported. OBJECTIVE The study aims to describe the cultural adaptation of a digital mental health intervention Step-by-Step in order to address depression among Chinese young adults. METHODS Cultural adaptation was carried out in four phases following Ecological Validity Model: 1) Stage setting and expert consultation; 2) Preliminary content adaptation; 3) Iterative content adaptation with community members; 4) Finalized adaptation with community feedback meetings. Cognitive interviewing was applied to probe for relevance, acceptability, comprehensibility, and completeness of illustrations and text. Six mental health experts and 34 Chinese young adults were recruited for key informant interviews and focus group discussions. RESULTS We adapted the text and illustrations to fits the culture among Chinese young adults. Eight elements of the intervention were chosen as the targets of cultural adaptation (e.g., language, metaphors, content). Samples of major adaptations included: adding scenarios related to university life (relevance), changing leading characters from a physician to a peer and a cartoon (acceptability), incorporating two language versions (traditional Chinese and simplified Chinese) in the intervention (comprehensibility), and maintaining fundamental therapeutic components (completeness). CONCLUSIONS This study showed the utility of using Ecological Validity Model and a four-point procedure framework for cultural adaptation and achieved a culturally appropriate version of the Step-by-Step program for Chinese young adults.

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