scholarly journals The Friendship Bench as a brief psychological intervention with peer support in rural Zimbabwean women: a mixed methods pilot evaluation

2021 ◽  
Vol 8 ◽  
Author(s):  
Shamiso Fernando ◽  
Tim Brown ◽  
Kavita Datta ◽  
Dzivaidzo Chidhanguro ◽  
Naume V. Tavengwa ◽  
...  
Keyword(s):  
Problem Solving ◽  
Mental Disorders ◽  
Peer Support ◽  
Low Income ◽  
Rural Women ◽  
Rural Areas ◽  
Common Mental Disorders ◽  
Psychological Intervention ◽  
Treatment Gap ◽  
Problem Solving Therapy

Abstract Background There is a large treatment gap for common mental disorders in rural areas of low-income countries. We tested the Friendship Bench as a brief psychological intervention delivered by village health workers (VHWs) in rural Zimbabwe. Methods Rural women identified with depression in a previous trial received weekly home-based problem-solving therapy from VHWs for 6 weeks, and joined a peer-support group. Depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS) and Shona Symptom Questionnaire (SSQ). Acceptability was explored through in-depth interviews and focus group discussions. The proportion of women with depression pre- and post-intervention was compared using McNemar's test. Results Ten VHWs delivered problem-solving therapy to 27 women of mean age 33 years; 25 completed six sessions. Women valued an established and trustful relationship with their VHW, which ensured confidentiality and prevented gossip, and reported finding individual problem-solving therapy beneficial. Peer-support meetings provided space to share problems, solutions and skills. The proportion of women with depression or suicidal ideation on the EPDS declined from 68% to 12% [difference 56% (95% confidence interval (CI) 27.0–85.0); p = 0.001], and the proportion scoring high (>7) on the SSQ declined from 52% to 4% [difference 48% (95% CI 24.4–71.6); p < 0.001] after the 6-week intervention. Conclusion VHW-delivered problem-solving therapy and peer-support was acceptable and showed promising results in this pilot evaluation, leading to quantitative and qualitative improvements in mental health among rural Zimbabwean women. Scale-up of the Friendship Bench in rural areas would help close the treatment gap for common mental disorders.

scholarly journals Common Mental Disorders and Its Socio-Demographic Correlates Among Women Of Reproductive Age In Urban And Rural Area Of Meerut

2020 ◽  
Vol 32 (2) ◽  
pp. 359-364
Author(s):  
Vertika Agarwal ◽  
Seema Jain ◽  
Sunil Kumar Garg ◽  
Ganesh Singh ◽  
Chhaya Mittal
Keyword(s):  
Mental Disorders ◽  
Urban Area ◽  
Rural Area ◽  
Low Income ◽  
Rural Women ◽  
Common Mental Disorders ◽  
Demographic Variables ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Self Reporting Questionnaire

Background: Common Mental disorders are distress states manifesting with anxiety, depressive and unexplained somatic symptoms categorized as ‘neurotic, stress-related and somatoform disorders’ in ICD-10. These are 2-3 times more common in women than in men and also more in urban area than rural. Women of reproductive age are at higher risk especially those with social disadvantage, low income and low education. Aims & Objectives: To assess the prevalence of common mental disorders and associated socio-demographic factors among women of reproductive age (15-49 years) residing in urban and rural area of Meerut. Material and Methods: This was a cross-sectional study done in urban and rural area of Meerut from June 2018 to October 2019. 267 women in reproductive age (15-49years) were interviewed in urban as well as rural area using a predesigned pretested questionnaire regarding socio-demographic profile. Self- Reporting Questionnaire-20 was used to determine presence of common mental disorders. Results: Overall prevalence of common mental disorders among women of reproductive age group was 19.8%(106) with 24.2%(65) in urban and 15.4%(41) in rural area. Statistical analysis revealed that various socio-demographic variables like belonging to urban area (24.2%),being widowed/separated (urban-85.7%;rural-75.0%), belonging to broken family(urban-54.5%%; rural-58.3%), being employed(urban-39.6%;rural-33.3%) and lower socio-economic status(urban-54.5%;rural-40.0%) were significantly associated with presence of common mental disorders. In urban women increasing age was also associated with common mental disorders. Conclusion: The study revealed a high prevalence of common mental disorders in both urban and rural area and a significant association with various socio-demographic variables.

scholarly journals Cost-effectiveness of referral for generic care or problem-solving treatment from community mental health nurses, compared with usual general practitioner care for common mental disorders

2006 ◽  
Vol 189 (1) ◽  
pp. 50-59 ◽  
Author(s):  
Tony Kendrick ◽  
Lucy Simons ◽  
Laurence Mynors-Wallis ◽  
Alastair Gray ◽  
Judith Lathlean ◽  
...  
Keyword(s):  
Mental Health ◽  
Cost Effectiveness ◽  
Problem Solving ◽  
Community Mental Health ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
Mental Health Nurses ◽  
Nurse Care ◽  
Gp Care ◽  
Community Mental Health Nurses

BackgroundUK general practitioners (GPs) refer patients with common mental disorders to community mental health nurses.AimsTo determine the effectiveness and cost-effectiveness of this practice.MethodRandomised trial with three arms: usual GP care, generic mental health nurse care, and care from nurses trained in problem-solving treatment; 98 GPs in 62 practices referred 247 adult patients with new episodes of anxiety, depression and life difficulties, to 37 nurses.ResultsThere were 212 (86%) and 190 (77%) patients followed up at 8 and 26 weeks respectively. No significant differences between groups were found in effectiveness at either point. Mean differences in Clinical Interview Schedule – Revised scores at 26 weeks compared with GP care were –1.4 (95% Cl –5.5 to 2.8) for generic nurse care, and 1.1 (–2.9 to 5.1) for nurse problem-solving. Satisfaction was significantly higher in both nurse-treated groups. Mean extra costs per patient were £283 (95% Cl 154–411) for generic nurse care, and £315 (183–481) for nurse problem-solving treatment.ConclusionsGPs should not refer unselected patients with common mental disorders to specialist nurses. Problem-solving should be reserved for patients who have not responded to initial GP care.

scholarly journals Optimising implementation strategies of the first scaleup of a primary care psychological intervention for common mental disorders in Sub-Saharan Africa: a mixed methods study protocol for the optimised Friendship Bench (OptFB)

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e045481
Author(s):  
Ruth Verhey ◽  
Charmaine Chitiyo ◽  
Sandra Ngonidzashe Mboweni ◽  
Ephraim Chiriseri ◽  
Dixon Chibanda ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
Psychological Intervention ◽  
Controlled Trial ◽  
Implementation Strategies ◽  
Evaluation Framework ◽  
Sub Saharan Africa ◽  
Clinical Trial Registry ◽  
Randomised Controlled

IntroductionCommon mental disorders (CMDs) are a leading cause of disability globally. CMDs are highly prevalent in Zimbabwe and have been addressed by an evidence-based, task-shifting psychological intervention called the Friendship Bench (FB). The task-shifted FB programme guides clients through problem-solving therapy. It was scaled up across 36 implementation sites in Zimbabwe in 2016.Methods and analysisThis study will employ a mixed-method framework. It aims to: (1) use quantitative survey methodologies organised around the Reach, Effectiveness, Adoption and Implementation and Maintenance evaluation framework to assess the current scaleup of the FB intervention and classify 36 clinics according to levels of performance; (2) use qualitative focus group discussions and semistructured interviews organised around the Consolidated Framework for Implementation Research to analyse determinants of implementation success, as well as elucidate heterogeneity in implementation strategies through comparing high-performing and low-performing clinics; and (3) use the results from aims 1 and 2 to develop strategies to optimise the Friendship Bench intervention and apply this model in a cluster randomised controlled trial to evaluate potential improvements among low-performing clinics. The trial will be registered with the Pan African Clinical Trial Registry (www.pactr.org). The planned randomised controlled trial for the third research aim will be registered after completing aims one and two because the intervention is dependent on knowledge generated during these phases.Ethics and disseminationThe research protocol received full authorisation from the Medical Research Council of Zimbabwe (MRCZ A/242). It is anticipated that changes in data collection tools and consent forms will take place at all three phases of the study and approval from MRCZ will be sought. All interview partners will be asked for informed consent. The research team will prioritise open-access publications to disseminate research results.

scholarly journals The Use of Antidepressants, Anxiolytics, Sedatives and Hypnotics in Europe: Focusing on Mental Health Care in Portugal and Prescribing in Older Patients

2020 ◽  
Vol 17 (22) ◽  
pp. 8612
Author(s):  
Marta Estrela ◽  
Maria Teresa Herdeiro ◽  
Pedro Lopes Ferreira ◽  
Fátima Roque
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Health Care ◽  
Older Patients ◽  
Common Mental Disorders ◽  
Health Policies ◽  
Depression And Anxiety ◽  
Treatment Gap ◽  
Mental Health Policies

(1) Background: Mental disorders are a growing concern in the 21st century. The most prevalent common mental disorders include depression and anxiety. It is predicted that half of the population will at some point in their lives experience one or more mental disorders. Although common mental disorders are highly prevalent, some of the most significant related problems are the wide treatment gap and the excessive use of antidepressants, anxiolytics and sedatives/hypnotics, especially among older patients. (2) Methods: This study aimed to analyze mental health care in Portugal, with a focus on the consumption of antidepressants, anxiolytics, sedatives and hypnotics among older patients. (3) Results: The use of antidepressants, anxiolytics, sedatives and hypnotics has increased overall across Europe. In Portugal, a downward trend of sedatives and hypnotics consumption can be observed. Anxiolytics and antidepressants, on the other hand, have been increasing. Patients aged ≥60 years old consume more than half of the aforementioned drugs. (4) Conclusions: Mental health policies should be designed to improve the conscientious use of antidepressants, anxiolytics, sedatives and hypnotics, particularly among older adults.

scholarly journals Preventing sickness absence among employees with common mental disorders or stress-related symptoms at work: a cluster randomised controlled trial of a problem-solving-based intervention conducted by the Occupational Health Services

2020 ◽  
Vol 77 (7) ◽  
pp. 454-461 ◽  
Author(s):  
Marijke Keus van de Poll ◽  
Lotta Nybergh ◽  
Caroline Lornudd ◽  
Jan Hagberg ◽  
Lennart Bodin ◽  
...  
Keyword(s):  
Mental Health ◽  
Problem Solving ◽  
Mental Disorders ◽  
Occupational Health ◽  
Sickness Absence ◽  
Primary Outcome ◽  
Common Mental Disorders ◽  
Significant Group ◽  
Secondary Outcomes

ObjectivesCommon mental disorders (CMDs) are among the main causes of sickness absence and can lead to suffering and high costs for individuals, employers and the society. The occupational health service (OHS) can offer work-directed interventions to support employers and employees. The aim of this study was to evaluate the effect on sickness absence and health of a work-directed intervention given by the OHS to employees with CMDs or stress-related symptoms.MethodsRandomisation was conducted at the OHS consultant level and each consultant was allocated into either giving a brief problem-solving intervention (PSI) or care as usual (CAU). The study group consisted of 100 employees with stress symptoms or CMDs. PSI was highly structured and used a participatory approach, involving both the employee and the employee’s manager. CAU was also work-directed but not based on the same theoretical concepts as PSI. Outcomes were assessed at baseline, at 6 and at 12 months. Primary outcome was registered sickness absence during the 1-year follow-up period. Among the secondary outcomes were self-registered sickness absence, return to work (RTW) and mental health.ResultsA statistical interaction for group × time was found on the primary outcome (p=0.033) and PSI had almost 15 days less sickness absence during follow-up compared with CAU. Concerning the secondary outcomes, PSI showed an earlier partial RTW and the mental health improved in both groups without significant group differences.ConclusionPSI was effective in reducing sickness absence which was the primary outcome in this study.

Sign in / Sign up

Export Citation Format

Share Document