scholarly journals Conducting global mental health research: lessons learned from Kenya

2021 ◽  
Vol 8 ◽  
Author(s):  
Akash R. Wasil ◽  
Tom L. Osborn ◽  
Katherine E. Venturo-Conerly ◽  
Christine Wasanga ◽  
John R. Weisz

Abstract Mental health disorders are prevalent among youth and adolescents in low- and middle-income countries, and access to evidence-based treatments is poor. Although there is a great need for high-quality research to serve young people in low- and middle-income countries, there is limited guidance available for researchers who wish to conduct such work. Here, we describe our process of conducting school-based youth mental health work in Kenya over the last several years. We focus on five key lessons we learned that could guide future global mental health work with youth: (a) reducing stigma with strengths-focused interventions, (b) expanding access by working in schools, (c) generating buy-in from local stakeholders, (d) adapting the intervention via multicultural collaboration, and (e) applying insights from low- and middle-income countries to serve young people in high-income countries. We conclude by discussing how these lessons, and those shared by other teams, can be applied to help reduce the treatment gap for young people around the world.

2021 ◽  
Author(s):  
Catherine Porter ◽  
Annina Hittmeyer ◽  
Marta Favara ◽  
Douglas Scott ◽  
Alan Sánchez

Background Though COVID-19 presents less risk to young people of serious morbidity or mortality, the resulting economic crisis has impacted their livelihoods. There is relatively little evidence on young people's mental health in Low-and-Middle-Income-Countries (LMICs) as the pandemic has progressed. Methods Two consecutive phone-surveys (August/October and November/December 2020) in Ethiopia, India, Peru and Vietnam interviewed around 9,000 participants of a 20-year cohort study who grew up in poverty (now aged 19 and 26). We investigate how young people's mental health has evolved in the four countries during the pandemic. Rates of (at least mild) anxiety (depression) measured by GAD-7 (PHQ-8) were compared across countries; between males/females, and food secure/food insecure households. Results Overall, rates of at least mild anxiety (depression) significantly decreased in all countries but Ethiopia as infection rates fell. However, young people in food insecure households report high rates of anxiety and depression and have not shown consistent improvements. Food insecure households are poorer, and have significantly more children (p<0.05) except in Ethiopia. Conclusions Food insecurity has increased during the COVID-19 pandemic and is negatively associated with young people's mental health. Urgent support is needed for the most vulnerable. Keywords COVID-19, mental health, anxiety, depression, food insecurity, youth


2015 ◽  
Vol 2 ◽  
Author(s):  
W. A. Tol

The first World Health Organization's global action plan for mental health recognizes the importance of mental health promotion and prevention of mental disorders, through the inclusion of one of four objectives focused on this crucial area of research and practice. This paper aims to provide an ‘aerial view’ of the field of mental health promotion and prevention of mental disorders with a focus on low- and middle-income countries. Starting with reasons why promotion and prevention need to take center stage in global mental health efforts, the paper provides a framework and four general principles to guide such efforts: a socio-ecological perspective (place); an inter-sectoral and interdisciplinary approach (collaboration), a developmental perspective (timing), and a participatory and empowerment approach (strengths), or PaCTS. Evidence-based examples of mental health promotion, universal, selective, and indicated prevention are described.


10.2196/25847 ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. e25847
Author(s):  
Susanna Lehtimaki ◽  
Jana Martic ◽  
Brian Wahl ◽  
Katherine T Foster ◽  
Nina Schwalbe

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.


2018 ◽  
Vol 17 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Folashade T Alloh ◽  
Pramod Regmi ◽  
Igoche Onche ◽  
Edwin Van Teijlingen ◽  
Steven Trenoweth

Despite being globally recognised as an important public health issue, mental health is still less prioritised as a disease burden in many Low-and Middle-Income Countries (LMICs). More than 70% of the global mental health burden occurs in these countries. We discussed mental health issues in LMICs under themes such as abuse and mental illness, cultural influence on mental health, need for dignity in care, meeting financial and workforce gaps and the need for national health policy for the mental health sector. We highlighted that although mental health education and health care services in most LMICs are poorly resourced; there is an urgent need to address issues beyond funding that contribute to poor mental health. In order to meet the increasing challenge of mental health illness in LMICs, there is a need for effort to address cultural and professional challenges that contribute to poor mental health among individuals. We have a notion that mental health should be integrated into primary health care in LMICs. Creating awareness on the impact of some cultural attitudes/practices will encourage better uptake of mental health services and increase the ease when discussing mental health issues in these countries which can contribute to reducing the poor mental health in LMICs.


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