scholarly journals Health workers’ health in face of disasters: what the experience in Brumadinho, Brazil, taught us

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M S A Lazarino ◽  
J P S A Lazarino ◽  
J M da Silva

Abstract When the Dam I of Córrego do Feijão mine ruptured, in the municipality of Brumadinho, Minas Gerais, Brazil, on 25/01/2019, the released mudflow of iron mining residues caused environmental, human, social, cultural and economic damages in 18 municipalities. It also resulted in psychosocial suffering for all the populace and 272 immediate deaths, 259 of which were occupational accidents, thus being considered the largest expanded occupational accident in Latin America. In this context, the public health workers involved in the care of affected populations presented risks of developing mental illness. The team in the Workeŕs Health Reference Centre (Cerest) observed signs of mental suffering in multiple Primary Health Care workers of Brumadinho. Cerest professionals proposed the realization of therapeutic groups, which did not occur due to the high level of demand generated by the accident. As such, individual consultations were provided by 3 psychologists on duty, on the workplaces that had more complaints. 20 workers with symptoms like insomnia, fatigue and body aches were assisted.Among the 20 patients, 2 were referred to specialized treatment and 3 left the municipality. As such, despite having shown positive effects, the results from this therapeutic approach are not final. The consultations and formal identification of this demand based the creation of a care project centered in therapeutic groups for workers of the health system and other public sectors, like social assistance. This experience shows that the mental health of the response and repair workers was severely neglected. Said professionals, once inserted in a context of high demands and urgency, were not only subjected to more distress, but also had limited opportunities to seek or receive care. As an expanded occupational accident, the unique perspective from teams specialized in occupational health played a key role in this practice, which facilitated the proper assistance required for such a scenario. Key messages This experience reaffirms the need to include health care measures, including mental health, for workers responsible for assisting populations affected by disasters. Worker’s Health Reference Centres of the Brazilian public healthcare system have a prominent role in health vigilance and assistance for all workers affected by expanded occupational accidents.

2018 ◽  
Author(s):  
Tanjir Rashid Soron

UNSTRUCTURED Though health and shelter are two basic human rights, millions of refugees around the world are deprived of these basic needs. Moreover, the mental health need is one of least priority issues for the refugees. Bangladesh a developing country in the Southeast Asia where the health system is fragile and the sudden influx of thousands of Rohingya put the system in a more critical situation. It is beyond the capacity of the country to provide the minimum mental health care using existing resource. However, the refuges need immediate and extensive mental health care as the trauma, torture and being uprooted from homeland makes them vulnerable for various mental. Telepsychiatry (using technology for mental health service) opened a new window to provide mental health service for them. Mobile phone opened several options to reach to the refugees, screen them with mobile apps, connect them with self-help apps and system, track their symptoms, provide distance intervention and train the frontline health workers about the primary psychological supports. The social networking sites give the opportunity to connect the refugees with experts, create peer support group and provide interventions. Bangladesh can explore and can use the telepsychiatry to provide mental health service to the rohingya people.


2017 ◽  
Vol 28 (3) ◽  
pp. 371-380 ◽  
Author(s):  
Jessica Holley ◽  
Steven Gillard

There is a lack of literature evaluating the development and use of vignettes to explore contested constructs in qualitative health care research where a conventional interview schedule might impose assumptions on the data collected. We describe the development and validation of vignettes in a study exploring mental health worker and service user understandings of risk and recovery in U.K. mental health services. Focus groups with mental health workers and service users explored study questions from experiential perspectives. Themes identified in the groups were combined with existing empirical literature to develop a set of vignettes. Feedback focus groups were conducted to validate and amend the vignettes. Following use in research interviews, results suggested that the vignettes had successfully elicited data on issues of risk and recovery in mental health services. Further research using creative, comparative methods is needed to fully understand how vignettes can best be used in qualitative health care research.


Author(s):  
Paul Harrison ◽  
Philip Cowen ◽  
Tom Burns ◽  
Mina Fazel

‘Global psychiatry’ discusses the global mental health movement. Across the globe, and especially in low- and middle-income settings, there is a high prevalence of untreated psychiatric illness. In lower resourced settings there is often the need to address the added influence of poverty. The chapter discusses the question of how to scale up services and models, including using lay mental health workers and also integration of mental health care into primary health care settings to better meet the needs of those suffering from psychiatric illnesses across the globe. Four areas are discussed in more detail—the HIV/AIDS pandemic, perinatal mental illness, child and adolescent mental health, and humanitarian emergencies.


Expert public psychiatrists use case studies to share best practice strategies in this clinically oriented introduction to community mental health. Today, the majority of psychiatrists work with people who suffer not only from mental illness but also from poverty, trauma, social isolation, and discrimination. Psychiatrists cannot do this work alone but, instead, are part of teams of behavioral health workers navigating larger health care and social service systems. In an increasingly complex health care environment, mental health clinicians need to master systems-based practice in order to provide optimal care to their patients. The rapid development of public psychiatry training programs is a response to the learning needs of psychiatrists in an evolving system. This book begins with seven foundational principles of public psychiatry—recovery, trauma-informed care, integrated care, cultural humility, harm reduction, systems of care, and financing care—using cases to bring these concepts to life. Then, using a population health framework, cases are used to explore the typical needs of different age groups or vulnerable populations and to illustrate evidence-based/best practices that have been employed to meet these needs. Common to all of the chapters is a focus on the potential of each person, regardless of illness, to achieve personal goals, supported by a clinician who is also an advocate, activist, and leader.


2015 ◽  
Vol 2 ◽  
Author(s):  
P. K. Maulik ◽  
S. Devarapalli ◽  
S. Kallakuri ◽  
D. Praveen ◽  
V. Jha ◽  
...  

Background.India has few mental health professionals to treat the large number of people suffering from mental disorders. Rural areas are particularly disadvantaged due to lack of trained health workers. Ways to improve care could be by training village health workers in basic mental health care, and by using innovative methods of service delivery. The ongoing Systematic Medical Appraisal, Referral and Treatment Mental Health Programme will assess the acceptability, feasibility and preliminary effectiveness of a task-shifting mobile-based intervention using mixed methods, in rural Andhra Pradesh, India.Method.The key components of the study are an anti-stigma campaign followed by a mobile-based mental health services intervention. The study will be done across two sites in rural areas, with intervention periods of 1 year and 3 months, respectively. The programme uses a mobile-based clinical decision support tool to be used by non-physician health workers and primary care physicians to screen, diagnose and manage individuals suffering from depression, suicidal risk and emotional stress. The key aim of the study will be to assess any changes in mental health services use among those screened positive following the intervention. A number of other outcomes will also be assessed using mixed methods, specifically focussed on reduction of stigma, increase in mental health awareness and other process indicators.Conclusions.This project addresses a number of objectives as outlined in the Mental Health Action Plan of World Health Organization and India's National Mental Health Programme and Policy. If successful, the next phase will involve design and conduct of a cluster randomised controlled trial.


2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Kyaw Lin ◽  
Sun Lin ◽  
Than Tun Sein

PurposeMyanmar has an insufficient number of mental health workers with few institutional facilities resulting in a significant treatment gap. Although few mental health services are integrated into primary health care (PHC), the challenges are unknown. This study aimed to assess the challenges perceived by providers in the service delivery of satellite mental health care (SMHC) in two sample townships in Yangon.Design/methodology/approachThe research was based on a case study design by applying a qualitative approach using in-depth interviews (IDIs). In the three types of service providers, a total of six staff participated as interviewees. These consisted of two team leaders, two clinical specialists providing consultations to clients and two mental health nurses.FindingsProviders perceived the following as major challenges in the provision of services: unstable financial resources and management, insufficient human resources and capacity of service providers, restricted outpatient services, the lack of a functional referral system, overcrowding, inadequate individual consultation time, long-waiting hours, finite opening days and hours and poor setting of infrastructure, resulting in lack of privacy.Research limitations/implicationsIn the absence of similar studies in Myanmar, findings could not be placed in the context of the national literature for comparison. Further, the study involved a limited number of respondents, which may have affected the findings.Originality/valueAlthough the challenges revealed were not uncommon in mental health services in developing countries, this study focused on a specific model of mental health care integrated into general healthcare settings in Myanmar. The findings offer a benchmark on efforts to develop decentralized mental health services in Myanmar and provide input for future in-depth studies.


2021 ◽  
Vol 32 (120) ◽  
pp. 143-155
Author(s):  
Edgar Landa-Ramírez ◽  
Cintia Tamara Sánchez-Cervantes ◽  
Sofía Sánchez-Román ◽  
Eryka del Carmen Urdapilleta-Herrera ◽  
Jorge Luis Basulto-Montero ◽  
...  

Around the world, the COVID-19 pandemic has generated clinical challenges for health personnel in general and hospital personnel in particular. In Mexico, the clinical psychologists who are part of the local hospital systems have adapted professional practices to provide mental health care in COVID-19 frontline hospitals. This text describes the actions and challenges arising from treating patients, families, and health workers in six COVID-19 hospitals in Mexico. It highlights the main problems identified, strategies to address them, and the barriers encountered during this pandemic. Finally, this document may be useful for planning clinical psychological activities within COVID-19 hospitals in places where new waves of contagion appear.


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