scholarly journals Evaluation of the use of standardized methods to identify mental health problems among refugees

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Delilovic ◽  
K Lonnroth ◽  
A Hagstrom
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Problems ◽  
Health Problems ◽  
Health Screening ◽  
Mental Health Screening ◽  
Health Needs ◽  
Primary Health ◽  
Primary Health Care Centers ◽  
Health Care Centers

Abstract Background The number of refugees arriving and residing in Sweden remains high. They represent one of the most vulnerable sub-populations in the country, who carry a disproportional part of the disease burden. Information on health status, health determinants and the extent to which refugees get access to needed services is limited. In Sweden refugees are offered a free-of -charge health examination (HE). Yet, standardized mental health screening is often neglected as a part of the HE. A pilot project aimed to initiate early mental health screening was implemented. Methods The Refugee Health Screener-13 (RHS-13) was identified as an efficient, valid, and reliable tool for assessing mental health in this population and was integrated into the HE. The RHS-13 was administrated by nurses conducting the HE at two primary health care centers in Stockholm. Results During the one-month pilot 80 individuals were screened. The majority originated from Syria, DR Congo and Afghanistan and the distribution by migration background were 58% quota refugees, 35% asylum seekers and 8% others (family reunification and undocumented migrants). Of those screened, 30% screened positive for risk of mental health (cut off ≥11). Out of those who screened positive, 29% screened for mild mental health, 33% for moderate mental health and 38% for severe mental health problems. No statistically significant differences in RHS score were found according to country of origin, sex and age. The results are preliminary. Implementation will continue for 12 months at 4 primary health care centers. Conclusions This pilot demonstrated feasibility of RHS-13 in routine care. The findings reinforce the need for standardized guidelines and procedures for mental health screening of refugees. Routine mental health screening should be a part of the overall comprehensive HE, which could improve systematic monitoring of mental health care needs for refugees and ensure access to appropriate mental health care. Key messages Standardized procedures for identifying mental health problems among refugees is feasible and can identify health needs while ensuring equitable health examinations. Standardized procedures for identifying mental health problems among refugees is feasible and can identify health needs while ensuring equitable health examinations.

scholarly journals Perception and Attitude toward Mental Illness in Antenatal Mothers in Rural Population of Southern India: A Cross-Sectional Study

2018 ◽  
Vol 09 (04) ◽  
pp. 473-477 ◽  
Author(s):  
Shivani Manjrekar ◽  
Sandeep Patil
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Problems ◽  
Cross Sectional Study ◽  
Health Problems ◽  
Cross Sectional ◽  
Primary Health ◽  
Primary Health Care Centers ◽  
Study Participants ◽  
Health Care Centers

ABSTRACT Background: Mental health disorders globally are on a rise due to various reasons. Gender differences have been one of the reasons. Pregnancy is a stressful event in mothers and it can either exacerbate preexisting mental illness or can give rise to other mental health disorders. Studies have shown that women residing in rural areas are at higher risk of developing mental health problems. Mental health problems have detrimental effects in post-partum period. Most of the complications can be prevented if psychiatric symptoms are detected in early part of pregnancy and if women are aware of these symptoms. Aim: To find the awareness, attitude and perception towards mental illness in antenatal mothers residing in rural area of India. Setting and Design: It's a descriptive cross sectional study conducted at primary health care centers. Methods and Materials: Total of 300 antenatal mothers attending primary health care centers were recruited into the study after a written informed consent was obtained. Statistical Analysis: Basic socio demographic data were collected and a semi structured questionnaire was designed. The participants were interviewed according to the questionnaire. Data collected was analyzed using SPSS software. Results and Conclusion: The mean age of the study participants was 24+5. Of the 300 study participants more than 90% were unaware that mental illness can occur during pregnancy and only around 07% could agree say that it can occur in pregnancy. There is poor awareness of mental health problems amongst pregnant women residing in rural part of southern India. The reasons for the same are lack of awareness, low levels of education, lower socio economic status, cultural beliefs and practices, lack of mental health services and stigma associated with mental illness. There is no routine screening for mental health problems during antenatal visits. If done otherwise could bring down adverse maternal outcome.

scholarly journals POS1321 MENTAL HEALTH SCREENING IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 943.1-943
Author(s):  
S. Eulert ◽  
M. Niewerth ◽  
J. Hörstermann ◽  
C. Sengler ◽  
D. Windschall ◽  
...  
Keyword(s):  
Mental Health ◽  
Young People ◽  
Mental Health Problems ◽  
Functional Limitations ◽  
Health Problems ◽  
Health Screening ◽  
Mental Health Screening ◽  
Psychological Support ◽  
Web Based ◽  
Patient Health

Background:Mental disorders often begin in the vulnerable phase of adolescence and young adulthood. Young people with chronic diseases are particularly at risk. Early recognition of mental health problems is necessary in order to be able to support those affected in a timely and adequate manner. By implementing a web-based generic screening tool for mental health in routine care, patients with juvenile idiopathic arthritis (JIA) and mental health conditions can be identified and provided with targeted treatment.Objectives:To investigate the prevalence of mental health conditions in young people with JIA in routine rheumatology care.Methods:Mental health screening is implemented as an add-on module to the National Paediatric Rheumatology Database (NPRD). The current data was gathered over a period of 24 months. Patients complete the screening tool which includes the Patient Health Questionnaire1 (PHQ-9, score 0-27) and the Generalized Anxiety Disorder scale2 (GAD-7, score 0-21) via a web-based questionnaire. The cut-off for critical values in PHQ-9 and GAD-7 were defined as values ≥ 10. Simultaneously, other data, such as sociodemographic data, disease activity (cJADAS10, score 0-30), functional status (CHAQ, score 0-3) were collected as well.Results:The analysis included 245 patients (75% female) with a mean age of 15.7 years and a mean disease duration of 8.8 years. 38.8% of the patients had oligoarthritis (18.0% OA, persistent/20.8% OA, extended) and 23.3% RF negative polyarthritis. At the time of documentation 49 patients (30.6%) had an inactive disease (cJADAS10 ≤ 1) and 120 (49.4%) no functional limitations (CHAQ = 0). In total, 53 patients (21.6%) had screening values in either GAD-7 or PHD-9 ≥10. Patients with critical mental health screening values showed higher disease activity and more frequent functional limitations than inconspicuous patients (cJADAS10 (mean ± SD): 9.3 ± 6 vs. 4.9 ± 4.9; CHAQ: 0.66 ± 0.6 vs. 0.21 ± 0.42). When compared to males, females were significantly more likely to report either depression or anxiety symptoms (11.7% vs. 24.9%, p = 0.031).17.6% of all patients with valid items for these data reported to receive psychological support, meaning psychotherapeutic support (14.5%) and/or drug therapy (8.6%). Among those with a critical mental health screening score, 38.7% received psychological support (psychotherapeutic support (35.5%) and/or drug therapy (16.1%)).Conclusion:Every fifth young person with JIA reported mental health problems, however, not even every second of them stated to receive psychological support. The results show that screening for mental health problems during routine adolescent rheumatology care is necessary to provide appropriate and targeted support services to young people with a high burden of illness.References:[1]Löwe B, Unützer J, Callahan CM, Perkins AJ, Kroenke K. Monitoring depression treatment outcomes with the patient health questionnaire-9. Med Care. 2004 Dec;42(12):1194-201.[2]Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006 May 22; 166(10):1092-7.[3]The screening data were collected as part of COACH (Conditions in Adolescents: Implementation and Evaluation of Patient-centred Collaborative Healthcare), a project supported by the Federal Ministry of Education and Research (FKZ: 01GL1740F).Disclosure of Interests:Sascha Eulert: None declared, Martina Niewerth: None declared, Jana Hörstermann: None declared, Claudia Sengler: None declared, Daniel Windschall: None declared, Tilmann Kallinich: None declared, Jürgen Grulich-Henn: None declared, Frank Weller-Heinemann Consultant of: Pfizer, Abbvie, Sobi, Roche, Novartis, Ivan Foeldvari Consultant of: Gilead, Novartis, Pfizer, Hexal, BMS, Sanofi, MEDAC, Sandra Hansmann: None declared, Harald Baumeister: None declared, Reinhard Holl: None declared, Doris Staab: None declared, Kirsten Minden: None declared

scholarly journals Mental Health in Children with Cerebral Palsy: Does Screening Capture the Complexity?

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
H. M. Bjorgaas ◽  
I. Elgen ◽  
T. Boe ◽  
M. Hysing
Keyword(s):  
Mental Health ◽  
Cerebral Palsy ◽  
Psychiatric Disorders ◽  
Mental Health Problems ◽  
Health Problems ◽  
Health Screening ◽  
Mental Health Screening ◽  
High Prevalence ◽  
Children With Cerebral Palsy ◽  
Bergen Child Study

Introduction. Children with cerebral palsy (CP), one of the most common childhood neurological disorders, often have associated medical and psychological symptoms. This study assesses mental health problems compared to population controls and the ability of a mental health screening tool to predict psychiatric disorders and to capture the complexity of coexisting symptoms.Methods. Children with CP (N=47) were assessed according to DSM-IV criteria using a psychiatric diagnostic instrument (Kiddie-SADS) and a mental health screening questionnaire (SDQ). Participants from the Bergen Child Study, a large epidemiological study, served as controls.Results. Children with CP had significantly higher means on all problem scores including impact scores. Two in three children scored above 90th percentile cutoff on Total Difficulties Score (TDS), and 57% met criteria for a psychiatric disorder, yielding a sensitivity of 0.85 and a specificity of 0.55. Mental health problems coexisted across symptom scales, and peer problems were highly prevalent in all groups of psychiatric disorders.Conclusion. A high prevalence of mental health problems and cooccurrence of symptoms were found in children with CP compared to controls. Screening with SDQ detects mental health problems, but does not predict specific disorders in children with CP. ADHD is common, but difficult to diagnose due to complexity of symptoms. Mental health services integrated in regular followup of children with CP are recommended due to high prevalence and considerable overlap of mental health symptoms.

scholarly journals Impact of mental health and addiction NIMHANS ECHO on primary care physicians: study from a rural state of India

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S157-S157
Author(s):  
Shabinabegam A M Sheth ◽  
Bhavya Bairy ◽  
Aurobind Ganesh ◽  
Sumi Jain ◽  
Prabhat Chand ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Mental Health Problems ◽  
Health Problems ◽  
Care Providers ◽  
Primary Health ◽  
Secondary Outcomes

AimsAs per National Mental Health Survey-2015-16, 83 out of 100 people having mental health problems do not have access to care in India. Further, primary health care providers (PCPs) have not been adequately trained in the screening, diagnosis, and initial management of common mental health conditions. There is thus a need to train health care providers at the State level to incorporate mental health into primary health care. In this paper, we report the findings of a collaborative project between the National Institute of Mental Health and Neuro Sciences (NIMHANS) Bangalore India, and the state of Chhattisgarh incorporating mental health into primary care and addressing urban-rural disparities through tele-mentoring.MethodWe assessed the impact of the NIMHANS Extended Community Health Care Outcome (ECHO), an online, blended training program on participants' knowledge and competence (primary outcome) and commitment, satisfaction, and performance (Secondary outcomes) using Moore's evaluation framework. Primary and secondary outcomes were determined through a pre-post evaluation, assessment of trainee participation in the quarterly tele ECHO clinic as well as periodic assignments, respectively.ResultOver ten months of the NIMHANS ECHO program, there was a significant improvement in the participants' knowledge post-ECHO (p < 0.05, t = −3.52). Self-efficacy in diagnosis and management of mental health problems approached significance; p < 0.001. Increased engagement in tele-ECHO sessions was associated with better performance for declarative and procedural knowledge. The attrition rate was low (5 out of 30 dropped out), and satisfaction ratings of the course were high across all fields. The participants reported a 10- fold increase in the number of patients with mental health problems they had seen, following the training. A statistically significant increase in the number of psychotropic drugs prescribed post ECHO with t = −3.295, p = 0.01.ConclusionThe outcomes indicate that the NIMHANS ECHO with high participant commitment is a model with capacity building potential in mental health and addiction for remote and rural areas by leveraging technology. This model has the potential to be expanded to other states in the country in providing mental health care to persons in need of care.

Nature, prevalence and determinants of common mental health problems and their management in primary health care

2011 ◽  
Vol 57 (1_suppl) ◽  
pp. 9-12 ◽  
Author(s):  
Jane Fisher ◽  
Meena Cabral de Mello ◽  
Takashi Izutsu ◽  
Lakshmi Vijayakumar ◽  
Myron Belfer ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Problems ◽  
Health Problems ◽  
Primary Health ◽  
Common Mental Health Problems

Socioeconomic status and primary health service use for mental health problems among immigrants with short and long lengths of stay

2016 ◽  
Vol 12 (2) ◽  
pp. 85-98 ◽  
Author(s):  
Melanie Lindsay Straiton ◽  
Anne Reneflot ◽  
Esperanza Diaz
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Services ◽  
Service Use ◽  
Mental Health Problems ◽  
Health Problems ◽  
Content Type ◽  
Care Services ◽  
Primary Health ◽  
The Relationship

Purpose – High socioeconomic status (SES) is associated with better health and lower use of health care services in the general population. Among immigrants, the relationship appears less consistent. The purpose of this paper is to determine if the relationship between income level (a proxy for SES) and use of primary health care services for mental health problems differs for natives and five immigrant groups in Norway. It also explores the moderating effect of length of stay (LoS) among immigrants. Design/methodology/approach – Using data from two registers with national-level coverage, logistic regression analyses with interactions were carried out to determine the association between income level and having used primary health care services for mental health problems. Findings – For Norwegian men and women there was a clear negative relationship between income and service use. Interaction analyses suggested that the relationship differed for all immigrant groups compared with Norwegians. When stratifying by LoS, income was not associated with service use among recently arrived immigrants but was negatively associated among immigrants staying more than two years (with the exception of Pakistani and Iraqi women). Research limitations/implications – Country of origin and LoS should be considered when applying measures of SES in immigrant health research. Social implications – There may be an initial transition period for recently arrived immigrants where competing factors mask the association between SES and service use. Originality/value – This study benefits from nationwide coverage, eliminating self-selection biases. It demonstrates the complexity of the relationship between SES and health care use.

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