Neuroethics and global mental health: Establishing a dialogue

2017 ◽  
Author(s):  
Dan J. Stein ◽  
James Giordano
Keyword(s):  
Mental Health ◽  
Global Mental Health ◽  
Patient Empowerment ◽  
Well Being ◽  
Scaling Up ◽  
Human Diversity ◽  
Middle Income ◽  
Middle Income Countries ◽  
Primary Care Settings ◽  
Deep Appreciation

At first glance, neuroethics and global mental health would seem to have relatively little in common; the former is often focused on the use or misuse of novel and specialized neurotechnologies in specialized or high-income settings, while the latter is often focused on the scaling up of existing treatments in primary care settings in low- and middle-income countries. On closer examination, however, they have significant overlapping concerns and approaches that may be mutually empowering. They both (1) take a naturalist and empirical approach to their questions of interest, (2) are concerned with both disease and with well-being, (3) embrace human rights and patient empowerment, and (4) hold a deep appreciation for human diversity. This chapter considers each of these areas and argues for the importance of conversation and collaboration between neuroethics and global mental health toward a truly international neuroethics.

scholarly journals Towards a more nuanced global mental health

2014 ◽  
Vol 204 (6) ◽  
pp. 415-417 ◽  
Author(s):  
Ross G. White ◽  
S. P. Sashidharan
Keyword(s):  
Mental Health ◽  
Global Mental Health ◽  
Scale Up ◽  
Scaling Up ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Gap ◽  
Action Programme ◽  
Health Organization

SummaryThe World Health Organization has made concerted efforts to scale up mental health services in low- and middle-income countries through the Mental Health Gap Action Programme (mhGAP) initiative. However, an overreliance on scaling up services based on those used in high-income countries may risk causing more harm than good.

scholarly journals Stemming the tide: promoting mental health and preventing mental disorders in low- and middle-income countries

2015 ◽  
Vol 2 ◽  
Author(s):  
W. A. Tol
Keyword(s):  
Mental Health ◽  
Health Promotion ◽  
Mental Disorders ◽  
Global Mental Health ◽  
Action Plan ◽  
Mental Health Promotion ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

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.

Economic evaluations in global mental health

2015 ◽  
Author(s):  
Iris Mosweu ◽  
Paul McCrone
Keyword(s):  
Mental Health ◽  
Clinical Trials ◽  
Economic Evaluation ◽  
Global Mental Health ◽  
Scaling Up ◽  
Economic Evaluations ◽  
Access To Services ◽  
Middle Income ◽  
Policy Makers ◽  
All Solutions

This chapter discusses the importance of undertaking economic evaluations in mental health and the subsequent use of the results to inform policy relating to priority setting, resource allocation, or simply scaling up mental health services in low and middle income settings. We present examples o f economic evaluations conducted either alongside clinical trials or using economic models, in LAMIC. We also point out challenges that researchers in these settings may encounter and possible ways of dealing with these, but at the same time acknowledging that economic evaluation does not provide all solutions for issues facing mental health in the developing world. Access to services, affordability, equity, and stigma also need to be given a priority, while economic evaluation first needs to be understood and approved by policy makers, before it can be adopted.

scholarly journals Promotion, prevention and treatment interventions for mental health in low- and middle-income countries through a task-shifting approach

2020 ◽  
Vol 29 ◽  
Author(s):  
Marianna Purgato ◽  
Eleonora Uphoff ◽  
Rakesh Singh ◽  
Ambika Thapa Pachya ◽  
Jibril Abdulmalik ◽  
...  
Keyword(s):  
Mental Health ◽  
At Risk ◽  
Global Mental Health ◽  
Task Shifting ◽  
Treatment Interventions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Prevention And Treatment ◽  
Prevention Interventions ◽  
Definition Of

Abstract Recently, mental health and ill health have been reframed to be seen as a continuum from health to ill health, through the stages of being asymptomatic ‘at risk’, to experiencing ‘mental distress’, ‘sub-syndromal symptoms’ and finally ‘mental disorders’. This new conceptualisation emphasised the importance of mental health promotion and prevention interventions, aimed at reducing the likelihood of future disorders with the general population or with people who are identified as being at risk of a disorder. This concept generated discussion on the distinction between prevention and treatment interventions, especially for those mental health conditions which lie between psychological distress and a formal psychiatric diagnosis. The present editorial aims to clarify the definition of promotion, prevention and treatment interventions delivered through a task-shifting approach according to a global mental health perspective.

scholarly journals Challenges to peer support in low- and middle-income countries during COVID-19

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Richard Mpango ◽  
Jasmine Kalha ◽  
Donat Shamba ◽  
Mary Ramesh ◽  
Fileuka Ngakongwa ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Peer Support ◽  
Global Mental Health ◽  
Health Conditions ◽  
Middle Income ◽  
Low Resource Settings ◽  
Mental Health Conditions ◽  
Middle Income Countries

Abstract Background A recent editorial urged those working in global mental health to “change the conversation” on coronavirus disease (Covid-19) by putting more focus on the needs of people with severe mental health conditions. UPSIDES (Using Peer Support In Developing Empowering mental health Services) is a six-country consortium carrying out implementation research on peer support for people with severe mental health conditions in high- (Germany, Israel), lower middle- (India) and low-income (Tanzania, Uganda) settings. This commentary briefly outlines some of the key challenges faced by UPSIDES sites in low- and middle-income countries as a result of Covid-19, sharing early lessons that may also apply to other services seeking to address the needs of people with severe mental health conditions in similar contexts. Challenges and lessons learned The key take-away from experiences in India, Tanzania and Uganda is that inequalities in terms of access to mobile technologies, as well as to secure employment and benefits, put peer support workers in particularly vulnerable situations precisely when they and their peers are also at their most isolated. Establishing more resilient peer support services requires attention to the already precarious situation of people with severe mental health conditions in low-resource settings, even before a crisis like Covid-19 occurs. While it is essential to maintain contact with peer support workers and peers to whatever extent is possible remotely, alternatives to face-to-face delivery of psychosocial interventions are not always straightforward to implement and can make it more difficult to observe individuals’ reactions, talk about emotional issues and offer appropriate support. Conclusions In environments where mental health care was already heavily medicalized and mostly limited to medications issued by psychiatric institutions, Covid-19 threatens burgeoning efforts to pursue a more holistic and person-centered model of care for people with severe mental health conditions. As countries emerge from lockdown, those working in global mental health will need to redouble their efforts not only to make up for lost time and help individuals cope with the added stressors of Covid-19 in their communities, but also to regain lost ground in mental health care reform and in broader conversations about mental health in low-resource settings.

scholarly journals 407 - Living through the pandemic as an older person: Long-term psychological impacts in low- and middle-income countries

2021 ◽  
Vol 33 (S1) ◽  
pp. 33-33
Author(s):  
Clarissa Giebel ◽  
Bwire Ivan ◽  
Maria Isabel Zuluaga ◽  
Suresh Kumar ◽  
Mark Gabbay ◽  
...  
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Well Being ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health And Social Care ◽  
The Impact ◽  
Low And Middle Income

Background:The pandemic has put a huge strain on people’s mental health, with varying restrictions affecting people’s lives. Little is known how the pandemic affects older adults’ mental health, particularly those living in low- and middle-income countries (LMICs) where restrictions are affecting people’s access to basic necessities. Thus, the aim of this 3-country study was to understand the long- term impacts of the pandemic on the mental well-being of older adults with and without dementia in LMICs.Methods:We are collecting 30 baseline and 15 follow-up interviews with older adults (aged 60+), people with dementia, and family carers in Colombia, India, and Uganda, as well as a baseline and follow-up focus group with health and social are professionals in each country. Interviews are conducted remotely over the phone due to pandemic restrictions, with data collection taking place between March and July 2021. Transcripts are translated into English before being analysed using thematic analysis.Results:To date, we have completed close to 90 baseline interviews and 3 focus groups with health and social care professionals. Analysis is ongoing, but findings are capturing the detrimental second wave in India and follow-up interviews will capture the longitudinal impacts on mental health.Conclusions:Whilst vaccines are starting to be rolled out in LMICs, albeit at different rates, the virus will likely take much longer to be somewhat managed in LMICs. This leaves more room for people’s physical as well as mental health to be impacted by the restrictions, and with often limited mental health service coverage, it is all the more important o understand the impact of the pandemic on older people’s mental health.

Sign in / Sign up

Export Citation Format

Share Document