scholarly journals Study protocol for a longitudinal study evaluating the impact of rape on women’s health and their use of health services in South Africa

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017296 ◽  
Author(s):  
Naeemah Abrahams ◽  
Soraya Seedat ◽  
Carl Lombard ◽  
Andre P Kengne ◽  
Bronwyn Myers ◽  
...  
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Longitudinal Study ◽  
Health Services ◽  
Health Outcomes ◽  
Service Providers ◽  
Adult Women ◽  
Gender Based Violence ◽  
Gender Based ◽  
The Impact

IntroductionSouth Africa is a country known for its high levels of HIV infection and sexual violence. Although the interface between gender-based violence, HIV and mental health has been described, there are substantial gaps in knowledge of the medium-term and long-term health impact. The 2010 Global Burden of Disease study excluded many health outcomes associated with rape and other forms of gender-based violence because systematic reviews revealed huge gaps in data and poor evidence of health effects. This study aims to describe the incidence and attributable burden of physical and mental health problems (including HIV acquisition) in adult women over a 2-year postrape period, through comparison with a cohort of women who have not been raped. The study will substantially advance our understanding of the impact of rape and will generate robust data to assist in the development of postrape health services and the delivery of evidence-based care.Methods and analysisThis longitudinal study seeks to recruit 1008 rape-exposed and 1008 rape non-exposed women. Women were recruited from health services, and assessments were carried out at baseline, 3, 6, 9, 12, 18 and 24 months. Outcome measures include exposure to risk factors; mental health status; cardio-metabolic risks; and biomarkers for HIV, sexually transmitted infections, pregnancy and stress. The primary analysis will be to compare HIV incidence in the two groups using log-rank tests. Appropriate models to predict health outcomes over time will also be applied.Ethics and disseminationThe South African Medical Research Council’s Ethics Committee approved the study. As rape is a key element of the study, the safety and protection of participants guides the research process. We will adopt a research uptake strategy to ensure dissemination to policy makers, service providers and advocacy groups. Peer-reviewed journal articles will be published.

scholarly journals Understanding and evaluating new models of Child and Adolescent Mental Health Services in South-East England: a study protocol for an observational mixed-methods study

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e024230 ◽  
Author(s):  
Stephen Rocks ◽  
Melissa Stepney ◽  
Margaret Glogowska ◽  
Mina Fazel ◽  
Apostolos Tsiachristas
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Mental Health Services ◽  
Health Services ◽  
Health Outcomes ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Resource Utilisation ◽  
South East England ◽  
The Impact

IntroductionIncreased demand for Child and Adolescent Mental Health Services (CAMHS), alongside concerns that services should be better commissioned to meet the needs of the most vulnerable, has contributed to a requirement to transform services to improve accessibility, quality of care and health outcomes. Following the submission of government-mandated transformation plans for CAMHS, services in England are changing in how, where and by whom they are delivered. This protocol describes the research methods to be applied to understand CAMHS transformations and evaluate the impact on the use of mental health services, patient care, satisfaction, health outcomes and health resource utilisation costs.Methods and analysisA mixed-methods approach will be taken in an observational retrospective study of CAMHS provided by a large National Health Service (NHS) mental health trust in South-East England (Oxford Health NHS Foundation Trust). Quantitative research will include descriptive analysis of routinely collected data, with difference-in-differences analysis supplemented with propensity score matching performed to assess the impact of CAMHS transformations from 2015 onwards. An economic evaluation will be conducted from a healthcare perspective to provide commissioners with indications of value for money. Qualitative research will include observations of services and interviews with key stakeholders including CAMHS staff, service users and guardians, to help identify mechanisms leading to changes in service delivery, as well as barriers and enabling factors in this phase of transformation.Ethics and disseminationThis project has been registered with NHS Oxford Health Foundation Trust as a service evaluation. Informed consent will be sought from all stakeholders partaking in interviews according to good clinical practice. A local data sharing protocol will govern the transfer of quantitative data. Study findings will be published in professional journals for NHS managers and peer-reviewed scientific journals. They will be discussed in seminars targeting CAMHS providers, managers and commissioners and presented at scientific conferences.

scholarly journals Initial cohort characteristics and protocol for SIGMA: An accelerated longitudinal study of environmental factors, inter- and intrapersonal processes, and mental health in adolescence

2021 ◽  
Author(s):  
Olivia J Kirtley ◽  
Robin Achterhof ◽  
Noëmi Hagemann ◽  
Karlijn Susanna Francisca Maria Hermans ◽  
Anu Pauliina Hiekkaranta ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Longitudinal Study ◽  
Health Outcomes ◽  
Environmental Risk ◽  
Daily Life ◽  
Experience Sampling ◽  
Environmental Risk Factors ◽  
Mental Health Outcomes ◽  
The Impact

Background: Over half of all mental health conditions have their onset in adolescence. Large-scale epidemiological studies have identified relevant environmental risk factors for mental health problems. Yet, few have focused on potential mediating inter- and intrapersonal processes in daily life, hampering intervention development. Objectives: To investigate 1) the impact of environmental risk factors on changes in inter- and intrapersonal processes; 2) the impact of altered inter- and intrapersonal processes on the development of (sub)clinical mental health symptoms in adolescents and; 3) the extent to which changes in inter- and intrapersonal processes mediate the association between environmental risk factors and the mental health outcomes in adolescents.Methods: ‘SIGMA’ is an accelerated longitudinal study of adolescents aged 12 to 18 from across Flanders, Belgium. Using self-report questionnaires, experience sampling, an experimental task, and wearables, we are investigating the relationship between environmental risk factors (e.g. trauma, parenting), inter- and intrapersonal processes (e.g. real-life social interaction and interpersonal functioning) and mental health outcomes (e.g. psychopathology, self-harm) over time. Results: N= 1913 adolescents (63% female) aged 11 – 20, from 22 schools, participated. The range of educational trajectories within the sample was broadly representative of the Flemish general adolescent population.Conclusions: Our findings will enable us to answer fundamental questions about inter- and intrapersonal processes involved in the development and maintenance of poor mental health in adolescence. This includes insights regarding the role of daily-life social and cognitive-affective processes, gained by using experience sampling. The accelerated longitudinal design enables rapid insights into developmental and cohort effects.

scholarly journals Risk of Gender-Based Violence and Poor Mental Health Among Nepalese Women During COVID-19 Pandemic: A Review

2020 ◽  
Vol 3 (2) ◽  
pp. 39-46
Author(s):  
Lalita Kumari Sah ◽  
Prabhu Sah ◽  
Manoj Kumar Yadav ◽  
Surya B. Parajuli ◽  
Rinku Shah
Keyword(s):  
Mental Health ◽  
Service Providers ◽  
Poor Mental Health ◽  
Service Access ◽  
Gender Based Violence ◽  
Health Service Access ◽  
Limited Health ◽  
Gender Based ◽  
And Gender ◽  
Financial Dependency

During Covid-19 pandemic, gender-based violence (GBV) against women and poor mental health with limited health service access for women have received paramount attention among researchers, policy makers, health professionals and healthcare service providers. This paper presents a review of published articles in an attempt to understand GBV and poor mental health among Nepalese women in the context of Covid-19. Evidence suggests that gender inequality and gender-based violence have played a significant role in increasing mental health issues among women during the pandemic. Social factors such as low education, financial dependency, lack of support system, limited access to healthcare, lack of awareness about the GBV laws, and cultural norms that put women in the lower position within the society are the realities of majority of Nepalese women. These factors intersect each other and present compounded risks that put women at more vulnerable position than others, which is further exacerbated during the COVID-19 pandemic putting Nepalese women at risks of GBV and poor mental health compared to men in the society. The paper also recommends actions that are required to address the GBV and poor mental health among Nepalese women.

Children of Parents with a Mental Illness — The COPMI Project

2003 ◽  
Vol 13 (1) ◽  
pp. 99-105
Author(s):  
Elizabeth Fudge
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Health Outcomes ◽  
Mental Health Problems ◽  
Service Providers ◽  
Good Practice ◽  
Health Problems ◽  
Mental Health Outcomes ◽  
Outcomes For Children ◽  
The Impact

When adults experience mental health problems, the effect on their family members can be immense. The impact on the person's children, both of the parent's behaviour and of their treatment, can be profound but is frequently overlooked by service providers for a range of reasons. The current national COPMI project has been initiated to promote better mental health outcomes for children of parents with a mental illness, especially by providing information and good practice guidance for services and people in the community who work with these families and their children.

scholarly journals Health Status and Health Care Needs of Drought-Related Migrants in the Horn of Africa—A Qualitative Investigation

2020 ◽  
Vol 17 (16) ◽  
pp. 5917
Author(s):  
Kristina Lindvall ◽  
John Kinsman ◽  
Atakelti Abraha ◽  
Abdirisak Dalmar ◽  
Mohamed Farah Abdullahi ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Large Scale ◽  
Mental Health Problems ◽  
Horn Of Africa ◽  
Gender Based Violence ◽  
Care Needs ◽  
Internally Displaced ◽  
Gender Based ◽  
And Gender

Somalia, Kenya and Ethiopia, situated in the Horn of Africa, are highly vulnerable to climate change, which manifests itself through increasing temperatures, erratic rains and prolonged droughts. Millions of people have to flee from droughts or floods either as cross-border refugees or as internally displaced persons (IDPs). The aim of this study was to identify knowledge status and gaps regarding public health consequences of large-scale displacement in these countries. After a scoping review, we conducted qualitative in-depth interviews during 2018 with 39 stakeholders from different disciplines and agencies in these three countries. A validation workshop was held with a selection of 13 interviewees and four project partners. Malnutrition and a lack of vaccination of displaced people are well-known challenges, while mental health problems and gender-based violence (GBV) are less visible to stakeholders. In particular, the needs of IDPs are not well understood. The treatment of mental health and GBV is insufficient, and IDPs have inadequate access to essential health services in refugee camps. Needs assessment and program evaluations with a patients’ perspective are either lacking or inadequate in most situations. The Horn of Africa is facing chronic food insecurity, poor population health and mass displacement. IDPs are an underserved group, and mental health services are lacking. A development approach is necessary that moves beyond emergency responses to the building of long-term resilience, the provision of livelihood support and protection to reduce displacement by droughts.

Clinical psychology service distribution and integration into primary health care in KwaZulu-Natal, South Africa

2018 ◽  
Vol 49 (3) ◽  
pp. 391-402
Author(s):  
Evy-Terressah Busisiwe Siyothula
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Psychological Services ◽  
Unequal Distribution ◽  
Kwazulu Natal ◽  
Service Distribution ◽  
The Impact

Inadequate investment in mental health care by the governments of both high- and low-income countries contributes to recurrent challenges of uneven distribution of and access to mental health services between urban and non-urban communities. While recent research has acknowledged the role of mental health in well-being and the cost of failure to invest in the sector, prioritising mental health to the same degree as physical health remains a challenge. This article highlights the unequal distribution of mental health services, and psychological services in particular, in KwaZulu-Natal. This is achieved by considering the background of psychology in South Africa and KwaZulu-Natal and then examining the ratio of clinical psychologists to the KwaZulu-Natal population. Furthermore, the article explores the geographical distribution of psychological services in KwaZulu-Natal and concludes with a discussion of the impact of uneven mental health service distribution on service provision and utilisation in non-urban areas of KwaZulu-Natal.

National standards: improving patient rights and safety of health services

2014 ◽  
Vol 19 (3) ◽  
pp. 194-206 ◽  
Author(s):  
Lisa O’Farrell ◽  
Michael Byrne ◽  
Linda Moore
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Mental Health Professionals ◽  
Online Survey ◽  
Survey Methodology ◽  
Service Providers ◽  
Patient Rights ◽  
Content Type ◽  
Regulatory Standards ◽  
The Impact

Purpose – Regulation is increasingly being used in healthcare to influence the behaviour of healthcare organisations. Since 2006, a key change in Ireland has been the introduction of national regulatory standards in mental health services under new legislation. Little empirical evidence, however, exists on the effects of regulation. The purpose of this paper is to examine the perceived impact of standards at patient level as well as on professional and organisational practice in services. Design/methodology/approach – An anonymous online survey methodology using a self-devised questionnaire instrument was employed. A national cohort of service managers and multi-disciplinary mental health professionals were asked their views on the introduction of standards. Findings – A total of 185 individuals responded to the survey, yielding a response rate of 38 per cent. Substantial improvements were reported to have taken place across services with the most notable changes being improved safeguarding of patients’ rights and increased safety of care. Additionally, major changes were reported in professional working with new topics being discussed at management meetings and new functions being incorporated into certain professionals’ roles. Practical implications – Standards can change behaviour at several levels across healthcare organisations, although professional groups differ in their views on the degree of this impact. Originality value – To the authors’ knowledge, this is the first evaluation of the impact of national regulatory standards in healthcare in Ireland. This study lends support to the use of standards to enhance patient rights and the safety of services. The results provide useful direction for policy makers, regulators, and service providers.

“Always Know Where the Gun Is”: Service Providers Perceptions of Firearm Access, Violence, and Safety Planning During the COVID-19 Pandemic

2021 ◽  
pp. 088626052110462
Author(s):  
Kellie R. Lynch ◽  
TK Logan
Keyword(s):  
Rural Areas ◽  
Service Providers ◽  
Elder Abuse ◽  
Safety Planning ◽  
Gender Based Violence ◽  
The Us ◽  
Trafficking Victims ◽  
Gender Based ◽  
N 93 ◽  
The Impact

Given the heightened risk for fatality and known non-fatal harm firearms pose in abusive situations, it is critical to consider the impact of the COVID-19 pandemic on firearm-related abuse and safety planning—particularly considering the surge in firearm sales in 2020. This study documented the impact of the pandemic on firearm access and violence, advice and safety planning surrounding firearms, and firearm-related abuse tactics through the perspective of victim service providers across the US participants included victim service professionals from both rural ( n = 93) and urban/suburban (i.e., non-rural; n = 78) areas who worked with victims of gender-based violence (i.e., intimate partner abuse and dating violence, child abuse, elder abuse, sexual assault, stalking, or human trafficking victims). Results revealed that nearly half of participants reported that abusers threatening to shoot victims or others became more frequent since the start of the pandemic, while nearly 30% reported that homicide involving firearms became more frequent during the pandemic. Further, nearly 40% of participants indicated an increase in firearm sales during pandemic—with higher sales in non-rural versus rural areas. Common themes related to safety planning with firearms included advising the victim to contact the system for help, assessing the location of firearms and/or remove the firearms, and leaving the abuser. The results stress the importance for safety planning around firearms when victims are isolated with an abuser at home and potential impact of abuser firearm access on public safety.

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