Global mental health, autonomy and medical paternalism: reconstructing the ‘French ethical tradition’ in psychiatry

2017 ◽  
Vol 28 (3) ◽  
pp. 326-343 ◽  
Author(s):  
Tiago Pires Marques
Keyword(s):  
Mental Health ◽  
Ethical Decision Making ◽  
Global Mental Health ◽  
Global Scale ◽  
Deontological Ethics ◽  
American Model ◽  
History Of ◽  
Anglo American ◽  
Definition Of ◽  
Ethical Reflections

In the last few decades, the definition of deontological ethics, a well-identified ethical territory in psychiatry, has been the object of increasing concerns. This has been the case in France, where claims of a specific ethical tradition in psychiatry have accompanied the institutionalization of psychiatric ethics and the perceived globalization of an Anglo-American model of mental health care. This study traces the history of the ‘French ethical tradition in psychiatry’ and its relationship with establishing institutional spaces for ethical decision-making. The ‘ethical tradition’ thus conceived proves to be functional in terms of preserving the threatened identity of French psychiatry. Nevertheless, this movement also pinpoints impasses that transcend the French context and may provide valuable resources for ethical reflections on mental health on a global scale.

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 Radiological Weapons (Excerpts from the History of Ban Talks)

2020 ◽  
pp. 184-199
Author(s):  
Yurii Kostenko
Keyword(s):  
National Level ◽  
The United States ◽  
Global Scale ◽  
Diplomatic History ◽  
Security Threat ◽  
Nuclear Terrorism ◽  
Nuclear Security ◽  
History Of ◽  
The 1960S ◽  
Definition Of

Abstract. The article highlights the history of radiological weapons ban negotiations. In 1948, the United Nations Commission on Conventional Armaments identified radiological weapons as WMD. Since as early as the 1960s, some states have put forward proposals to ban radiological weapons at the international level as potentially threatening human lives and the environment. In 1977 to 1979, a treaty banning radiological weapons was approved on the basis of a draft developed at bilateral Soviet-American negotiations in Geneva, which could have become an important impetus for further actions in limiting the arms race. The careful preparation of the text of the future treaty by the USSR and US delegations raised expectations that its finalisation by the Disarmament Commission would not take much time. The reality, however, was far different. In December 1979, the Afghan war broke out. In response to the Soviet aggression against Afghanistan, the United States took a whole set of measures, including the refusal to continue bilateral talks on the prohibition of radiological weapons. The author notes that control over radioactive materials was strengthened at the national level, without waiting for an international legal definition of radiological weapons. Political ambitions of a number of countries have prevented the Conference on Disarmament from achieving positive results. The author emphasises that today nuclear terrorism is regarded by world leaders as an urgent global-scale security threat, as confirmed by the international Nuclear Security Summit in Washington, D.C. in 2016, attended by delegations from over 50 countries. The author states that the issue of the radiological weapons prohibition remains pending. Keywords: radiological weapons, Conference on Disarmament, Ukrainian diplomatic history, USA, Geneva, USSR.

scholarly journals Anxiety and Depression in Patients Who Undergo a Cerebrovascular Procedure

2020 ◽  
Author(s):  
Lauren Lombardo ◽  
Richard Shaw ◽  
Kathleen Sayles ◽  
Dorothea Altschul
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Physical Health ◽  
Global Mental Health ◽  
Anxiety And Depression ◽  
Life Outcomes ◽  
Quality Of Life Outcomes ◽  
Significant Difference ◽  
History Of

Abstract Background: Observe the relationship of anxiety and depression on quality of life outcomes after open and endovascular cerebrovascular procedures. Methods: We retrospectively analyzed 349 patients who underwent a procedure for aneurysm, arteriovenous malformation, intraparenchymal hemorrhage, carotid stenosis, acute stroke, and conventional catheter angiogram over three years at a community hospital. We correlated pre-procedural anxiety and depression with Global Physical Health, Global Mental Health, and Modified Rankin Scale scores. We performed univariate and multivariate linear and logistic regression analyses adjusting for past medical history and sociodemographic factors. Results: Anxiety or depression occurred in eighteen percent of patients. Patients with anxiety or depression were more likely to be female (81% vs 60.8%; p=0.002) and younger (54 vs. 59 years old; p=0.025). The groups did not differ in type or urgency of procedure, smoking or history of diabetes, or cardiovascular disease. Patients with anxiety or depression reported lower mental health scores at 30 days (45.1 vs 48.2; p=0.002) post-procedure. In multivariate analyses, anxious or depressed patients had worse mental health scores at 30 days (t=-2.893; p=0.008) than those who did not have a history of anxiety or depression. There was no difference between groups in length of stay, mortality, physical health t-scores, functionality scores, or six month quality of life outcomes. Conclusions: Patients undergoing cerebrovascular procedures who self-reported anxiety or depression showed a significant difference in mental health outcomes at 30 days, but six month mental health and other medical and functional outcomes measures were similar to patients without these diagnoses.

scholarly journals Nonconsensual Sexual Experience Histories of Incarcerated Men: A Mixed Methods Approach

2021 ◽  
pp. 0306624X2110655
Author(s):  
Raymond M. McKie ◽  
Shulamit Sternin ◽  
Chelsea D. Kilimnik ◽  
Drake D. Levere ◽  
Terry P. Humphreys ◽  
...  
Keyword(s):  
Mental Health ◽  
Lived Experience ◽  
Sexual Experience ◽  
Psychological Impact ◽  
Sexual Experiences ◽  
Maximum Security ◽  
Novel Approach ◽  
Incarcerated Men ◽  
History Of ◽  
Definition Of

Nonconsensual sexual experiences (NSEs) may contribute to mental health concerns among incarcerated individuals, yet NSEs are understudied in this population. This study takes a novel approach in examining the prevalence of NSEs among incarcerated males by utilizing both quantitative and qualitative measures. The sample consisted of 189 men from three provincial maximum-security prisons in Ontario, Canada. Based on quantitative findings, 44.2% of the sample experienced NSEs before the age of 18, and 41.7% of the sample endorsed an experience that fit the legal definition of a NSEs as adults. Participants also responded to a qualitative open-ended question about their history of NSEs. Based on qualitative findings, a total of 23% of the men reported at least one incident of a NSE (e.g., child and adult). Based Findings highlight the high prevalence of NSEs among incarcerated men with quantitative responses demonstrating how the use of a behavioral questionnaire may, to some extent, correct for underreporting of NSEs. Qualitative responses illustrate the lived experience of incarcerated men and provide a deeper understanding of their NSEs. Responses also speak to the lack of resources and support available to these men. Findings underscore the need for proactive approaches in meeting mental health needs of incarcerated men in general and with regard to NSEs in particular. Results may inform the development of future correctional procedures (i.e., intake protocols that account for men with NSEs) and resources to support incarcerated men in navigating the psychological impact of non-consensual sexual experiences.

The importance of trials for global mental health

2015 ◽  
Author(s):  
Graham Thornicroft ◽  
Vikram Patel
Keyword(s):  
Mental Health ◽  
Global Mental Health ◽  
Mental Health Research ◽  
Middle Income ◽  
Middle Income Countries ◽  
Randomized Controlled ◽  
History Of ◽  
Research Continuum ◽  
Key Terms

This chapter sets the scene for the book as a whole by defining key terms, giving a brief history of randomized controlled trails (RCTs) in mental health research, explaining why RCTs can produce strong forms of evidence, and by locating trials within the translational research continuum. The authors describe criteria with which to judge the quality of pragmatic RCTs. Finally the authors discuss how the results of trials can be used to inform policy, investment, and service delivery decisions in low and middle income countries.

Mental Competence and Consent to Treatment

1980 ◽  
Vol 25 (3) ◽  
pp. 251-253 ◽  
Author(s):  
P. Burra ◽  
R. Kimberley ◽  
C. Miura
Keyword(s):  
Mental Health ◽  
Young Woman ◽  
Case History ◽  
Mental Competence ◽  
Mental Health Act ◽  
Consent To Treatment ◽  
History Of ◽  
Definition Of ◽  
Practical Implications

The issue of mental competence in relation to consent to treatment has been high-lighted in the recently amended Mental Health Act in Ontario. The definition of mental competence in this context, how it is to be determined, and some practical implications of the Section of the Act pertaining to this matter, are discussed. The case history of a young woman is used to illustrate some of the points made.

Global mental health

2020 ◽  
pp. 12-22
Author(s):  
Crick Lund ◽  
Dörte Bemme ◽  
Judy Bass
Keyword(s):  
Mental Health ◽  
Implementation Science ◽  
Global Mental Health ◽  
Mental Health Policy ◽  
Global Burden ◽  
Health It ◽  
Future Directions ◽  
Research Implementation ◽  
Disciplinary Field ◽  
History Of

Global mental health has emerged in recent years as a field of research, advocacy, and practice that is concerned with improving the mental health of populations and reducing inequity in the global burden of mental illness. Because these challenges are multi-faceted, global mental health has been marked from its inception as a multi-disciplinary field, incorporating disciplines of psychiatry, psychology, epidemiology, health economics, anthropology, and implementation science. This chapter provides an overview of the emerging and dynamic field of global mental health. It starts with a brief history of the field, noting landmark publications and events. The chapter then introduces key areas of enquiry and action in global mental health, including epidemiology, mental health policy and services, intervention research, implementation science, qualitative research, instrument development, and economic evaluation. Finally, it concludes with reflections on critiques of the field and future directions.

Design issues in global mental health trials in low-resource settings

2015 ◽  
Author(s):  
Helen Weiss
Keyword(s):  
Mental Health ◽  
Gold Standard ◽  
Trial Design ◽  
Global Mental Health ◽  
Stepped Wedge ◽  
Randomized Controlled ◽  
Superiority Trial ◽  
Definition Of ◽  
Preference Trial ◽  
Size Estimates

In this chapter we outline the key principles in design and analysis of trials for mental health. The chapter focuses on randomized controlled trials as these are the gold-standard trial design, which minimizes confounding due to other factors and enables us to draw conclusions about the effectiveness of the intervention. Other key principles of trial design discussed in the chapter include methods to develop a clearly stated, testable research hypothesis, definition of well-defined outcomes, appropriate choice of the control condition, masking of providers and participants where possible, realistic sample size estimates, and appropriate data monitoring and statistical analysis plans. The chapter also outlines alternatives to the parallel arm superiority trial design, such as equivalence and non-inferiority trials, cross-over, stepped wedge, fixed adaptive, and patient preference trial designs.

scholarly journals Global mental health and sustainable development 2018

2019 ◽  
Vol 16 (02) ◽  
pp. 34-37 ◽  
Author(s):  
Rachel Jenkins
Keyword(s):  
Mental Health ◽  
Sustainable Development ◽  
Global Mental Health ◽  
Scientific Understanding ◽  
Social Sector ◽  
Sector Reform ◽  
Recent Developments ◽  
History Of ◽  
Health Concepts ◽  
Health Programmes

The Lancet Commission summarises some of the history of mental health concepts, recent developments in scientific understanding, mental health programmes and threats to progress, and proposes a way forward. Although ostensibly aiming to reframe global mental health within the paradigm of sustainable development, in practice it has taken a narrower academic perspective rather than a generic approach to health and social sector reform, leading to much less of an integrated implementation focus than would have been useful.

scholarly journals Anxiety and Depression in Patients Who Undergo a Cerebrovascular Procedure

2020 ◽  
Author(s):  
Lauren Lombardo ◽  
Richard Shaw ◽  
Kathleen Sayles ◽  
Dorothea Altschul
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Physical Health ◽  
Global Mental Health ◽  
Anxiety And Depression ◽  
Life Outcomes ◽  
Quality Of Life Outcomes ◽  
Significant Difference ◽  
History Of

Abstract Background: Observe the relationship of anxiety and depression on quality of life outcomes after open and endovascular cerebrovascular procedures. Methods: We retrospectively analyzed 349 patients who underwent a procedure for aneurysm, arteriovenous malformation, intraparenchymal hemorrhage, carotid stenosis, acute stroke, and conventional catheter angiogram over three years at a community hospital. We correlated pre-procedural anxiety and depression with Global Physical Health, Global Mental Health, and Modified Rankin Scale scores. We performed univariate and multivariate linear and logistic regression analyses adjusting for past medical history and sociodemographic factors. Results: Anxiety or depression occurred in eighteen percent of patients. Patients with anxiety or depression were more likely to be female (81% vs 60.8%; p=0.002) and younger (54 vs. 59 years old; p=0.025). The groups did not differ in type or urgency of procedure, smoking or history of diabetes, or cardiovascular disease. Patients with anxiety or depression reported lower mental health scores at 30 days (45.1 vs 48.2; p=0.002) post-procedure. In multivariate analyses, anxious or depressed patients had worse mental health scores at 30 days (t=-2.893; p=0.008) than those who did not have a history of anxiety or depression. There was no difference between groups in length of stay, mortality, physical health t-scores, functionality scores, or six month quality of life outcomes. Conclusions: Patients undergoing cerebrovascular procedures who self-reported anxiety or depression showed a significant difference in mental health outcomes at 30 days, but six month mental health and other medical and functional outcomes measures were similar to patients without these diagnoses.

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