scholarly journals Delivering maternal mental health through peer volunteers: a 5-year report

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Najia Atif ◽  
Amina Bibi ◽  
Anum Nisar ◽  
Shaffaq Zulfiqar ◽  
Ikhlaq Ahmed ◽  
...  
Keyword(s):  
Mental Health ◽  
Financial Incentives ◽  
Health Workers ◽  
Maternal Mental Health ◽  
Scale Up ◽  
Psychosocial Interventions ◽  
World Health ◽  
Research Attention ◽  
Peer Volunteers

Abstract Background Maternal depression affects one in five women in low-and middle income countries (LMIC) and has significant economic and social impacts. Evidence-based psychosocial interventions delivered by non-specialist health workers are recommended as first-line management of the condition, and recent studies on such interventions from LMIC show promising results. However, lack of human resource to deliver the interventions is a major bottle-neck to scale-up, and much research attention has been devoted to ‘task-sharing’ initiatives. A peer-delivered version of the World Health Organization’s Thinking Healthy Programme for perinatal depression in Pakistan and India showed clinical, functional and social benefits to women at 3 months postpartum. The programme has been iteratively adapted and continually delivered for 5 years in Pakistan. In this report, we describe the extended intervention and factors contributing to the peers’ continued motivation and retention, and suggest future directions to address scale-up challenges. Methods The study was conducted in rural Rawalpindi. We used mixed methods to evaluate the programme 5 years since its initiation. The competency of the peers in delivering the intervention was evaluated using a specially developed Quality and Competency Checklist, an observational tool used by trainers to rate a group session on key areas of competencies. In-depth interviews explored factors contributing to the peer volunteers’ continued motivation and retention, as well as the key challenges faced. Results Our key findings are that about 70% of the peer volunteers inducted 5 years ago continued to be part of the programme, retaining their competency in delivering the intervention, with only token financial incentives. Factors contributing to sustained motivation included altruistic aspirations, enhanced social standing in the community, personal benefits to their own mental health, and the possibility for other avenues of employment. Long-term challenges included demotivation due to lack of certainty about the programme’s future, increased requirement for financial incentivisation, the logistics of organising groups in the community, and resistance from some families to the need for ongoing care. Conclusions The programme, given the sustained motivation and competence of peer volunteers in delivering the intervention, has the potential for long-term sustainability in under-resourced settings and a candidate for scale-up.

Maternal mental health

2018 ◽  
pp. 122-125
Author(s):  
Robert Stewart ◽  
Selena Gleadow Ware
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Health Workers ◽  
Maternal Mental Health ◽  
Psychosocial Interventions ◽  
Perinatal Period ◽  
Health Problems ◽  
Middle Income ◽  
Mother And Child ◽  
Gender Based

This chapter describes the high burden of mental health problems affecting women in the perinatal period, their impact on both the mother and child, and approaches to prevention and management, with a particular focus on low and middle-income countries. It outlines the main clinical conditions, including postpartum psychosis and perinatal depression. It summarises key biological and psychosocial aetiological factors, including the link with gender-based inequality. It explains that suicide is a leading cause of indirect maternal death and presents the evidence that perinatal mental health problems can impact on foetal and infant growth and development. It argues the importance of taking a broad bio-psycho-social approach to prevention and treatment, and highlights evidence-based psychosocial interventions that can be delivered by community health workers in low-resource settings.

scholarly journals Scaling up mental healthcare in the Republic of Niger: priorities for and barriers to service improvement

2015 ◽  
Vol 12 (S1) ◽  
pp. S-6-S-9
Author(s):  
Alison Hwong ◽  
Djibo Maiga Douma ◽  
Soumana Zamo ◽  
Julian Eaton
Keyword(s):  
Mental Health ◽  
Health Workers ◽  
Health Centre ◽  
National Level ◽  
Scale Up ◽  
Mental Healthcare ◽  
Traditional Healers ◽  
World Health ◽  
Service Improvement ◽  
Local Health

As part of a pilot programme to scale up community mental health services, local health centre directors, community health workers and key informants were interviewed in two neighbouring political districts of Niger. Major priorities for improving services included training staff on the diagnosis and treatment of mental illness, collaborating with traditional healers, educating the community about the origins of psychiatric illness and building infrastructure for medication delivery. Barriers to care included long distances for travel to the nearest hospital and lack of funding for home-based visits by health workers. This study was the first step in Niger's plan to implement the World Health Organization's Mental Health Gap Action Programme (mhGAP) at a national level.

scholarly journals A praeeclampsia pszichoszociális vonatkozásai

2015 ◽  
Vol 156 (50) ◽  
pp. 2028-2034 ◽  
Author(s):  
Bernadett Szita ◽  
Ildikó Baji ◽  
János Rigó Jr.
Keyword(s):  
Mental Health ◽  
Preterm Labor ◽  
Mental Health Problems ◽  
Negative Impact ◽  
Maternal Mental Health ◽  
Psychosocial Interventions ◽  
Newborn Complications ◽  
Pituitary Adrenal Axis

Distress conditions during pregnancy may contribute to the development of preeclampsia by altering functions of the neuroendocrine and immune systems, e.g. activation of the hypothalamic-pituitary-adrenal axis and increase in plasma proinflammatory cytokines. Preeclampsia may also precipitate mental health problems due to long-term hospitalization or unpredictable and uncontrollable events such as preterm labor and newborn complications. Besides, preeclampsia may induce persistent neurocognitive complaints with a negative impact on patients’ quality of life. As growing evidence indicates that poor maternal mental health has an adverse effect on pregnancy outcome and fetal development, psychosocial interventions may be beneficial for women with preeclampsia. Orv. Hetil., 2015, 156(50), 2028–2034.

‘Adolescent and maternal mental health before during the pandemic’ – In Conversation Dr. Nicky Wright

2021 ◽  
Keyword(s):  
Mental Health ◽  
Health Informatics ◽  
Maternal Mental Health ◽  
Young Adolescent ◽  
Research Associate

This episode of our JCPP Advances series that focus on the papers and editors featured in the publication is with Dr. Nicola Wright, research associate at the department of Biostatistics and Health Informatics, Kings College London. Nicola discusses her paper 'Interplay between long-term vulnerability and new risk: Young adolescent and maternal mental health immediately before and during the COVID-19 pandemic'.

Global psychiatry

2017 ◽  
pp. 674-680
Author(s):  
Paul Harrison ◽  
Philip Cowen ◽  
Tom Burns ◽  
Mina Fazel
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Workers ◽  
Global Mental Health ◽  
Scale Up ◽  
Mental Health Workers ◽  
Middle Income ◽  
Humanitarian Emergencies ◽  
Psychiatric Illnesses ◽  
Aids Pandemic

‘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.

scholarly journals Impact of maternal mental health interventions on child-related outcomes in low- and middle-income countries: a systematic review and meta-analysis

2020 ◽  
Vol 29 ◽  
Author(s):  
W. A. Tol ◽  
M. C. Greene ◽  
M. E. Lasater ◽  
K. Le Roch ◽  
C. Bizouerne ◽  
...  
Keyword(s):  
Mental Health ◽  
Exclusive Breastfeeding ◽  
Home Visiting ◽  
Health Workers ◽  
Maternal Mental Health ◽  
Meta Analysis ◽  
Middle Income ◽  
Middle Income Countries ◽  
Child Height ◽  
Low And Middle Income

Abstract Aims Observational studies have shown a relationship between maternal mental health (MMH) and child development, but few studies have evaluated whether MMH interventions improve child-related outcomes, particularly in low- and middle-income countries. The objective of this review is to synthesise findings on the effectiveness of MMH interventions to improve child-related outcomes in low- and middle-income countries (LMICs). Methods We searched for randomised controlled trials conducted in LMICs evaluating interventions with a MMH component and reporting children's outcomes. Meta-analysis was performed on outcomes included in at least two trials. Results We identified 21 trials with 28 284 mother–child dyads. Most trials were conducted in middle-income countries, evaluating home visiting interventions delivered by general health workers, starting in the third trimester of pregnancy. Only ten trials described acceptable methods for blinding outcome assessors. Four trials showed high risk of bias in at least two of the seven domains assessed in this review. Narrative synthesis showed promising but inconclusive findings for child-related outcomes. Meta-analysis identified a sizeable impact of interventions on exclusive breastfeeding (risk ratio = 1.39, 95% confidence interval (CI): 1.13–1.71, ten trials, N = 4749 mother–child dyads, I2 = 61%) and a small effect on child height-for-age at 6-months (std. mean difference = 0.13, 95% CI: 0.02–0.24, three trials, N = 1388, I2 = 0%). Meta-analyses did not identify intervention benefits for child cognitive and other growth outcomes; however, few trials measured these outcomes. Conclusions These findings support the importance of MMH to improve child-related outcomes in LMICs, particularly exclusive breastfeeding. Given, the small number of trials and methodological limitations, more rigorous trials should be conducted.

Paternal Support and Involvement in Unmarried Fragile Families: Impacts on Long‐Term Maternal Mental Health

2019 ◽  
Vol 59 (2) ◽  
pp. 789-806 ◽  
Author(s):  
Jacquelyn K. Mallette ◽  
Ted G. Futris ◽  
Assaf Oshri ◽  
Geoffrey L. Brown
Keyword(s):  
Mental Health ◽  
Maternal Mental Health ◽  
Fragile Families ◽  
Paternal Support

scholarly journals Strategies for Delivering Mental Health Services in Response to Global Climate Change: A Narrative Review

2020 ◽  
Vol 17 (22) ◽  
pp. 8562
Author(s):  
Lawrence A. Palinkas ◽  
Meaghan L. O’Donnell ◽  
Winnie Lau ◽  
Marleen Wong
Keyword(s):  
Climate Change ◽  
Mental Health ◽  
Mental Health Problems ◽  
Health Workers ◽  
Civil Conflict ◽  
Well Being ◽  
Environmental Conservation ◽  
Narrative Review ◽  
Extreme Weather Events

This narrative review examined strategies for preparedness and response to mental health impacts of three forms of climate change from a services perspective: (1) acute and extreme weather events such as hurricanes, floods, and wildfires, (2) sub-acute or long-term events such as droughts and heatwaves; and (3) the prospect of long-term and permanent changes, including higher temperatures, rising sea levels, and an uninhabitable physical environment. Strategies for acute events included development and implementation of programs and practices for monitoring and treating mental health problems and strengthening individual and community resilience, training of community health workers to deliver services, and conducting inventories of available resources and assessments of at-risk populations. Additional strategies for sub-acute changes included advocacy for mitigation policies and programs and adaptation of guidelines and interventions to address the secondary impacts of sub-acute events, such as threats to livelihood, health and well-being, population displacement, environmental degradation, and civil conflict. Strategies for long-lasting changes included the implementation of evidence-based risk communication interventions that address the existing and potential threat of climate change, promoting the mental health benefits of environmental conservation, and promoting psychological growth and resilience.

scholarly journals Applications of the epidemiological modelling outputs for targeted mental health planning in conflict-affected populations: the Syria case-study

2016 ◽  
Vol 3 ◽  
Author(s):  
F. J. Charlson ◽  
Y. Y. Lee ◽  
S. Diminic ◽  
H. Whiteford
Keyword(s):  
Mental Health ◽  
Major Depression ◽  
Disease Burden ◽  
Health Planning ◽  
Scale Up ◽  
Health Benefit ◽  
World Health ◽  
Steady Increase ◽  
Linear Scale ◽  
Post Traumatic Stress

BackgroundEpidemiological models are frequently utilised to ascertain disease prevalence in a population; however, these estimates can have wider practical applications for informing targeted scale-up and optimisation of mental health services. We explore potential applications for a conflict-affected population, Syria.MethodsWe use prevalence estimates of major depression and post-traumatic stress disorder (PTSD) in conflict-affected populations as inputs for subsequent estimations. We use Global Burden of Disease (GBD) methodology to estimate years lived with a disability (YLDs) for depression and PTSD in Syrian populations. Human resource (HR) requirements to scale-up recommended packages of care for PTSD and depression in Syria over a 15-year period were modelled using the World Health Organisation mhGAP costing tool. Associated avertable burden was estimated using health benefit analyses.ResultsThe total number of cases of PTSD in Syria was estimated at approximately 2.2 million, and approximately 1.1 million for depression. An age-standardised major depression rate of 13.4 (95% UI 9.8–17.5) YLDs per 1000 Syrian population is estimated compared with the GBD 2010 global age-standardised YLD rate of 9.2 (95% UI 7.0–11.8). HR requirements to support a linear scale-up of services in Syria using the mhGAP costing tool demonstrates a steady increase from 0.3 FTE in at baseline to 7.6 FTE per 100 000 population after scale-up. Linear scale-up over 15 years could see 7–9% of disease burden being averted.ConclusionEpidemiological estimates of mental disorders are key inputs into determining disease burden and guiding optimal mental health service delivery and can be used in target populations such as conflict-affected populations.

scholarly journals Long-term outcomes of psychological interventions on children and young people’s mental health: A systematic review and meta-analysis

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0236525
Author(s):  
Stephen Pilling ◽  
Peter Fonagy ◽  
Elizabeth Allison ◽  
Phoebe Barnett ◽  
Chloe Campbell ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Publication Bias ◽  
Meta Analysis ◽  
Psychosocial Interventions ◽  
Long Term Outcomes ◽  
Self Harm ◽  
The Impact

Background Over 600 RCTs have demonstrated the effectiveness of psychosocial interventions for children and young people’s mental health, but little is known about the long-term outcomes. This systematic review sought to establish whether the effects of selective and indicated interventions were sustained at 12 months. Method We conducted a systematic review and meta-analysis focusing on studies reporting medium term outcomes (12 months after end of intervention). Findings We identified 138 trials with 12-month follow-up data, yielding 165 comparisons, 99 of which also reported outcomes at end of intervention, yielding 117 comparisons. We found evidence of effect relative to control at end of intervention (K = 115, g = 0.39; 95% CI: 0.30–0.47 I2 = 84.19%, N = 13,982) which was maintained at 12 months (K = 165, g = 0.31, CI: 0.25–0.37, I2 = 77.35%, N = 25,652) across a range of diagnostic groups. We explored the impact of potential moderators on outcome, including modality, format and intensity of intervention, selective or indicated intervention, site of delivery, professional/para-professional and fidelity of delivery. We assessed both risk of study bias and publication bias. Conclusions Psychosocial interventions provided in a range of settings by professionals and paraprofessionals can deliver lasting benefits. High levels of heterogeneity, moderate to high risk of bias for most studies and evidence of publication bias require caution in interpreting the results. Lack of studies in diagnostic groups such as ADHD and self-harm limit the conclusions that can be drawn. Programmes that increase such interventions’ availability are justified by the benefits to children and young people and the decreased likelihood of disorder in adulthood.

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