scholarly journals Proactive detection of people in need of mental healthcare: accuracy of the community case detection tool among children, adolescents and families in Sri Lanka

Author(s):  
Myrthe van den Broek ◽  
Puvaneswary Ponniah ◽  
P. Judy Ramesh Jeyakumar ◽  
Gabriela V. Koppenol-Gonzalez ◽  
John Vijay Sagar Kommu ◽  
...  

Abstract Background Most children and adolescents in need of mental healthcare remain untreated even when services are available. This study evaluates the accuracy of a new tool, the Community Case Detection Tool (CCDT). The CCDT uses illustrated vignettes, two questions and a simple decision algorithm to support proactive community-level detection of children, adolescents and families in need of mental healthcare to improve help-seeking. Methods Trusted and respected community members in the Eastern Province of Sri Lanka used the CCDT in their daily routine. Children and families detected as potentially in need of mental healthcare based on utilizing the CCDT (N = 157, aged 6–18 years) were invited for a clinical interview by a mental health counsellor using the Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). The CCDT results were compared against the results of the clinical interview. The concurrent validity and performance of the CCDT were also evaluated by comparing the CCDT outcomes against the Strengths and Difficulties Questionnaire (SDQ). Results 7 out of 10 children and families detected by community members using the CCDT were confirmed to be in need for treatment (positive predictive value [PPV] = 0.69; 0.75 when compared to the SDQ). Detections based on the family problem vignette were most accurate (PPV = 0.76), followed by the internalising problem vignette (PPV = 0.71) and the externalising problem vignette (PPV = 0.62). Conclusions The CCDT is a promising low-cost solution to overcome under-detection of children and families in need of mental healthcare. Future research should focus on evaluating the effectiveness, as well as additional strategies to improve help-seeking.

2021 ◽  
Vol 86 (1) ◽  
pp. 154-185
Author(s):  
Ricardo D. Martínez-Schuldt ◽  
Daniel E. Martínez

Sanctuary jurisdictions have existed in the United States since the 1980s. They have recently reentered U.S. politics and engendered contentious debates regarding their legality and influence on public safety. Critics argue that sanctuary jurisdictions create conditions that threaten local communities by impeding federal immigration enforcement efforts. Proponents maintain that the policies improve public safety by fostering institutional trust among immigrant communities and by increasing the willingness of immigrant community members to notify the police after they are victimized. In this study, we situate expectations from the immigrant sanctuary literature within a multilevel, contextualized help-seeking framework to assess how crime-reporting behavior varies across immigrant sanctuary contexts. We find that Latinos are more likely to report violent crime victimization to law enforcement after sanctuary policies have been adopted within their metropolitan areas of residence. We argue that social policy contexts can shift the nature of help-seeking experiences and eliminate barriers that undermine crime victims’ willingness to mobilize the law. Overall, this study highlights the unique role social policy contexts can serve in structuring victims’ help-seeking decisions.


PEDIATRICS ◽  
1987 ◽  
Vol 80 (5) ◽  
pp. 634-637
Author(s):  
Joseph G. Morelli ◽  
William L. Weston

Cleansing of the skin and hair is part of the daily routine of all neonates, infants, toddlers, children, and adolescents. Numerous soap and shampoo products are available to the consumer. The pediatrician is often asked to comment on the safety and efficacy of these products. Little information is available to help the pediatrician make a rational decision. The list of ingredients on the package are seldom useful and can be confusing. The theoretical and practical considerations leading to the addition of the major constituents of soaps and shampoos are reviewed and guidelines for the use of soaps and shampoos under normal circumstances and in a few selected conditions are suggested.


Author(s):  
Priyani Dharmawardena ◽  
Risintha Premaratne ◽  
Kamini Mendis ◽  
Rajitha Wickemasinghe ◽  
Chaturaka Rodrigo ◽  
...  

2021 ◽  
Author(s):  
W. M. Kumudunayana T. de A. W Gunasekera ◽  
Risintha Premaratne ◽  
Deepika Fernando ◽  
Muzrif Munaz ◽  
M. G. Y. Piyasena ◽  
...  

Abstract Background Sri Lanka sustained its malaria-free status by implementing, among other interventions, three core case detection strategies namely Passive Case Detection (PCD), Reactive Case Detection (RACD) and Proactive Case Detection (PACD). The outcomes of these strategies were analysed in terms of their effectiveness in detecting malaria infections for the period from 2017-2019. Methods Comparisons were made between the surveillance methods and between years, based on data obtained from the national malaria database and individual case reports of malaria patients. The number of blood smears examined microscopically was used as the measure of the volume of tests conducted. The yield from each case detection method was calculated as the proportion of blood smears which were positive for malaria. Within RACD and PACD, the yield of sub categories of travel cohorts and spatial cohorts was ascertained for 2019. Results A total of 158 malaria cases were reported in 2017-2019. During this period between 666,325-725,149 blood smears were examined annually. PCD detected 95.6%, with a yield of 16.1 cases per 100,000 blood smears examined. RACD and PACD produced a yield of 11.2 and 0.3, respectively. The yield of screening the sub category of travel cohorts was very high for RACD and PACD being 806.5 and 44.9 malaria cases per 100,000 smears, respectively. Despite over half of the blood smears examined being obtained by screening spatial cohorts within RACD and PACD, the yield of both was zero over all three years. Conclusions The PCD arm of case surveillance is the most effective and, therefore, has to continue and be further strengthened as the mainstay of malaria surveillance. Focus on travel cohorts within RACD and PACD should be even greater. Screening of spatial cohorts, on a routine basis and solely because people are resident in previously malarious areas, may be wasteful, except in situations where the risk of local transmission is very high, or is imminent. These findings may apply more broadly to most countries in the post-elimination phase.


2021 ◽  
Author(s):  
Nurun Layla Chowdhury

The quality of an individual’s mental health has a significant impact on their quality of life, as well as on the cost to society. Regular access to mental health services can help mitigate the risk factors of developing mental illnesses. This paper examines barriers to accessing mental health services, using the community of Peterborough, Ontario, as an example. Social, economic, and cultural barriers impact help-seeking amongst immigrants, putting them at a higher risk of developing mental disorders. The social determinants of mental health can be useful when developing policies aimed at improving utilization of mental healthcare services. Policy makers need to first focus on collecting accurate information on the population, and then developing targeted solutions to eliminate barriers such as language and employment that prevent help-seeking in immigrants.


2021 ◽  
pp. bmjmilitary-2020-001754
Author(s):  
Lauren Rose Godier-McBard ◽  
G Cable ◽  
A D Wood ◽  
M Fossey

IntroductionLimited UK research focuses on female military veterans’ gender-related experiences and issues when accessing civilian mental healthcare support. This study sought to illuminate a preliminary understanding of any gender differences in barriers that may discourage them accessing mental healthcare support.MethodsA total of 100 participants completed an open online survey of UK triservice veterans who identified as having experienced postmilitary mental health problems. They completed a 30-item Barriers to Access to Care Evaluation scale and were asked to elaborate using free-text questions. Resulting quantitative data were analysed for gender-related differences, while the qualitative text was thematically explored.ResultsWhile stigma, previous poor experience of mental healthcare and a lack of trust in civilian providers were found to act as barriers to postmilitary support for both men and women, significantly more women reported that their gender had also impacted on their intention to seek help. Women also commented on the impact of gender-related discrimination during service on their help-seeking experiences.ConclusionsWhile efforts are being made by the UK Ministry of Defence to reduce barriers to mental healthcare for those still serving in the Armed Forces, it has been more difficult to provide a similar level of support to the veteran population. With little veteran research focusing on the specific experiences of women, this study suggests that female veterans encounter specific access barriers and issues related to their gender. Further research is therefore needed to ensure these findings are addressed.


2021 ◽  
Vol 28 (1) ◽  
pp. 3
Author(s):  
Daniel Rogoža ◽  
Robertas Strumila ◽  
Eglė Klivickaitė ◽  
Edgaras Diržius ◽  
Neringa Čėnaitė

Background: Previous research suggests that healthcare professionals (HCPs) experience high levels of work-related psychological distress, including depressive symptoms. Due to the stigma of mental health problems and other barriers, HCPs are likely to be hesitant to seek appropriate mental healthcare. We aimed to explore these phenomena among HCPs in Lithuania.Methods: A web survey inquiring about depressive symptoms, help-seeking, and barriers to mental healthcare was conducted. Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9). 601 complete questionnaires were included in the analyses. The barriers to help-seeking were identified using the inductive content analysis approach. Descriptive, non-parametric, and robust statistical analysis was performed using SPSS software.Results: Most of the respondents have reported depression-like symptoms over the lifetime, although only about a third of them sought professional help. Of those, roughly half preferred a private specialist. The stigma and neglect of mental health problems were the most common barriers to help-seeking. Around half of the HCPs believed that seeking mental healthcare can imperil their occupational license. About a quarter of the HCPs screened positive for clinically relevant depressive symptoms. Statistically significant differences in the PHQ-9 score were found between categories of healthcare specialty, marital status, religious beliefs, workplace, and years of work as a HCP. Fewer years of work and younger age were associated with the higher PHQ-9 score.Conclusions: Our findings suggest that HCPs in Lithuania may be inclined not to seek appropriate mental healthcare and experience poor mental health, although stronger evidence is needed to verify these findings. 


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