scholarly journals Treatment of suicidal people around the world

2011 ◽  
Vol 199 (1) ◽  
pp. 64-70 ◽  
Author(s):  
R. Bruffaerts ◽  
K. Demyttenaere ◽  
I. Hwang ◽  
W.-T. Chiu ◽  
N. Sampson ◽  
...  
Keyword(s):  
Mental Health ◽  
Low Income ◽  
Mental Health Treatment ◽  
Suicide Ideation ◽  
Medical Practitioner ◽  
World Health ◽  
Low Income Countries ◽  
Structural Barriers ◽  
General Medical Practitioner ◽  
The World

BackgroundSuicide is a leading cause of death worldwide; however, little information is available about the treatment of suicidal people, or about barriers to treatment.AimsTo examine the receipt of mental health treatment and barriers to care among suicidal people around the world.MethodTwenty-one nationally representative samples worldwide (n=55 302; age 18 years and over) from the World Health Organization's World Mental Health Surveys were interviewed regarding past-year suicidal behaviour and past-year healthcare use. Suicidal respondents who had not used services in the past year were asked why they had not sought care.ResultsTwo-fifths of the suicidal respondents had received treatment (from 17% in low-income countries to 56% in high-income countries), mostly from a general medical practitioner (22%), psychiatrist (15%) or non-psychiatrist (15%). Those who had actually attempted suicide were more likely to receive care. Low perceived need was the most important reason for not seeking help (58%), followed by attitudinal barriers such as the wish to handle the problem alone (40%) and structural barriers such as financial concerns (15%). Only 7% of respondents endorsed stigma as a reason for not seeking treatment.ConclusionsMost people with suicide ideation, plans and attempts receive no treatment. This is a consistent and pervasive finding, especially in low-income countries. Improving the receipt of treatment worldwide will have to take into account culture-specific factors that may influence the process of help-seeking.

scholarly journals Cultural psychiatry, diversity and political correctness in a shrinking world

2008 ◽  
Vol 5 (2) ◽  
pp. 27-28 ◽  
Author(s):  
John L. Cox
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Low Income ◽  
Global Mental Health ◽  
World Health ◽  
Low Income Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World

It is perhaps unusual for an academic journal like the Lancet to spearhead a ‘movement’ to advocate the scaling up of mental health services in low-income countries. Yet at the movement's launch in London in November 2007, attended by representatives from World Health Organization (WHO), the World Bank, donor agencies, as well as the World Psychiatric Association (WPA) and the Royal College of Psychiatrists, it was clear that a seminal series of papers, published in September of last year, was of the utmost importance for world psychiatry and for our planet. The five papers in the series ‘Global Mental Health’ had the following titles: ‘No health without mental health’; ‘Resources for mental health: scarcity, equity, and inefficiency’; ‘Treatment and prevention of mental disorders in low-income and middle-income countries’; ‘Mental health systems in countries: where are we now?’; and ‘Barriers to improvement of mental health services in low-income and middle-income countries’ (Lancet, September 2007, vol. 370, nos 9590–9593).

scholarly journals Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries

2021 ◽  
Vol 18 (5) ◽  
pp. 2439
Author(s):  
Brendon Stubbs ◽  
Kamran Siddiqi ◽  
Helen Elsey ◽  
Najma Siddiqi ◽  
Ruimin Ma ◽  
...  
Keyword(s):  
Health Survey ◽  
Low Income ◽  
World Health ◽  
Low Income Countries ◽  
Multivariable Logistic Regression Analysis ◽  
World Health Survey ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Low And Middle Income

Tuberculosis (TB) is a leading cause of mortality in low- and middle-income countries (LMICs). TB multimorbidity [TB and ≥1 non-communicable diseases (NCDs)] is common, but studies are sparse. Cross-sectional, community-based data including adults from 21 low-income countries and 27 middle-income countries were utilized from the World Health Survey. Associations between 9 NCDs and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Eight out of 9 NCDs (all except visual impairment) were associated with TB (odds ratio (OR) ranging from 1.38–4.0). Prevalence of self-reported TB increased linearly with increasing numbers of NCDs. Compared to those with no NCDs, those who had 1, 2, 3, 4, and ≥5 NCDs had 2.61 (95% confidence interval (CI) = 2.14–3.22), 4.71 (95%CI = 3.67–6.11), 6.96 (95%CI = 4.95–9.87), 10.59 (95%CI = 7.10–15.80), and 19.89 (95%CI = 11.13–35.52) times higher odds for TB. Among those with TB, the most prevalent combinations of NCDs were angina and depression, followed by angina and arthritis. For people with TB, the YLDs were three times higher than in people without multimorbidity or TB, and a third of the YLDs were attributable to NCDs. Urgent research to understand, prevent and manage NCDs in people with TB in LMICs is needed.

A Fallacy of the World Health Organization's Mental Health Gap Action Programme and Intervention Guide: Counseling and Psychotherapy Are Also (Western) Indigenous/Traditional Healing Methods

2020 ◽  
Vol 22 (1) ◽  
pp. 49-61
Author(s):  
Robinder P. Bedi ◽  
Mohit Bassi
Keyword(s):  
Mental Health ◽  
Mental Health Treatment ◽  
Global Mental Health ◽  
World Health ◽  
Middle Income ◽  
Western Countries ◽  
The World ◽  
Health Gap ◽  
Cultural Healing ◽  
Action Programme

This article will argue that, rather than being objective and universal treatment appro-aches, counseling and psychotherapy are indigenous/traditional (i.e., cultural) healing methods of the Euro-American West. Therefore, the World Health Organization's Mental Health Gap Action Programme (MHGAP), designed to provide increased access to reportedly highly effective Western mental health treatment services in many low- and middle-income countries, is likely to falter. It can be argued that culturally adapted counseling and psychotherapy will be most effective for individuals in non-Western countries who endorse or are somewhat acculturated to Western understandings and ways of living. Therefore, Western psychological interventions should not be at the forefront of the MHGAP in non-Western countries. Supportive evidence for this perspective is summarized and alternative approaches to promoting global mental health that draw on non-Western indigenous healing practices are presented.

Suicide ideation, plans and attempts in Ukraine: findings from the Ukraine World Mental Health Survey

2007 ◽  
Vol 37 (6) ◽  
pp. 807-819 ◽  
Author(s):  
EVELYN J. BROMET ◽  
JOHAN M. HAVENAAR ◽  
NATHAN TINTLE ◽  
STANISLAV KOSTYUCHENKO ◽  
ROMAN KOTOV ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Psychiatric Disorders ◽  
Service Utilization ◽  
Suicide Ideation ◽  
World Health ◽  
Functional Impairments ◽  
World Mental Health ◽  
Co Morbidity ◽  
The World

Background. Because the suicide rates in Eastern Europe have increased, the epidemiology of suicide behaviors in this part of the world is in urgent need of study. Using data from the Ukraine site of the World Mental Health (WMH) Survey Initiative, we present the first population-based findings from a former Soviet country on the descriptive epidemiology of suicide ideation, plans and attempts, and their links to current functioning and service utilization.Method. In 2002, a nationally representative sample of 4725 adults in Ukraine was interviewed with the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Risk factors included demographic characteristics, trauma, smoking, and parental and personal psychiatric disorders. Current functional impairments and recent service utilization were assessed.Results. The lifetime prevalence of suicide ideation was 8·2%. The average age of onset was 31. The key risk factors were female sex, younger age, trauma, parental depression, and prior alcohol, depressive and intermittent explosive disorders, especially the presence of co-morbidity. Ideators had poorer functioning and greater use of health services. One-third of ideators had a plan, and one-fifth made an attempt. Among ideators, young age, smoking and prior psychiatric disorders were risk factors for these behaviors.Conclusions. Together with the increasing suicide rate, these results suggest that suicide intervention programs in Ukraine should focus on the generation of young adults under 30. The associations with co-morbidity, impairments in current functioning and greater service use indicate that a physician education program on suicidality should be comprehensive in scope and a public health priority in Ukraine.

scholarly journals Proportion of patients without mental disorders being treated in mental health services worldwide

2015 ◽  
Vol 206 (2) ◽  
pp. 101-109 ◽  
Author(s):  
Ronny Bruffaerts ◽  
Jose Posada-Villa ◽  
Ali Obaid Al-Hamzawi ◽  
Oye Gureje ◽  
Yueqin Huang ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Dose Response ◽  
Mental Health Treatment ◽  
World Health ◽  
Health Treatment ◽  
The Past ◽  
The World ◽  
Dsm Iv

BackgroundPrevious research suggests that many people receiving mental health treatment do not meet criteria for a mental disorder but are rather ‘the worried well’.AimsTo examine the association of past-year mental health treatment with DSM-IV disorders.MethodThe World Health Organization's World Mental Health (WMH) Surveys interviewed community samples of adults in 23 countries (n = 62 305) about DSM-IV disorders and treatment in the past 12 months for problems with emotions, alcohol or drugs.ResultsRoughly half (52%) of people who received treatment met criteria for a past-year DSM-IV disorder, an additional 18% for a lifetime disorder and an additional 13% for other indicators of need (multiple subthreshold disorders, recent stressors or suicidal behaviours). Dose–response associations were found between number of indicators of need and treatment.ConclusionsThe vast majority of treatment in the WMH countries goes to patients with mental disorders or other problems expected to benefit from treatment.

scholarly journals Barriers and opportunities for refugee mental health services: clinician recommendations from Jordan

2021 ◽  
Vol 8 ◽  
Author(s):  
Majd Al-Soleiti ◽  
Mahmoud Abu Adi ◽  
Ayat Nashwan ◽  
Eric Rafla-Yuan
Keyword(s):  
Mental Health ◽  
Health System ◽  
Mental Health Professionals ◽  
Low Income ◽  
Health Professionals ◽  
Mental Health Treatment ◽  
Qualitative Interviews ◽  
Low Income Countries ◽  
Syrian Refugees ◽  
Increased Risk

Abstract Background Jordan has received more than three million refugees from bordering countries during times of conflict, including over 600 000 Syrian refugees between 2011 and 2021. Amidst this humanitarian crisis, a new mental health system for Syrian refugees has developed in Jordan, with most clinical services administered through non-governmental organizations. Prior studies have identified increased risk of psychiatric disorders in refugee populations and significant barriers for Syrian refugees seeking mental health treatment, but few have reviewed the organization or ability of local systems to meet the needs of this refugee population. Methods Qualitative interviews of mental health professionals working with refugees in Jordan were conducted and thematically analyzed to assess efficacy and organizational dynamics. Results Interviewees described barriers to care inherent in many refugee settings, including financial limitations, shortages of mental health professionals, disparate geographic accessibility, stigma, and limited or absent screening protocols. Additional barriers not previously described in Jordan were identified, including clinician burnout, organizational metrics restricting services, insufficient visibility of services, and security restrictions. Advantages of the Jordanian system were also identified, including a receptive sociopolitical response fostering coordination and collaboration, open-door policies for accessing care, the presence of community and grassroots approaches, and improvements to health care infrastructure benefiting the local populace. Conclusions These findings highlight opportunities and pitfalls for program development in Jordan and other middle- and low-income countries. Leveraging clinician input can promote health system efficacy and improve mental health outcomes for refugee patients.

scholarly journals Democratizing Health Research

2020 ◽  
Author(s):  
Robert Fraser Terry ◽  
Erik Lieungh
Keyword(s):  
Low Income ◽  
Royal Society ◽  
Research Policy ◽  
Cultural Barriers ◽  
World Health ◽  
Low Income Countries ◽  
Research Assessment ◽  
The World ◽  
New Research ◽  
And Training

Is it fair that researchers and policymakers in low-income countries have to pay to read new research on diseases they treat? Today's guest is Robert Terry from the World Health Organization’s Special Programme for Research and Training in Tropical Diseases (TDR), where he works as a manager of research policy. His background is from both the Royal Society and the Wellcome Trust. For Terry, achieving open access requires addressing barriers across political, technical and cultural barriers, with the culture of research assessment and reward needing the biggest change to democratizing science. The host of this episode is Erik Lieungh. This episode was first published 16 December 2019.

scholarly journals Tailoring a training based on the Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) to Tunisia: process and relevant adaptations

2018 ◽  
Vol 5 ◽  
Author(s):  
Jessica Spagnolo ◽  
François Champagne ◽  
Nicole Leduc ◽  
Wahid Melki ◽  
Imen Guesmi ◽  
...  
Keyword(s):  
Mental Health ◽  
World Health Organization ◽  
Mental Health Treatment ◽  
Training Programme ◽  
World Health ◽  
Adaptation Process ◽  
The World ◽  
Health Gap ◽  
Action Programme ◽  
Health Organization

BackgroundIn order to make mental health services more accessible, the Tunisian Ministry of Health, in collaboration with the School of Public Health at the University of Montreal, the World Health Organization office in Tunisia and the Montreal World Health Organization-Pan American Health Organization Collaborating Center for Research and Training in Mental Health, implemented a training programme based on the Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) (version 1.0), developed by the World Health Organization. This article describes the phase prior to the implementation of the training, which was offered to general practitioners working in primary care settings in the Greater Tunis area of Tunisia.MethodsThe phase prior to implementation consisted of adapting the standard mhGAP-IG (version 1.0) to the local primary healthcare context. This adaptation process, an essential step before piloting the training, involved discussions with stakeholder groups, as well as field observations.ResultsThrough the adaptation process, we were able to make changes to the standard training format and material. In addition, the process helped uncover systemic barriers to effective mental health care.ConclusionsTargeting these barriers in addition to implementing a training programme may help reduce the mental health treatment gap, and promote implementation that is successful and sustainable.

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