Accuracy of proactive case finding for mental disorders by
                        community informants in Nepal

BackgroundAccurate detection of persons in need of mental healthcare is crucial to reduce the treatment gap between psychiatric burden and service use in low- and middle-income (LAMI) countries.AimsTo evaluate the accuracy of a community-based proactive case-finding strategy (Community Informant Detection Tool, CIDT), involving pictorial vignettes, designed to initiate pathways for mental health treatment in primary care settings.MethodCommunity informants using the CIDT identified screen positive (n = 110) and negative persons (n = 85). Participants were then administered the Composite International Diagnostic Interview (CIDI).ResultsThe CIDT has a positive predictive value of 0.64 (0.68 for adults only) and a negative predictive value of 0.93 (0.91 for adults only).ConclusionsThe CIDT has promising detection properties for psychiatric caseness. Further research should investigate its potential to increase demand for, and access to, mental health services.

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Drop out from out-patient mental healthcare in the World Health Organization's World Menta Health Survey initiative

The British Journal of Psychiatry ◽

10.1192/bjp.bp.112.113134 ◽

2013 ◽

Vol 202 (1) ◽

pp. 42-49 ◽

Cited By ~ 34

Author(s):

J. Elisabeth Wells ◽

Mark Oakley Browne ◽

Sergio Aguilar-Gaxiola ◽

Ali Al-Hamzawi ◽

Jordi Alonso ◽

...

Keyword(s):

Mental Health ◽

Mental Health Treatment ◽

Mental Healthcare ◽

Income Group ◽

Drop Out ◽

World Health ◽

Health Treatment ◽

Middle Income ◽

Middle Income Countries ◽

The World

BackgroundPrevious community surveys of the drop out from mental health treatment have been carried out only in the USA and Canada.AimsTo explore mental health treatment drop out in the World Health Organization World Mental Health Surveys.MethodRepresentative face-to-face household surveys were conducted among adults in 24 countries. People who reported mental health treatment in the 12 months before interview (n = 8482) were asked about drop out, defined as stopping treatment before the provider wanted.ResultsOverall, drop out was 31.7%: 26.3% in high-income countries, 45.1% in upper-middle-income countries, and 37.6% in low/ lower/middle-income countries. Drop out from psychiatrists was 21.3% overall and similar across country income groups (high 20.3%, upper-middle 23.6%, low/lower-middle 23.8%) but the pattern of drop out across other sectors differed by country income group. Drop out was more likely early in treatment, particularly after the second visit.ConclusionsDrop out needs to be reduced to ensure effective treatment.

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Prevalence, service use, and demographic correlates of 12-month DSM-IV psychiatric disorders in Mexico: results from the Mexican National Comorbidity Survey

Psychological Medicine ◽

10.1017/s0033291705005672 ◽

2005 ◽

Vol 35 (12) ◽

pp. 1773-1783 ◽

Cited By ~ 106

Author(s):

M. ELENA MEDINA-MORA ◽

GUILHERME BORGES ◽

CARMEN LARA ◽

CORINA BENJET ◽

JERÓNIMO BLANCO ◽

...

Keyword(s):

Mental Health ◽

Psychiatric Disorders ◽

Service Use ◽

Task Force ◽

Adult Population ◽

Composite International Diagnostic Interview ◽

Diagnostic Interview ◽

Selection Scheme ◽

Demographic Correlates ◽

Dsm Iv

Background. This paper describes the 12-month prevalence, severity and demographic correlates of 16 DSM-IV psychiatric disorders and service utilization in the Mexican urban population aged 18–65 years of age. This is representative of 75% of the national adult population.Method. The sample design was a strict probability selection scheme. The response rate was 76·6%. The World Mental Health Survey version of the Composite International Diagnostic Interview was installed on laptops and administered by lay interviewers. An international WHO task force carried out its translation into Spanish.Results. The 12-month prevalence of any disorder was 12·1%. The most common disorders were specific phobia (4·0%), major depressive disorder (3·7%) and alcohol abuse or dependence (2·2%). The 12-month prevalence of very severe disorders was 3·7% of which only 24% used any services. Age was the only variable associated with any 12-month disorder, with the younger more likely to report any disorder. Income was associated with severity, with low and low–average incomes more likely to report a 12-month disorder. Females were more likely to report a mood and anxiety disorder, but less likely to report a substance disorder. The group of separated/widowed/divorced was more likely to report a mood and an impulse-control disorder.Conclusions. The results show that while psychiatric disorders are common in the Mexican population, very severe mental disorders are less common and there is extreme under-utilization of mental health services.

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Embodied Ethical Decision-Making: A Clinical Case Study of Respect for Culturally Based Meaning Making in Mental Healthcare

American Journal of Dance Therapy ◽

10.1007/s10465-020-09338-3 ◽

2021 ◽

Author(s):

Megz Roberts

Keyword(s):

Mental Health ◽

Decision Making ◽

Mental Health Treatment ◽

Ethical Decision ◽

Ethical Decision Making ◽

Meaning Making ◽

Hospital Setting ◽

Mental Healthcare ◽

Clinical Case Study ◽

Culturally Based

AbstractHow does embodied ethical decision-making influence treatment in a clinical setting when cultural differences conflict? Ethical decision-making is usually a disembodied and rationalized procedure based on ethical codes (American Counseling Association, 2014; American Dance Therapy Association, 2015; American Mental Health Counseling Association, 2015) and a collective understanding of right and wrong. However, these codes and collective styles of meaning making were shaped mostly by White theorists and clinicians. These mono-cultural lenses lead to ineffective mental health treatment for persons of color. Hervey’s (2007) EEDM steps encourage therapists to return to their bodies when navigating ethical dilemmas as it is an impetus for bridging cultural differences in healthcare. Hervey’s (2007) nonverbal approach to Welfel’s (2001) ethical decision steps was explored in a unique case that involved the ethical decision-making process of an African-American dance/movement therapy intern, while providing treatment in a westernized hospital setting to a spiritual Mexican–American patient diagnosed with PTSD and generalized anxiety disorder. This patient had formed a relationship with a spirit attached to his body that he could see, feel, and talk to, but refused to share this experience with his White identifying psychiatric nurse due to different cultural beliefs. Information gathered throughout the clinical case study by way of chronological loose and semi-structured journaling, uncovered an ethical dilemma of respect for culturally based meanings in treatment and how we identify pathology in hospital settings. The application of the EEDM steps in this article is focused on race/ethnicity and spiritual associations during mental health treatment at an outpatient hospital setting. Readers are encouraged to explore ways in which this article can influence them to apply EEDM in other forms of cultural considerations (i.e. age) and mental health facilities. The discussion section of this thesis includes a proposed model for progressing towards active multicultural diversity in mental healthcare settings by way of the three M’s from the relational-cultural theory: movement towards mutuality, mutual empathy, and mutual empowerment (Hartling & Miller, 2004).

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Changes in daily mental health service use and mortality at the commencement and lifting of COVID-19 ‘lockdown’ policy in 10 UK sites: a regression discontinuity in time design

BMJ Open ◽

10.1136/bmjopen-2021-049721 ◽

2021 ◽

Vol 11 (5) ◽

pp. e049721

Author(s):

Ioannis Bakolis ◽

Robert Stewart ◽

David Baldwin ◽

Jane Beenstock ◽

Paul Bibby ◽

...

Keyword(s):

Mental Health ◽

Inpatient Care ◽

Service Use ◽

Regression Discontinuity ◽

Mental Healthcare ◽

Service Level ◽

Community Services ◽

Mental Health Service Use ◽

Healthcare Data ◽

Early Intervention In Psychosis

ObjectivesTo investigate changes in daily mental health (MH) service use and mortality in response to the introduction and the lifting of the COVID-19 ‘lockdown’ policy in Spring 2020.DesignA regression discontinuity in time (RDiT) analysis of daily service-level activity.Setting and participantsMental healthcare data were extracted from 10 UK providers.Outcome measuresDaily (weekly for one site) deaths from all causes, referrals and discharges, inpatient care (admissions, discharges, caseloads) and community services (face-to-face (f2f)/non-f2f contacts, caseloads): Adult, older adult and child/adolescent mental health; early intervention in psychosis; home treatment teams and liaison/Accident and Emergency (A&E). Data were extracted from 1 Jan 2019 to 31 May 2020 for all sites, supplemented to 31 July 2020 for four sites. Changes around the commencement and lifting of COVID-19 ‘lockdown’ policy (23 March and 10 May, respectively) were estimated using a RDiT design with a difference-in-difference approach generating incidence rate ratios (IRRs), meta-analysed across sites.ResultsPooled estimates for the lockdown transition showed increased daily deaths (IRR 2.31, 95% CI 1.86 to 2.87), reduced referrals (IRR 0.62, 95% CI 0.55 to 0.70) and reduced inpatient admissions (IRR 0.75, 95% CI 0.67 to 0.83) and caseloads (IRR 0.85, 95% CI 0.79 to 0.91) compared with the pre lockdown period. All community services saw shifts from f2f to non-f2f contacts, but varied in caseload changes. Lift of lockdown was associated with reduced deaths (IRR 0.42, 95% CI 0.27 to 0.66), increased referrals (IRR 1.36, 95% CI 1.15 to 1.60) and increased inpatient admissions (IRR 1.21, 95% CI 1.04 to 1.42) and caseloads (IRR 1.06, 95% CI 1.00 to 1.12) compared with the lockdown period. Site-wide activity, inpatient care and community services did not return to pre lockdown levels after lift of lockdown, while number of deaths did. Between-site heterogeneity most often indicated variation in size rather than direction of effect.ConclusionsMH service delivery underwent sizeable changes during the first national lockdown, with as-yet unknown and unevaluated consequences.

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Preferences toward digital and non-digital mental health treatment delivery formats: A survey of Indian college students (Preprint)

10.2196/preprints.30158 ◽

2021 ◽

Author(s):

Akash Wasil ◽

Tanvi Malhotra ◽

Nandita Tuteja ◽

Nivedita Nandakumar ◽

Laleh Pandole ◽

...

Keyword(s):

Mental Health ◽

College Students ◽

Group Therapy ◽

Mental Health Treatment ◽

Strong Association ◽

Middle Income ◽

Treatment Delivery ◽

Intervention Delivery ◽

Self Help ◽

Delivery Formats

BACKGROUND Digital mental health treatments have the potential to expand access to services in low- and middle-income countries (LMICs), but the uptake of interventions has been limited. Furthermore, the attitudes of those in LMICs toward intervention formats are rarely studied. OBJECTIVE To understand the attitudes of Indian college students toward a variety of digital and non-digital treatment delivery formats. METHODS Indian college students received descriptions of seven treatment delivery formats: unguided digital self-help, guided digital self-help, bibliotherapy, one-on-one therapy with a professional, one-on-one therapy with a lay provider, group therapy with a professional, and group therapy with a lay provider. They were asked to rate each delivery format on three domains: a) perceived helpfulness, b) availability, and c) willingness to try. RESULTS 95% of individuals were willing to try one-on-one therapy with a professional, 56% were willing to try one-on-one therapy with a lay counselor, participants were less willing to try group interventions than one-on-one interventions, and <50% were willing to try digital self-help interventions. Additionally, there was a strong association between willingness to try and ratings of helpfulness (r=0.61). Ratings were not associated with gender, age, or depressive symptoms. CONCLUSIONS Our findings suggest that one barrier limiting the uptake of digital interventions in LMICs is that individuals do not perceive them as helpful. Efforts to disseminate information about non-traditional intervention delivery formats and their benefits are warranted.

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Interventions to promote psychiatric patients’ compliance to mental health treatment: A systematic review

Health SA Gesondheid ◽

10.4102/hsag.v19i1.799 ◽

2014 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Mosidi B. Serobatse ◽

Emmerentia Du Plessis ◽

Magdalena P. Koen

Keyword(s):

Mental Health ◽

Systematic Review ◽

Mental Health Professionals ◽

Mental Health Treatment ◽

Psychiatric Patients ◽

Research Question ◽

Mental Healthcare ◽

Healthcare Services ◽

Current Evidence ◽

Health Treatment

Background: Non-compliance to treatment remains one of the greatest challenges in mental healthcare services, and how to improve this remains a problem.Aim: The aim of this study was to critically synthesise the best available evidence from literature regarding interventions to promote psychiatric patients’ compliance to mental health treatment. The interventions can be made available for mental health professionals to use in clinical practice.Method: A systematic review was chosen as a design to identify primary studies that answered the following research question: What is the current evidence on interventions to promote psychiatric patients’ compliance to mental health treatment? Selected electronic databases were thoroughly searched. Studies were critically appraised and identifid as answeringthe research questions. Evidence extraction, analysis and synthesis were then conducted by means of evidence class rating and grading of strength prescribed in the American Dietetic Association’s manual.Results: The systematic review identifid several interventions that can improve patients’ compliance in mental health treatment, for example adherence therapy and motivational interviewing techniques during in-hospital stay.Conclusions: Conclusions were drawn and recommendations formulated for nursing practice, education and research.Agtergrond: Geen-samewerking met behandeling bly steeds een van die grootste uitdagings in geestesgesondheidsorgdienste, en genoegsame kennis oor hoe om dit te verbeter, is steeds ’n probleem.Doelwit: Die doel van hierdie studie was om die beskikbare bewyse vanuit literatuur aangaande intervensies ter bevordering van psigiatriese pasiënte se samewerking met geestesgesondheidsbehandeling krities te sintetiseer. Hierdie intervensies kan aan professionele gesondheidsorgpersoneel beskikbaar gestel word ter bevordering van psigiatriese pasiënte se samewerking met geestesgesondheidsbehandeling.Metode: ’n Sistematiese literatuuroorsig is gekies as die ontwerp om primêre studieste identifieer wat die volgende navorsingsvraag beantwoord: Wat is die huidige kennis ten opsigte van intervensies wat psigiatriese pasiënte se samewerking met geestesgesondheidsbehandeling bevorder?Resultate: Studies is ingesluit vir kritiese gehalte-beoordeling ten opsigte van metodologie, en is uiteindelik geïdentifieer as bronne van bewyse wat die literatuuroorsigvraag toepaslik beantwoord. Bewysonttrekking, -analise en -sintese is gedoen deur middel van die beoordeling van bewysklas en -gradering van bewyssterkte, soos voorgeskryf in die American Dietetic Association se handleiding. Die sistemiese literatuuroorsig het aangedui datdaar heelparty intervensies is wat psigiatriese pasiënte se samewerking met behandeling kan verbeter, byvoorbeeld samewerkingsterapie en motiveringsonderhoudstegnieke.Gevolgtrekking: Gevolgtrekkings is gemaak en aanbevelings is geformuleer vir die verpleegpraktyk, verpleegonderrig en navorsing in verpleging.

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Effective Treatment Interventions for Global Mental Health: An Analysis of Biomedical and Psychosocial Approaches in Use Today

Psychology and Mental Health Care ◽

10.31579/2637-8892/076 ◽

2020 ◽

Vol 4 (3) ◽

pp. 01-14

Author(s):

Michael Galvin

Keyword(s):

Mental Health ◽

Mental Illness ◽

Mental Health Treatment ◽

Health Workers ◽

Global Mental Health ◽

Psychosocial Treatment ◽

Middle Income ◽

Public Health Workers ◽

The Right ◽

Psychosocial Approaches

We are in an important moment for mental health treatment around the world, as many Low and Middle Income Countries (LMICs) – representing an increasing majority of the world’s population – are currently developing and scaling up services for the first time. Yet, research on Global Mental Health (GMH) best practices remains scattered and difficult to synthesize. This review aims to simplify existing GMH research on effective biomedical and psychosocial treatment approaches from both high-income countries and LMICs to enable a more comprehensive understanding of the benefits and drawbacks of existing interventions, based on the highest quality, up-to-date research. By understanding which treatments are most effective and why, we can begin to not only implement more effective practices, but guide the future of GMH research in the right directions. The purpose of this review is therefore to understand mental illness, what it is, how it was treated in the past, how it manifests differently around the globe, and how to best treat it. Ultimately, while psychosocial approaches are advised for patients with more mild to moderate disorders, medications and other biomedical approaches are recommended increasingly only for more severe cases. While significant evidence exists to justify the use of psychotropic medications for mental illness, their adverse effects indicate that psychosocial approaches should be prioritized as first line treatments, particularly for mild to moderate disorders. As one of the first to analyze this research, this review is useful not only for GMH scholars, but for practitioners and public health workers globally, as well.

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Practices and Perspectives of Mental Health in the Balkan Countries: A Narrative Review

IU Journal of Undergraduate Research ◽

10.14434/iujur.v5i1.26876 ◽

2019 ◽

Author(s):

Maya E. Lee

Keyword(s):

Mental Health ◽

Mental Health Treatment ◽

Mental Healthcare ◽

Research Literature ◽

Economic Research ◽

Health Issues ◽

The Balkans ◽

Historical Perspectives ◽

Yugoslav Republic ◽

Balkan Region

Mental health and wellness are integral parts to person’s overall health and happiness. Globally, there has been an increased initiative to treat and support people living with mental health issues and disease; the Balkan region of southeastern Europe is no exception. A literary review researching the background of mental health treatment and how it intersects with the unique history and current administrative environment within the nations of the former Yugoslav Republic was conducted. Existing literature about mental health prevalence and practices within the region was analyzed and contextualized with historical perspectives. Significant gaps in research literature were identified, including lack of research into everyday mental disorders in the region that are not to do with the recent civil war, a need for standardized data collection about where mental health infrastructure exists within the region and how effective it is in treating patients, and finally economic research to determine how and by which governing body national healthcare systems should be funded. Filling these gaps in knowledge would greatly reduce barriers to mental healthcare and overall wellness within the Balkans.

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Family functioning but not social capital is associated with better mental health in adolescents affected by violence and displacement by armed conflict in Colombia

International Journal of Social Psychiatry ◽

10.1177/00207640211045417 ◽

2021 ◽

pp. 002076402110454

Author(s):

William Tamayo-Aguledo ◽

Alida Acosta-Ortiz ◽

Aseel Hamid ◽

Carolina Gómez-García ◽

María Camila García-Durán ◽

...

Keyword(s):

Mental Health ◽

Social Capital ◽

Family Functioning ◽

Armed Conflict ◽

Composite International Diagnostic Interview ◽

Poor Mental Health ◽

Diagnostic Interview ◽

Cross Sectional ◽

Nationally Representative ◽

Cognitive Social Capital

Background: The effect of the Colombian armed conflict on the mental health of adolescents is still poorly understood. Aims: Given social interventions are most likely to inform policy, we tested whether two potential intervention targets, family functioning and social capital, were associated with mental health in Colombian adolescents, and whether this was moderated by experience of violence and displacement. Methods: We examined the cross-sectional association between family functioning, cognitive social capital, structural social capital and 12-month prevalence of Composite International Diagnostic Interview (CIDI) diagnosed psychiatric disorder, using data on 12 to 17-year-old adolescents ( N = 1,754) from the 2015 National Mental Health Survey of Colombia, a nationally representative epidemiological study. We tested whether associations survived cumulative adjustment for demographic confounders, experience of non-specific violence and harm and displacement by armed conflict. Results: Neither structural nor cognitive social capital were associated with better mental health. Better family functioning was associated with reduced risk of poor mental health in an unadjusted analysis (OR 0.90 [0.85–0.96]), and after cumulative adjustments for demographic confounders (OR 0.91 [0.86–0.97]), non-specific violence and harm (OR 0.91 [0.86–0.97]) and social capital variables (OR 0.91 [0.85–0.97]). In the final model, each additional point on the family APGAR scale was associated with a 9% reduced odds of any CIDI diagnosed disorder in the last 12 months. Conclusions: Better family functioning was associated with better mental health outcomes for all adolescents. This effect remained present in those affected by the armed conflict even after accounting for potential confounders.

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Latent Class Analysis of DSM-5 Criteria for Opioid Use Disorders: Results from the Iranian National Survey on Mental Health

European Addiction Research ◽

10.1159/000369338 ◽

2015 ◽

Vol 21 (3) ◽

pp. 144-152 ◽

Cited By ~ 7

Author(s):

Mohammad Javad Tarrahi ◽

Afarin Rahimi-Movaghar ◽

Hojjat Zeraati ◽

Seyed Abbas Motevalian ◽

Masoumeh Amin-Esmaeili ◽

...

Keyword(s):

Mental Health ◽

Latent Class ◽

Composite International Diagnostic Interview ◽

Opioid Use Disorder ◽

Diagnostic Interview ◽

Opioid Use ◽

Dsm 5 ◽

Legal Problems ◽

Dsm Iv ◽

Opioid Users

Background: Assessments of DSM-IV and DSM-5 criteria with sample populations of opioid users are limited. This study aimed to determine the number of latent classes in opioid users and assessment of the proposed revisions to the DSM-5 opioid use disorder (OUD) criteria. Methods: Data came from the 2011 Iranian National Mental Health Survey (IranMHS) on 7,886 participants aged 15-64 years living in Iran. We used the Composite International Diagnostic Interview (CIDI) version 2.1 in all respondents who indicated using opioids at least 5 times in the previous 12 months (n = 236). Results: A three-class model provided the best fit of all the models tested. Classes showed a spectrum of severity that was compatible with the DSM-5 classification. ‘Legal problems' and ‘desire to cut down' showed poor discrimination between classes. The weighted prevalence of OUD using DSM-5 was 20.7% higher than with DSM-IV. Conclusions: Results support the grouping based on severity of symptoms, combining abuse and dependence into a single diagnosis, omitting legal problems, and addition of craving as a new criterion.

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