scholarly journals Training in psychiatry in less developed countries

1989 ◽  
Vol 13 (10) ◽  
pp. 558-560 ◽  
Author(s):  
Neil L. Holden
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Physical Health ◽  
Health Resources ◽  
Developed Countries ◽  
Traditional Healers ◽  
World Health ◽  
Less Developed Countries ◽  
Year 2000 ◽  
Developed World

The declared aim of the World Health Organization, based on the Alma Ata declaration (1978), is to promote health care for all by the year 2000. It is recognised that this can be achieved only by the channelling of efforts into the development of primary health care, with medical care greatly augmented by the utilisation of non-medical carers, traditional healers and public health measures. As in more developed countries, where psychiatry struggles to maintain its share of national health resources against the ever increasing demand of technical advances in physical health care, so the mental health services of the less developed countries constantly are in danger of losing out to physical health in the battle against illness and natural disasters. To redress this balance and to meet the needs for mental health by the year 2000, the less developed world needs more psychiatrists (who are currently estimated to relate to the population at a rate of approximately only one per million) and these psychiatrists need to be appropriately trained to meet the challenges. How can the more developed nations help in this training of trainees from the less developed world? Can a partnership be formed between nations that ensures that trainees in psychiatry, in whichever country, are equipped as well as possible for the needs of their home country?

The Coronavirus Disease 2019 Pandemic in Taiwan: An Facebook Online study on Concern/Fear Regarding the Disease and General Anxiety and Relevant Factors (Preprint)

2020 ◽  
Author(s):  
Peng-Wei Wang ◽  
Wei-Hsin Lu ◽  
Yi-Lung Chen ◽  
Dian-Jeng Li ◽  
Yu-Ping Chang ◽  
...  
Keyword(s):  
Mental Health ◽  
Environmental Factors ◽  
Online Survey ◽  
Psychological Impact ◽  
Health Resources ◽  
World Health ◽  
Regional Government ◽  
General Anxiety ◽  
Self Confidence ◽  
Health Organization

BACKGROUND The World Health Organization (WHO) declared COVID-19 a ‘public health emergency of international concern. Both worry and anxiety are the common psychological impact during the pandemic. The level of and determinants for worry and anxiety during COVID-19 are not well explored. OBJECTIVE The present study aimed to explore the associations of demographic and environmental factors with worry toward COVID-19 and general anxiety among people in Taiwan. METHODS In total, 1970 respondents were recruited through a Facebook advertisement and completed an online survey on worry toward COVID-19, general anxiety during the pandemic, and individual and environmental factors. RESULTS In total, 51.7% and 43.4% of respondents reported high levels of worry toward COVID-19 and general anxiety, respectively. Worse self-rated mental health, lower self-confidence in COVID-19 management, and insufficient mental health resources were significantly associated with high levels of both worry toward COVID-19 and general anxiety. Lower perceived confidence in COVID-19 management by the regional government was significantly associated with a higher level of worry toward COVID-19. Lower perceived social support was significantly associated with a higher level of general anxiety during the COVID-19 pandemic. CONCLUSIONS The results showed that high levels of worry toward COVID-19 and general anxiety were prevalent during the disease outbreak. Multiple individual and environmental factors related to worry toward COVID-19 and general anxiety were identified. CLINICALTRIAL

scholarly journals The employment and mental health impact of integrated improving access to psychological therapies services: Evidence on secondary health care utilization from a pragmatic trial in three English counties

2021 ◽  
pp. 135581962199749
Author(s):  
Veronica Toffolutti ◽  
David Stuckler ◽  
Martin McKee ◽  
Ineke Wolsey ◽  
Judith Chapman ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Utilization ◽  
Physical Health ◽  
Health Problems ◽  
Care Utilization ◽  
Psychological Therapies ◽  
Physical Health Problems ◽  
Secondary Health Care

Objective Patients with a combination of long-term physical health problems can face barriers in obtaining appropriate treatment for co-existing mental health problems. This paper evaluates the impact of integrating the improving access to psychological therapies services (IAPT) model with services addressing physical health problems. We ask whether such services can reduce secondary health care utilization costs and improve the employment prospects of those so affected. Methods We used a stepped-wedge design of two cohorts of a total of 1,096 patients with depression and/or anxiety and comorbid long-term physical health conditions from three counties within the Thames Valley from March to August 2017. Panels were balanced. Difference-in-difference models were employed in an intention-to-treat analysis. Results The new Integrated-IAPT was associated with a decrease of 6.15 (95% CI: −6.84 to −5.45) [4.83 (95% CI: −5.47 to −4.19]) points in the Patient Health Questionnaire-9 [generalized anxiety disorder-7] and £360 (95% CI: –£559 to –£162) in terms of secondary health care utilization costs per person in the first three months of treatment. The Integrated-IAPT was also associated with an 8.44% (95% CI: 1.93% to 14.9%) increased probability that those who were unemployed transitioned to employment. Conclusions Mental health treatment in care model with Integrated-IAPT seems to have significantly reduced secondary health care utilization costs among persons with long-term physical health conditions and increased their probability of employment.

scholarly journals Self-reported suboptimal sleep and receipt of sleep assessment and treatment among persons with and without a mental health condition in Australia: a cross sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alexandra P. Metse ◽  
Caitlin Fehily ◽  
Tara Clinton-McHarg ◽  
Olivia Wynne ◽  
Sharon Lawn ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Physical Health ◽  
Health Condition ◽  
Community Dwelling ◽  
Mental Health Condition ◽  
Cross Sectional ◽  
Sleep Assessment ◽  
Assessment And Treatment ◽  
Sleep Parameters

Abstract Background Poor sleep and poor mental health go hand in hand and, together, can have an adverse impact on physical health. Given the already disproportionate physical health inequities experienced by people with a mental health condition worldwide, the need to consider and optimise sleep has been highlighted as a means of improving both physical and mental health status. Sleep recommendations recently developed by the United States’ National Sleep Foundation incorporate a range of sleep parameters and enable the identification of ‘suboptimal’ sleep. Among community-dwelling persons with and without a 12-month mental health condition in Australia, this study reports: [1] the prevalence of ‘suboptimal’ sleep and [2] rates of sleep assessment by a health care clinician/service and receipt of and desire for sleep treatment. Methods A descriptive study (N = 1265) was undertaken using self-report data derived from a cross-sectional telephone survey of Australian adults, undertaken in 2017. Results Fifteen per cent (n = 184) of participants identified as having a mental health condition in the past 12 months. Across most (7 of 8) sleep parameters, the prevalence of suboptimal sleep was higher among people with a mental health condition, compared to those without (all p < 0.05). The highest prevalence of suboptimal sleep for both groups was seen on measures of sleep duration (36–39% and 17–20% for people with and without a mental health condition, respectively). In terms of sleep assessment and treatment, people with a mental health condition were significantly more likely to: desire treatment (37% versus 16%), have been assessed (38% versus 12%) and have received treatment (30% versus 7%). Conclusions The prevalence of suboptimal sleep among persons with a mental health condition in Australia is significantly higher than those without such a condition, and rates of assessment and treatment are low for both groups, but higher for people with a mental health condition. Population health interventions, including those delivered as part of routine health care, addressing suboptimal sleep are needed.

scholarly journals Community psychiatry's achievements

2014 ◽  
Vol 23 (4) ◽  
pp. 337-344 ◽  
Author(s):  
T. Burns
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Community Psychiatry ◽  
Psychosocial Interventions ◽  
Community Mental Health Team ◽  
Pattern Of Care ◽  
Mental Health Team ◽  
Health Team ◽  
Developed World

Mental health care in the second half of the 20th century in much of the developed world has been dominated by the move out from large asylums. Both in response to this move and to make it possible, a pattern of care has evolved which is most commonly referred to as ‘Community Psychiatry’. This narrative review describes this process, from local experimentation into the current era of evidence-based mental health care. It focuses on three main areas of this development: (i) the reprovision of care for those discharged during deinstitutionalisation; (ii) the evolution and evaluation of its characteristic feature the Community Mental Health Team; and (iii) the increasing sophistication of psychosocial interventions developed to support patients. It finishes with an overview of some current challenges.

Determinants of Quality of Life during the COVID-19 pandemic: An analysis of a large sample of Brazilian Health Professionals

2021 ◽  
Author(s):  
Jonas Jardim de Paula ◽  
Danielle de Souza Costa ◽  
Antônio Geraldo Silva ◽  
Débora Marques de Miranda ◽  
Leandro Malloy-Diniz
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Risk Factors ◽  
Health Care ◽  
Social Relations ◽  
Health Professionals ◽  
World Health ◽  
Large Sample ◽  
Explained Variance

Quality of Life (QoL) is a multidimensional estimate of biopsychosocial health and wellbeing.1 The COVID-19 pandemic led to an abrupt change in our lifestyle, demanding resilience and coping mechanisms2. Health care providers are in the frontline of COVID-19 patients’ diagnosis, treatment, and rehabilitation, and there is a well-documented impact of this context on their physical and mental health2. This might impact their wellbeing and reduce their quality of life. In this research letter, we investigated which factors are associated with QoL in Brazilian healthcare professionals. We aim to investigate both protective and risk factors for the four main aspects of QoL: physical, psychological, social relations, and environment. We assessed 97.771 Brazilian adults, most (92.3%) health professionals of different professions from all the five-country regions. All included individuals agreed in a written consent to participate. Participants showed an average of 35.45 years old (±9.49) and were predominantly female (80%). They answered an online questionnaire about sociodemographic aspects, measures of mental health, and quality of life in the first semester of 2020. A detailed description of the sample and procedures can be found elsewhere3. All participants answered the WHOQoL-BREF, a standardized tool for QoL assessment developed by the World Health Organization. Stepwise linear regression analysis was used to assess the role of sociodemographic factors, previously diagnosed mental disorders, COVID-19 related symptoms as well a series of specific questions regarding participants worries and perceptions about the pandemic, including the protective behaviors' adoption (social distancing, usage of masks and sanitizer, among others). A full list of variables (64 in total) is available on the SAMBE webpage (http://abpbrasil.org.br/pcabp/). Since we have a large sample size our statistical power is about 99% (alpha=0.01) to detect small effect sizes. To simplify our results and allow a more direct application to real-life settings we only included significant predictors which showed at least 1% of adjusted explained variance in the stepwise models. The stepwise regression model was summarized in the figure below. All regression models were significant (p&lt;0.001) as well all the predictors reported in the Figure. Total explained variance was 26% for Physical QoL, 27% for Psychological, 13% for Social Relations, and 19% for Environmental. A history of previous depression, presence of Headache, and the perception of worsening in home relationships were risk factors for lower QoL in all four domains. Our results suggest a multidimensional pattern of determinants of QoL in health care professionals in the early days of the pandemic. Interesting features emerged as predictors of QoL such as changes in home relationships, worsening in work productivity, and mental health. Expected and new predictors may shed light on which factors should be considered in interventions aiming at the development of mitigation of impact QoL in these populations.

Critical Care Nurses’ Physical and Mental Health, Worksite Wellness Support, and Medical Errors

2021 ◽  
Vol 30 (3) ◽  
pp. 176-184
Author(s):  
Bernadette Mazurek Melnyk ◽  
Alai Tan ◽  
Andreanna Pavan Hsieh ◽  
Kate Gawlik ◽  
Cynthia Arslanian-Engoren ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Critical Care ◽  
Physical Health ◽  
Medical Errors ◽  
Odds Ratio ◽  
Care Quality ◽  
Critical Care Nurses ◽  
Worksite Wellness ◽  
Physical And Mental Health

Background Critical care nurses experience higher rates of mental distress and poor health than other nurses, adversely affecting health care quality and safety. It is not known, however, how critical care nurses’ overall health affects the occurrence of medical errors. Objective To examine the associations among critical care nurses’ physical and mental health, perception of workplace wellness support, and self-reported medical errors. Methods This survey-based study used a cross-sectional, descriptive correlational design. A random sample of 2500 members of the American Association of Critical-Care Nurses was recruited to participate in the study. The outcomes of interest were level of overall health, symptoms of depression and anxiety, stress, burnout, perceived worksite wellness support, and medical errors. Results A total of 771 critical care nurses participated in the study. Nurses in poor physical and mental health reported significantly more medical errors than nurses in better health (odds ratio [95% CI]: 1.31 [0.96-1.78] for physical health, 1.62 [1.17-2.29] for depressive symptoms). Nurses who perceived that their worksite was very supportive of their well-being were twice as likely to have better physical health (odds ratio [95% CI], 2.16 [1.33-3.52]; 55.8%). Conclusion Hospital leaders and health care systems need to prioritize the health of their nurses by resolving system issues, building wellness cultures, and providing evidence-based wellness support and programming, which will ultimately increase the quality of patient care and reduce the incidence of preventable medical errors.

scholarly journals The nursing shortage: a worldwide problem

2002 ◽  
Vol 10 (3) ◽  
pp. 392-400 ◽  
Author(s):  
Rachel Z. Booth
Keyword(s):  
Health Care ◽  
Work Environment ◽  
Health Care System ◽  
Health Care Systems ◽  
Developed Countries ◽  
World Health ◽  
Insurance Companies ◽  
Advisory Group ◽  
Positive Effects ◽  
Care System

A worldwide shortage of nurses has been acknowledged by the multidisciplinary Global Advisory Group of the World Health Organization. The shortage is caused by an increased demand for nurses, while fewer people are choosing nursing as a profession and the current nurses worldwide are aging. The shortage applies to nurses in practice as well as the nurse faculty who teach students. The inter-country recruitment and migration of nurses from developing countries to developed countries exacerbates the problem. Although public opinion polls identifies the nurse as the person who makes the health care system work for them, the conditions of the work environment in which the nurse functions is unsatisfactory and must change. Numerous studies have shown the positive effects on the nurse of a healthy work environment and the positive relationships between nursing care and patient outcomes. It is important that government officials, insurance companies, and administrators and leaders of health care systems acknowledge and operationalize the value of nurses to the health care system in order to establish and maintain the integrity and viability of that system.

scholarly journals Cross-cultural differences in the epidemiology of unexplained fatigue syndromes in primary care

2003 ◽  
Vol 182 (3) ◽  
pp. 205-209 ◽  
Author(s):  
Petros Skapinakis ◽  
Glyn Lewis ◽  
Venetsanos Mavreas
Keyword(s):  
Primary Care ◽  
Secondary Analysis ◽  
Composite International Diagnostic Interview ◽  
Developed Countries ◽  
Diagnostic Interview ◽  
World Health ◽  
Less Developed Countries ◽  
Cross Cultural Differences ◽  
International Data ◽  
Health Organization

BackgroundUnexplained fatigue has been extensively studied but most of the samples used were from Western countries.AimsTo present international data on the prevalence of unexplained fatigue and fatigue as a presenting complaint in primary care.MethodSecondary analysis of the World Health Organization study of psychological problems in general health care. A total of 5438 primary care attenders from 14 countries were assessed with the Composite International Diagnostic Interview.ResultsThe prevalence of unexplained fatigue of 1-month duration differed across centres, with a range between 2.26 (95% CI 1.17–4.33) and 15.05 (95% CI 10.85–20.49). Subjects from more-developed countries were more likely to report unexplained fatigue but less likely to present with fatigue to physicians compared with subjects from less developed countries.ConclusionsIn less-developed countries fatigue might be an indicator of unmet psychiatric need, but in more-developed countries it is probably a symbol of psychosocial distress.

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