Interview with Dr. Yasser Abu Jamei: The Gaza Community Mental Health Programme

2016 ◽  
Vol 45 (2) ◽  
pp. 120-126 ◽  
Author(s):  
Brittany Dawson ◽  
Zeina Azzam
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Mental Health Professionals ◽  
Structural Damage ◽  
Large Scale ◽  
Community Education ◽  
Health Workers ◽  
Psychosocial Support ◽  
Mental Health Programme ◽  
Health Programme

This October 2015 interview with director of the Gaza Community Mental Health Programme (GCMHP) Dr. Yasser Abu Jamei addresses how mental health professionals care for themselves and each other in an environment with little break from sustained conflict. Mental health workers in the Gaza Strip must cope with the resource shortage generated by the Israeli blockade and their own trauma while aiding others. The United Nations Children's Emergency Fund (UNICEF) estimates that over one-third of Gaza's children require direct and specialized psychosocial support as a result of Israel's Operation Protective Edge (OPE), the fifty-day war on Gaza in the summer of 2014, and earlier assaults. GCMHP provides services free of charge at clinics, community centers, and by phone via a twenty-four-hour hotline, and since its founding, has served more than twenty thousand Gazans with capacity-building programs and trainings, community education, scientific research, and human rights advocacy. GCMHP provided mental health support to the community both during and after each of the three large-scale Israeli assaults on Gaza (in 2008, 2012, and 2014), helping the community to work through both collective and individual trauma. Over twenty-one hundred Palestinians, five hundred of them children, were killed during OPE and another eleven thousand injured. During OPE an airstrike killed twenty-eight members of Abu Jamei's extended family, including nineteen children, as they broke their Ramadan fast. It was the largest loss of life within a single family at that point in the war. The structural damage was similarly catastrophic, leaving over one hundred thousand Gazans homeless. Long after the cease-fire, the psychological wounds sustained during consecutive assaults continue to disrupt everyday life.

scholarly journals Identifying pathways for large-scale implementation of a school-based mental health programme in the Eastern Mediterranean Region: a theory-driven approach

2020 ◽  
Vol 35 (Supplement_2) ◽  
pp. ii112-ii123 ◽  
Author(s):  
Olakunle Alonge ◽  
Anna Chiumento ◽  
Hesham M Hamoda ◽  
Eman Gaber ◽  
Zill-e- Huma ◽  
...  
Keyword(s):  
Mental Health ◽  
Mediterranean Region ◽  
Large Scale ◽  
Eastern Mediterranean ◽  
Eastern Mediterranean Region ◽  
Theory Of Change ◽  
Programme Implementation ◽  
School Based ◽  
Mental Health Programme ◽  
Health Programme

Abstract Globally there is a substantial burden of mental health problems among children and adolescents. Task-shifting/task-sharing mental health services to non-specialists, e.g. teachers in school settings, provide a unique opportunity for the implementation of mental health interventions at scale in low- and middle-income countries (LMICs). There is scant information to guide the large-scale implementation of school-based mental health programme in LMICs. This article describes pathways for large-scale implementation of a School Mental Health Program (SMHP) in the Eastern Mediterranean Region (EMR). A collaborative learning group (CLG) comprising stakeholders involved in implementing the SMHP including policymakers, programme managers and researchers from EMR countries was established. Participants in the CLG applied the theory of change (ToC) methodology to identify sets of preconditions, assumptions and hypothesized pathways for improving the mental health outcomes of school-aged children in public schools through implementation of the SMHP. The proposed pathways were then validated through multiple regional and national ToC workshops held between January 2017 and September 2019, as the SMHP was being rolled out in three EMR countries: Egypt, Pakistan and Iran. Preconditions, strategies and programmatic/contextual adaptations that apply across these three countries were drawn from qualitative narrative summaries of programme implementation processes and facilitated discussions during biannual CLG meetings. The ToC for large-scale implementation of the SMHP in the EMR suggests that identifying national champions, formulating dedicated cross-sectoral (including the health and education sector) implementation teams, sustained policy advocacy and stakeholders engagement across multiple levels, and effective co-ordination among education and health systems especially at the local level are among the critical factors for large-scale programme implementation. The pathways described in this paper are useful for facilitating effective implementation of the SMHP at scale and provide a theory-based framework for evaluating the SMHP and similar programmes in the EMR and other LMICs.

Transcultural issues in the dynamics of a Balint clinical reflection group for community mental health workers

2012 ◽  
Vol 49 (2) ◽  
pp. 366-376 ◽  
Author(s):  
Andrew Leggett
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Group Dynamics ◽  
Mental Health Professionals ◽  
Group Process ◽  
Health Workers ◽  
Clinical Work ◽  
Reflection Group ◽  
Mental Health Workers ◽  
Community Mental Health Workers

The author presents transcultural issues in the content, process, and group dynamics of consecutive meetings of a Balint clinical reflection group for community mental health workers at Inala, Australia. Balint work and the context and evolution of the group process are briefly described, as is the consultative research methodology. The process of a Balint group meeting is reported in detail, following the author’s consultation with group members. The collaborative work of a culturally diverse team of mental health professionals is examined in the context of discussion of a practitioner–patient relationship in which transcultural, gender, and family conflicts were the focus of affective and cognitive dissonance. For mental health workers engaging with communities of cultural diversity, Balint reflection groups can facilitate insight into cultural countertransferences that adversely affect clinical work. The group served to support the caseworkers’ engagement with patients of different cultures, and provided a safe environment for the creative consideration and exploration in fantasy of the emotional pressures and complex ethical dilemmas related to boundaries in transcultural client–practitioner relationships, including those in which open discussion would otherwise be avoided.

scholarly journals Systematic Medical Appraisal, Referral and Treatment (SMART) Mental Health Programme for providing innovative mental health care in rural communities in India

2015 ◽  
Vol 2 ◽  
Author(s):  
P. K. Maulik ◽  
S. Devarapalli ◽  
S. Kallakuri ◽  
D. Praveen ◽  
V. Jha ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mixed Methods ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Rural Areas ◽  
Health Workers ◽  
Mental Health Programme ◽  
Health Programme

Background.India has few mental health professionals to treat the large number of people suffering from mental disorders. Rural areas are particularly disadvantaged due to lack of trained health workers. Ways to improve care could be by training village health workers in basic mental health care, and by using innovative methods of service delivery. The ongoing Systematic Medical Appraisal, Referral and Treatment Mental Health Programme will assess the acceptability, feasibility and preliminary effectiveness of a task-shifting mobile-based intervention using mixed methods, in rural Andhra Pradesh, India.Method.The key components of the study are an anti-stigma campaign followed by a mobile-based mental health services intervention. The study will be done across two sites in rural areas, with intervention periods of 1 year and 3 months, respectively. The programme uses a mobile-based clinical decision support tool to be used by non-physician health workers and primary care physicians to screen, diagnose and manage individuals suffering from depression, suicidal risk and emotional stress. The key aim of the study will be to assess any changes in mental health services use among those screened positive following the intervention. A number of other outcomes will also be assessed using mixed methods, specifically focussed on reduction of stigma, increase in mental health awareness and other process indicators.Conclusions.This project addresses a number of objectives as outlined in the Mental Health Action Plan of World Health Organization and India's National Mental Health Programme and Policy. If successful, the next phase will involve design and conduct of a cluster randomised controlled trial.

scholarly journals Where there is no psychiatrist: A mental health programme in Sierra Leone

2014 ◽  
Vol 20 (3) ◽  
pp. 6
Author(s):  
Pino Alonso ◽  
Brian Price ◽  
Abdul R Conteh ◽  
Carmen Valle ◽  
Patrick E Turay ◽  
...  
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Mental Disorders ◽  
Sierra Leone ◽  
Health Workers ◽  
Middle Income ◽  
Middle Income Countries ◽  
Mental Health Programme ◽  
Drug Use Disorders ◽  
Health Programme

<p><strong>Background.</strong> For most low- and middle-income countries, mental health remains a neglected area, despite the recognised burden associated with neuropsychiatric conditions and the inextricable link to other public health priorities.</p><p><strong>Objectives.</strong> To describe the results of a free outpatient mental health programme delivered by non-specialist health workers in Makeni, Sierra Leone between July 2008 and May 2012. </p><p><strong>Methods.</strong> A nurse and two counsellors completed an 8-week training course focused on the identification and management of seven priority conditions: psychosis, bipolar disorder, depression, mental disorders due to medical conditions, developmental and behavioural disorders, alcohol and drug use disorders, and dementia. The World Health Organization recommendations on basic mental healthcare packages were followed to establish treatment for each condition. </p><p><strong>Results.</strong> A total of 549 patients was assessed and diagnosed as suffering from psychotic disorders (<em>n</em>=295, 53.7%), manic episodes (<em>n</em>=69, 12.5%), depressive episodes (<em>n</em>=53, 9.6%), drug use disorders (<em>n</em>=182, 33.1%), dementia (<em>n</em>=30, 5.4%), mental disorders due to medical conditions (<em>n</em>=39, 7.1%), and developmental disorders (<em>n</em>=46, 8.3%). Of these, 417 patients received pharmacological therapy and 70.7% were rated as much or very much improved. Of those who could not be offered medication, 93.4% dropped out of the programme after the first visit. </p><p><strong>Conclusions.</strong> The identification and treatment of mental disorders must be considered an urgent public health priority in low- and middle-income countries. Trained primary health workers can deliver safe and effective treatment for mental disorders as a feasible alternative to ease the scarcity of mental health specialists in developing countries.</p>

scholarly journals Mental health integration in primary health services after the earthquake in Nepal: a mixed-methods program evaluation

2021 ◽  
Vol 8 ◽  
Author(s):  
Ashley Leichner ◽  
Aemal Akhtar ◽  
Caoimhe Nic a Bhaird ◽  
Rebecca Wener ◽  
Shiromi M. Perera ◽  
...  
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Health Services ◽  
Large Scale ◽  
Health Workers ◽  
Psychosocial Support ◽  
Lessons Learned ◽  
Service Users ◽  
Functional Impairments ◽  
Non Governmental Organizations

Abstract Background In the aftermath of the devastating 2015 earthquakes in Nepal, three non-governmental organizations collaborated to develop a program responding to the immediate mental health and psychosocial support (MHPSS) needs in three severely affected districts: Dhading, Gorkha, and Sindhuli. The program was implemented between April 2015 and February 2017 and aimed to (i) strengthen health worker capacity to provide integrated MHPSS services; and (ii) increase access to mental health services. This paper describes the program's implementation and the results of a pragmatic evaluation of the program's overall reach, effectiveness, and lessons learned. Methods The mixed-methods evaluation used routine program data, quantitative data from pre- and post-tests conducted with trainees and service users, and qualitative data from stakeholder interviews and focus group discussions. Results A total of 1041 health workers received MHPSS training and supervision. Participants demonstrated significant improvements in skills, knowledge, and self-rated perceived competency. Trainees went on to provide MHPSS services to 3422 people. The most commonly identified presenting problems were epilepsy (29%) and depression (26%). A total of 67% of service users reported being ‘completely satisfied’ with the services received and 83% of those experiencing severe functional impairments on enrollment demonstrated improvement after receiving services. Conclusions Despite operational challenges, the program successfully engaged both laypeople and health workers to provide MHPSS in the aftermath of the crisis. Lessons learned can inform the planning and implementation of future training and integration programs to provide large-scale MHPSS efforts in humanitarian settings.

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