scholarly journals The future of psychiatry

10.17816/cp63 ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 3-7
Author(s):  
Norman Sartorius
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Human Rights ◽  
Mental Disorders ◽  
Mental Health Problems ◽  
Health Workers ◽  
Mental Healthcare ◽  
Past Century ◽  
Middle Income ◽  
Adequate Treatment

Since the Second World War mental health programmes and psychiatry have made significant advances. Countries, as well as the United Nations, have recognized the magnitude and severity of mental health problems, and numerous national programmes have been launched to deal with them. Technology relating to the treatment of mental disorders has advanced and significant progress has been made in terms of knowledge regarding the functioning of the brain. The awareness of the need to protect the human rights of those with mental illness has increased. National and regional programmes against stigma and the consequent discrimination of those with mental illness, have been launched in many countries. Associations bringing together those who have experienced mental illness and their relatives, have come into existence in many countries. While these are great steps forward, more work is necessary to complete these advances. In low- and middle-income countries, the vast majority of people with mental disorders do not receive adequate treatment. Even in highly industrialized countries, a third of people with severe forms of mental illness are not receiving the appropriate therapy. Laws concerning mental health are outdated in many countries. The protection of the human rights of the mentally ill is incomplete and imperfect. The emphasis on economic gain and the digitalization of medicine in recent years has not helped. On occasions, this has even slowed down the development of mental health services, and the provision of mental healthcare. Thus, psychiatry must still deal with the challenges of the past century, while facing new demands and tasks. Among the new tasks for psychiatry are undoubtedly reforms which will allow (i) the provision of appropriate care of people with comorbid mental and physical disorders, (ii) the application of interventions leading to the primary prevention of mental and neurological disorders, and (iii) a radical reform of the education of psychiatrists and other mental health workers, dealing with mental illness. Collaboration with other stakeholders in the field of mental health and medicine, will be of crucial importance in relation to all these tasks.

scholarly journals Global Mental Health: concepts, conflicts and controversies

2015 ◽  
Vol 24 (4) ◽  
pp. 285-291 ◽  
Author(s):  
Rob Whitley
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Problems ◽  
Health Workers ◽  
Global Mental Health ◽  
Scale Up ◽  
Cost Effective ◽  
Colonial Medicine ◽  
Middle Income ◽  
Intervention Delivery

This paper introduces, describes and analyses the emerging concept of Global Mental Health (GMH). The birth of GMH can be traced to London, 2007, with the publication of a series of high-profile papers inThe Lancet. Since then, GMH has developed into a movement with proponents, adherents, opponents, an ideology and core activities. The stated aims of the Movement for GMH are ‘to improve services for people living with mental health problems and psychosocial disabilities worldwide, especially in low- and middle-income countries where effective services are often scarce’. GMH could be considered an attempt to right a historic wrong. During the colonial and post-colonial eras, the mental health of subject populations was accorded a very low priority. This was fuelled by scientific racism, which alleged that mental illness was uncommon in places such as Africa. As developing nations have made the epidemiological transition, the burden of mental illness has proportionately increased, with research suggesting a massive ‘treatment gap’ between those in need and those actually receiving formal mental health care. As such, much GMH research and action has been devoted to: (i) the identification and scale-up of cost-effective evidence-supported interventions that could be made more widely available; (ii) task-shifting of such intervention delivery to mental-health trained non-specialist Lay Health Workers. GMH has come under sustained critique. Critics suggest that GMH is colonial medicine come full circle, involving the top-down imposition of Western psychiatric models and solutions by Western-educated elites. These critiques suggest that GMH ignores the various indigenous modalities of healing present in non-Western cultures, which may be psychologically adaptive and curative. Relatedly, critics argue that GMH could be an unwitting Trojan horse for the mass medicalisation of people in developing countries, paving the way for exploitation by Big Pharma, while ignoring social determinants of health.

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

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.

scholarly journals Related Health Service Provider with Mental Health during Pregnancy

2020 ◽  
Vol 8 (T2) ◽  
pp. 188-191
Author(s):  
Nurul Husnul Lail ◽  
Rizanda Machmud ◽  
Adnil Edwin ◽  
Yusrawati Yusrawati ◽  
Anwar Mallongi
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Pregnant Women ◽  
Mental Health Problems ◽  
Health Problems ◽  
Political Support ◽  
Independent Practice ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

BACKGROUND: Mental illness or mental health problems during pregnancy in low- and middle-income countries are very high; the average prevalence reaches 15.6%. Subsequent research was conducted by Indian in the Jakarta and Bogor regions in the period January–June 2018 regarding the incidence of perinatal depression by 23.6% in the Bogor. AIM: This study aimed to evaluate the mental illness or mental health problems during pregnancy in low- and middle-income countries. METHODS: This research is qualitative research. This research was conducted in January–June 2019 in the Bogor independent practice midwife. Informants in the study came from the East Jakarta Health Office, Chair of the Indonesian Midwives Association, Head of the Health Center, Coordinating Midwives, Pregnant Women and husbands, and families of pregnant women. Data are analyzed by Regression Logistic. RESULTS: Construction model mental health of mothers during pregnancy in independent practice midwives is very important and needs attention. Pregnancy is still considered a physical change that needs to be intervened because it is easier to handle and easily detects it. Maternal examination during pregnancy is carried out by midwives, in the implementation of mental health checks during pregnancy for pregnant women, this role has not all been carried out optimally. CONCLUSION: This research suggests conducting socialization with midwives as well as across-related sectors to get political support in carrying out activities in health facilities and independent practice midwives.

scholarly journals Next steps for meeting the needs of people with severe mental illness in low- and middle-income countries

2016 ◽  
Vol 26 (4) ◽  
pp. 348-354 ◽  
Author(s):  
C. Hanlon
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Human Rights ◽  
Mental Health Care ◽  
Severe Mental Illness ◽  
Mental Health Professionals ◽  
Task Sharing ◽  
Middle Income ◽  
Middle Income Countries

The explicit inclusion of mental health within the Sustainable Development Goals is a welcome development, borne out of powerful advocacy using public health, economic and human rights arguments. As funding comes on line for scale-up of evidence-based mental health care by task-sharing with primary care, it is time to take stock about care for people affected by severe mental illness (SMI). The existing evidence base for task shared care for SMI provides an imperative to get started, but is skewed towards relatively more affluent and urban populations in middle-income countries where specialist mental health professionals provide most of the care. Randomised, controlled trials and rigorous implementation research on task shared service models are underway which will go some way to improving understanding of the quality, safety, effectiveness and acceptability of more widely generalisable care for people with SMI. A sub-group of people with SMI have more complex and long-term needs for care, with a high risk of homelessness, imprisonment and human rights violations as family and social supports become overwhelmed. Case studies from non-governmental organisations provide examples of holistic approaches to rehabilitation, recovery and empowerment of people with SMI, but rigorous comparative studies are needed to identify the most efficient, effective and scalable approaches to care. Health system constraints are emerging as the over-riding barriers to successful task-sharing, highlighting a need to develop and evaluate chronic care models for people with SMI that succeed in reducing premature mortality, improving wellbeing and achieving better social outcomes. Addressing these evidence gaps is essential if task-sharing mental health care is going to deliver on its promise of promoting recovery for the full range of people affected by SMI.

scholarly journals How do we engage global communities in the de-stigmatisation of mental illness?

2021 ◽  
Vol 30 (3) ◽  
pp. 184-187
Author(s):  
Paul Illingworth
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Problems ◽  
Good Health ◽  
World Health ◽  
Middle Income ◽  
Low Middle Income Countries ◽  
Stigma Of Mental Illness ◽  
Development Goals ◽  
Health Organization

The World Health Organization (WHO) has acknowledged that high-income countries often address discrimination against people with mental health problems, but that low/middle income countries often have significant gaps in their approach to this subject—in how they measure the problem, and in strategies, policies and programmes to prevent it. Localised actions have occurred. These include the Hong Kong government's 2017 international conference on overcoming the stigma of mental illness, and the 2018 London Global Ministerial Mental Health Summit. Furthermore, the UK's Medical Research Council has funded Professor Graham Thornicroft (an expert in mental health discrimination and stigma) to undertake a global study. These and other approaches are welcome and bring improvements; however, they often rely on traditional westernised, ‘global north’ views/approaches. Given the rapid global demographic changes/dynamics and the lack of evidence demonstrating progress towards positive mental health globally, it is time to consider alternative and transformative approaches that encompasses diverse cultures and societies and aligns to the United Nations' Sustainable Development Goals (SDGs), specifically UN SDG 3 (Good health and wellbeing). This article describes the need for the change and suggests how positive change can be achieved through transnational inclusive mental health de-stigmatising education.

scholarly journals PEMBENTUKAN DAN PENDIDIKAN KADER KESEHATAN JIWA DALAM MENDETEKSI GANGGUAN JIWA DI WILAYAH KERJA PUSKESMAS BANDAR JAYA KABUPATEN LAHAT TAHUN 2020

2021 ◽  
Vol 5 (1) ◽  
pp. 433
Author(s):  
Yeni Elviani ◽  
A. Gani ◽  
Wahyu Dwi Ari Wibowo
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Mental Disorders ◽  
Mental Health Problems ◽  
Health Workers ◽  
Good News ◽  
Good Knowledge ◽  
Sufficient Knowledge ◽  
Level Of Knowledge ◽  
And Training

ABSTRAKTerbentuknya kader kesehatan jiwa di masyarakat merupakan angin segar bagi pelayanan kesehatan jiwa. Hal ini harus didukung oleh tingkat pengetahuan, kemampuan, dan pengalaman kader dalam menangani penderita gangguan jiwa, sehingga perlu diadakan pendidikan bagi kader kesehatan jiwa dalam penanganan gangguan jiwa dan deteksi gangguan jiwa di masyarakat. Kader kesehatan jiwa berperan sebagai penghubung antara tenaga kesehatan di fasilitas kesehatan dengan masyarakat. Metode dilakukan dengan cara berkoordinasi dengan ketua kader kesehatan dan petugas kesehatan di Puskesmas Bandar Jaya untuk membentuk kader kesehatan jiwa dan memberikan edukasi kader terkait penanganan dan pendeteksian gangguan jiwa.Tingkat pengetahuan kader tentang penanganan dan pendeteksian gangguan jiwa sebelum dibentuknya kader kesehatan jiwa dan pendidikan kesehatan pada kategori kurang (75%) dan cukup (25%), dan semua kader tidak dapat mendeteksi gangguan jiwa. Setelah mendapatkan penyuluhan terjadi peningkatan pengetahuan kader pada kategori baik menjadi 60%, kategori baik 40%, dan tidak ada kader dalam kategori tingkat pengetahuan kurang, untuk deteksi gangguan jiwa 75% kader mampu mendeteksi gangguan jiwa. Setelah terciptanya kader kesehatan jiwa dan kegiatan ini diharapkan dapat menciptakan kader kesehatan jiwa di masyarakat yang dapat meningkatkan efektivitas pencegahan, kuratif, dan pemulihan masalah kesehatan jiwa khususnya dalam penanganan dan pendeteksian gangguan jiwa di masyarakat. Kata kunci: kader kesehatan jiwa; dekteksi gangguan jiwa; gangguan jiwa; komunitas.  ABSTRACTThe establishment of mental health cadres in the community is good news for mental health services. It must be supported by the cadre’s level of knowledge, ability, and experience in handling people with mental disorders. It is necessary to educate mental health cadres on handling mental disorders and detecting mental disorders in the community. Mental health cadres serve as a communicator between health workers in health facilities and the community. The method is used by coordinating with cadre’s leader and health workers in the Bandar Jaya Public health center to educate cadres about handling and detecting mental disorders. The level of knowledge of cadres before education and training was 74% of respondents lacking knowledge, 25% of respondents had sufficient knowledge, and no one of respondents had good knowledge of handling and detecting mental disorders. The level of knowledge obtained after education was carried out, and there was an increase in knowledge where 60% of respondents obtained good knowledge scores, 40% of respondents had sufficient knowledge. There were no respondents who found that their level of knowledge was lacking. This activity is expected to create mental health cadres in the community to increase the effectiveness of preventive, curative, and recovery mental health problems, especially in handling and detecting mental disorders in the community. Keywords:  mental health cadre; mental disorder detection; mental disorders; community.  

scholarly journals Challenges Encountered by Mental Health Workers in Rwanda; Current Situation and Future Needs

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Nkundimana Balthazar
Keyword(s):  
Mental Health ◽  
Data Analysis ◽  
Mental Health Professionals ◽  
Qualitative Data ◽  
Health Workers ◽  
Demographic Data ◽  
Mental Healthcare ◽  
Mental Health Workers ◽  
Mental Health Training ◽  
Middle Income

The burden of mental health has become a great concern for public health as the diseases caused by mental health is ranking second worldwide. According to the HWO countries of Low- and Middle-Income Countries (LMICs) don’t allocate enough financial means to mental healthcare. The lack of will or interest in mental health in these countries causes different challenges in this sector. Rwanda as one of LMICs is not served on the challenges although it might have its particularities. This study aimed to explore the challenges encountered by Rwandan local mental health workers within and outside of their demanding work. Method: An interpretative qualitative mixed with quantitative design. The self-administrated questionnaire with open-ended questions, demographic data as well as qualitative data was systematically prepared, explained, and given to respondents. The questionnaire was completed by sixty mental health workers from various institutions with mental health in Rwanda. SPSS was used in quantitative data analysis while the main part of data used Thematic analysis for qualitative data analysis. Results: The main results immersed in themes that consist of the shortage of; salary, poverty of mental health seekers, culture, and beliefs toward mental health, training, and professional development of mental health works. The study concluded with a better understanding of challenges in mental health practice in Rwanda and the outcome could be used to decrease challenges for mental health professionals and sustain of the mental healthcare system in Rwanda.

scholarly journals Mental illness in Bwindi, Uganda: Understanding stakeholder perceptions of benefits and barriers to developing a community-based mental health programme

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Kristen L. Sessions ◽  
Lydia Wheeler ◽  
Arya Shah ◽  
Deenah Farrell ◽  
Edwin Agaba ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Health Workers ◽  
Psychiatric Disease ◽  
Structured Interviews ◽  
Community Members ◽  
Community Based ◽  
Significant Treatment ◽  
Middle Income ◽  
Wide Range

Background: Mental illness has been increasingly recognised as a source of morbidity in low- and middle-income countries and significant treatment gaps exist worldwide. Studies have demonstrated the effectiveness of task sharing through community-based treatment models for addressing international mental health issues.Aim: This paper aims to evaluate the perceptions of a wide range of mental health stakeholders in a Ugandan community regarding the benefits and barriers to developing a community-based mental health programme.Setting: Bwindi Community Hospital (BCH) in south-west Uganda provides services through a team of community health workers to people in the Kanungu District.Methods: Thematic analysis of 13 semi-structured interviews and 6 focus group discussions involving 54 community members and 13 mental health stakeholders within the BCH catchment area.Results: Stakeholders perceived benefits to a community-based compared to a hospital-based programme, including improved patient care, lower costs to patients and improved community understanding of mental illness. They also cited barriers including cost, insufficient workforce and a lack of community readiness.Conclusions: Stakeholders express interest in developing community-based mental health programmes, as they feel that it will address mental health needs in the community and improve community awareness of mental illness. However, they also report that cost is a significant barrier to programme development that will have to be addressed prior to being able to successfully establish such programming. Additionally, many community members expressed unique sociocultural beliefs regarding the nature of mental illness and those suffering from a psychiatric disease.

scholarly journals To travel is to live: embracing the emerging field of travel psychiatry

2020 ◽  
pp. 1-3
Author(s):  
Gerard Flaherty ◽  
Shang Yuin Chai ◽  
Brian Hallahan
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Disorders ◽  
Mental Health Problems ◽  
Travel Medicine ◽  
Health Problems ◽  
International Travel ◽  
Clear Understanding ◽  
Healthcare Practitioner ◽  
Travel Experience

Summary For a person with mental illness, travelling abroad can be challenging but it can be easier when the traveller and healthcare practitioner have a clear understanding of the likely impact of travel on the illness and of the illness on the travel experience. Travel may also precipitate first presentations of mental illness or unmask previously undiagnosed mental disorders. We propose that mental health problems should receive greater recognition in travel medicine and that psychiatrists should collaborate more closely with travel medicine clinicians to ensure that their patients benefit from the opportunities afforded by international travel.

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