scholarly journals Simple, Stigma-free, Scalable, and School-based: A Four-step Approach to Developing Adolescent Mental Health Treatments in Sub Saharan Africa

2020 ◽  
Author(s):  
Tom L Osborn ◽  
Christine Wasanga
Keyword(s):  
Mental Health ◽  
Low Income ◽  
Mental Health Problems ◽  
Healthcare Access ◽  
Intervention Development ◽  
Mental Healthcare ◽  
Adolescent Mental Health ◽  
Sub Saharan Africa ◽  
School Based ◽  
Sub Saharan

-Adolescent mental health problems—which are associated with many negative life outcomes—are prevalent in low-income regions such as those in Sub Saharan Africa (SSA) yet many youths suffering from these problems never get treatment.-Existing treatments are inaccessible to SSA youths because they are long, costly, and require expert delivery in a setting where incomes are low, and a paucity of caregivers exist and where social stigma limits help-seeking.-Most of the efforts to develop interventions for youth mental have been led by researchers from Western high-income countries and can be criticized as socio-culturally inappropriate and costly. -To guide intervention development efforts, we propose a four-step approach that encourages researchers to develop mental health interventions that are simple, stigma-free, scalable and school-based. Through this four-step approach, researchers can expand mental healthcare access in SSA by developing interventions that circumvent existing barriers.

scholarly journals Relationships with caregivers and mental health outcomes among adolescents living with HIV: a prospective cohort study in South Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yulia Shenderovich ◽  
Mark Boyes ◽  
Michelle Degli Esposti ◽  
Marisa Casale ◽  
Elona Toska ◽  
...  
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Cohort Study ◽  
Mental Health Problems ◽  
Health Problems ◽  
Sub Saharan Africa ◽  
Depression Symptoms ◽  
Sub Saharan ◽  
Positive Caregiving ◽  
Living With Hiv

Abstract Background Mental health problems may impact adherence to anti-retroviral treatment, retention in care, and consequently the survival of adolescents living with HIV. The adolescent-caregiver relationship is an important potential source of resilience. However, there is a lack of longitudinal research in sub-Saharan Africa on which aspects of adolescent-caregiver relationships can promote mental health among adolescents living with HIV. We draw on a prospective longitudinal cohort study undertaken in South Africa to address this question. Methods The study traced adolescents aged 10–19 initiated on antiretroviral treatment in government health facilities (n = 53) within a health district of the Eastern Cape province. The adolescents completed standardised questionnaires during three data collection waves between 2014 and 2018. We used within-between multilevel regressions to examine the links between three aspects of adolescent-caregiver relationships (caregiver supervision, positive caregiving, and adolescent-caregiver communication) and adolescent mental health (depression symptoms and anxiety symptoms), controlling for potential confounders (age, sex, rural/urban residence, mode of infection, household resources), n=926 adolescents. Results Improvements in caregiver supervision were associated with reductions in anxiety (0.98, 95% CI 0.97–0.99, p=0.0002) but not depression symptoms (0.99, 95% CI 0.98–1.00, p=.151), while changes in positive caregiving were not associated with changes in mental health symptoms reported by adolescents. Improvements in adolescent-caregiver communication over time were associated with reductions in both depression (IRR=0.94, 95% CI 0.92–0.97, p<.0001) and anxiety (0.91, 95% CI 0.89–0.94, p<.0001) symptoms reported by adolescents. Conclusions Findings highlight open and supportive adolescent-caregiver communication and good caregiver supervision as potential factors for guarding against mental health problems among adolescents living with HIV in South Africa. Several evidence-informed parenting programmes aim to improve adolescent-caregiver communication and caregiver supervision, and their effect on depression and anxiety among adolescents living with HIV should be rigorously tested in sub-Saharan Africa. How to improve communication in other settings, such as schools and clinics, and provide communication support for caregivers, adolescents, and service providers through these existing services should also be considered.

scholarly journals Public health and research funding for childhood neurodevelopmental disorders in Sub-Saharan Africa: a time to balance priorities

2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Muideen O. Bakare ◽  
Kerim M. Munir ◽  
Mashudat A. Bello-Mojeed
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Neurodevelopmental Disorders ◽  
Research Funding ◽  
Mental Health Problems ◽  
Policy Formulation ◽  
Sub Saharan Africa ◽  
Under Five ◽  
Mortality Index ◽  
Sub Saharan

Sub-Saharan African (SSA) population consists of about 45% children, while in Europe and North America children population is 10- 15%. Lately, attention has been directed at mitigating childhood infectious and communicable diseases to reduce under-five mortality. As the under-five mortality index in Sub-Saharan Africa has relatively improved over the last two decades, more Sub-Saharan African children are surviving beyond the age of five and, apparently, a sizeable percentage of this population would be living with one or more childhood neurodevelopmental disorders (NDD). The distribution of child mental health service resources across the world is unequal. This manifests in the treatment gap of major childhood onset mental health problems in SSA, with the gap being more pronounced for childhood NDD. It is important to balance the public health focus and research funding priorities in Sub-Saharan Africa. We urgently need to define the burden of childhood NDD in the region for healthcare planning and policy formulation.

Working with vulnerable populations

2015 ◽  
Author(s):  
Theresa S. Betancourt ◽  
William Beardslee ◽  
Catherine Kirk ◽  
Katrina Hann ◽  
Moses Zombo ◽  
...  
Keyword(s):  
Mental Health ◽  
Vulnerable Populations ◽  
Mental Health Problems ◽  
Community Based Participatory Research ◽  
Sub Saharan Africa ◽  
Vulnerable Groups ◽  
Ethical Practices ◽  
Research Attention ◽  
Referral Networks ◽  
Sub Saharan

We discuss key issues to consider when conducting clinical trials with vulnerable children, youths, and families, with particular attention to groups affected by communal violence/war and families affected by HIV/AIDS. Across these settings, there is an overlap of several forms of adversity and vulnerability which require careful research attention. We also discuss ethical practices with vulnerable groups, including the use of qualitative methods to enhance understanding of local perspectives and language around mental health problems and resilience, planning for risk of harm referral networks, and applications of community-based participatory research (CBPR) techniques.  Such approaches can raise community awareness and increase engagement for addressing mental health in vulnerable populations while also informing and promoting practice and policy change. Drawing from examples of work in Sub-Saharan Africa and with refugees in the US, we conclude with a series of recommendations for advancing sensitive research practices with vulnerable populations.

scholarly journals Risk and protective factors for suicidal ideation and behaviour in Rwandan children

2015 ◽  
Vol 207 (3) ◽  
pp. 262-268 ◽  
Author(s):  
Lauren C. Ng ◽  
Catherine M. Kirk ◽  
Frederick Kanyanganzi ◽  
Mary C. Smith Fawzi ◽  
Vincent Sezibera ◽  
...  
Keyword(s):  
Mental Health ◽  
Suicidal Ideation ◽  
Mental Health Problems ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Hiv Status ◽  
Increased Risk ◽  
Matched Case ◽  
Sub Saharan ◽  
Control Study

BackgroundSuicide is a leading cause of death for young people. Children living in sub-Saharan Africa, where HIV rates are disproportionately high, may be at increased risk.AimsTo identify predictors, including HIV status, of suicidal ideation and behaviour in Rwandan children aged 10–17.MethodMatched case–control study of 683 HIV-positive, HIV-affected (seronegative children with an HIV-positive caregiver), and unaffected children and their caregivers.ResultsOver 20% of HIV-positive and affected children engaged in suicidal behaviour in the previous 6 months, compared with 13% of unaffected children. Children were at increased risk if they met criteria for depression, were at high-risk for conduct disorder, reported poor parenting or had caregivers with mental health problems.ConclusionsPolicies and programmes that address mental health concerns and support positive parenting may prevent suicidal ideation and behaviour in children at increased risk related to HIV.

scholarly journals Severe physical punishment and mental health problems in an economically disadvantaged population of children and adolescents

2006 ◽  
Vol 28 (4) ◽  
pp. 290-296 ◽  
Author(s):  
Isabel Altenfelder Santos Bordin ◽  
Cristiane Silvestre Paula ◽  
Rosimeire do Nascimento ◽  
Cristiane Seixas Duarte
Keyword(s):  
Mental Health ◽  
Low Income ◽  
Child Behavior Checklist ◽  
Mental Health Problems ◽  
Adolescent Mental Health ◽  
Health Problems ◽  
Physical Punishment ◽  
Marital Violence ◽  
Self Report ◽  
Cross Sectional

OBJECTIVE: To estimate the prevalence of severe physical punishment of children/adolescents in a low-income community, and to examine child mental health problems as a potential correlate. METHOD: This study is a Brazilian cross-sectional pilot study of the World Studies of Abuse in Family Environments. A probabilistic sample of clusters including all eligible households (women aged 15-49 years, son/daughter < 18 years) was evaluated. One mother-child pair was randomly selected per household (n = 89; attrition = 11%). Outcome (severe physical punishment of children/adolescents by mother/father) was defined as shaking (if age < 2 years), kicking, choking, smothering, burning/scalding/branding, beating, or threatening with weapon. Three groups of potential correlates were examined: child/adolescent (age, gender, physical/mental health); mother (education, unemployment, physical/mental health, harsh physical punishment in childhood, marital violence); father (unemployment, drunkenness). Severe marital violence was defined as kicking, hitting, beating or use of /threat to use a weapon. The following standardized questionnaires were applied by trained interviewers: World Studies of Abuse in Family Environments Core Questionnaire, Child Behavior Checklist, Self-Report Questionnaire. RESULTS: Outcome prevalence was 10.1%. Final logistic regression models identified two correlates: maternal harsh physical punishment in childhood (total sample, OR = 5.3, p = 0.047), and child/adolescent mental health problems (sub-sample aged 4-17 years, n = 67, OR = 9.1, p = 0.017). CONCLUSIONS: Severe physical punishment of children/adolescents is frequent in the studied community. The victims have a higher probability of becoming future perpetrators. When intrafamilial violence occurs, child/adolescent mental health may be compromised.

scholarly journals Attitudes towards mental illness in Uganda: a survey in 18 districts

2007 ◽  
Vol 4 (1) ◽  
pp. 19-21 ◽  
Author(s):  
Vuokko Wallace ◽  
Jed Boardman ◽  
James Walsh
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Health Workers ◽  
Mental Healthcare ◽  
Traditional Healers ◽  
Capital City ◽  
Sub Saharan Africa ◽  
Psychiatric Nurses ◽  
Poor Access ◽  
Sub Saharan

Uganda, in common with many countries in sub-Saharan Africa, has many population risk factors predictive of high levels of mental disorder but poor coverage of mental healthcare (Kigozi, 2005). Recent population studies conducted in Uganda have shown rates of disorder in excess of 20% (Kasoro et al, 2002; Bolton et al, 2004; Ovuga et al, 2005) and the survey by Kasoro et al (2002) showed a high prevalence of patients with severe mental illness and poor access to services. There are 19 psychiatrists for 24.8 million people in Uganda, all but one of whom is based in the capital city, Kampala (Kigozi, 2005). The provision of mental health services relies on the use of psychiatric clinical officers (a cadre of trained mental health workers, similar to community psychiatric nurses, who currently cover 18 of the 56 districts in Uganda), primary care personnel, non-governmental organisations and members of the community. Liaison with traditional healers is encouraged (Ovuga et al, 1999).

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