Integrating Mental Health and Psychosocial Support Into Health Facilities in Conflict Settings: A Retrospective Review From Six African Countries

Introduction: The International Committee of the Red Cross runs an increasing number of mental health and psychosocial programmes integrated into health facilities in conflict settings across Africa. This study looks at changes in symptoms of psychological distress and impaired functioning among patients supported through such programmes.Material and Methods: Between January and December 2019, 5,527 victims of violence received mental health and psychosocial support in 29 health facilities in Burundi, Central African Republic, Democratic Republic of the Congo, Mali, Nigeria and South Sudan. Symptoms of psychological distress (IES-R or DASS21) and daily functioning (ICRC scale) were assessed before and after the intervention. Logistical regression models were used to measure associations between these symptoms and the other variables.Results: Factors associated with high distress prior to receiving support included age (peaking at 45–54 years), intervening within three months, rape, caretaker neglect, internal displacement, secondary education level and referral pathway. Anxiety levels in particular were higher among victims of violence committed by unknown civilians, the military or armed groups. Low functioning was associated with divorce, grief and violence committed by the military or armed groups. Following the intervention, the vast majority of patients reported reduced psychological distress (97.25% for IES-R and 99.11% for DASS21) and improved daily functioning (93.58%). A linear trend was found between number of individual sessions and reduction in symptoms of distress. Financial losses were associated with less reduction in symptoms of depression and stress.Discussion: To further address the mental health and psychosocial needs of victims of violence, intervening quickly and increasing the number of individual sessions per patient is crucial. This requires proximity—being in the right place at the right time—which is challenging when working in stable health structures. Symptoms of depression should not be overlooked, and financial losses must be addressed in order to holistically meet the needs of victims of violence.

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Community-level Mental Health and Psychosocial Support During Armed Conflict: A Cohort Study from the Democratic Republic of Congo, Mali and Nigeria

10.21203/rs.3.rs-1049021/v1 ◽

2021 ◽

Author(s):

Ida Andersen ◽

Rodolfo Rossi ◽

Ives Hubloue

Keyword(s):

Mental Health ◽

Psychological Distress ◽

Democratic Republic ◽

Psychosocial Support ◽

Democratic Republic Of Congo ◽

Physical Violence ◽

Community Level ◽

Daily Functioning ◽

Republic Of Congo ◽

Victims Of Violence

Abstract Introduction: Community-level mental health and psychosocial support (MHPSS) was the first type of MHPSS program launched by the International Committee of the Red Cross (ICRC) back in 2004. Standardized beneficiary-level monitoring was put in place in late 2018. This is the first study to explore whether this type of program correlates, as intended, with reduced psychological distress and increased daily functioning.Methods: Between December 2018 and June 2020, 6,413 victims of violence received MHPSS through 32 community-level projects in the Democratic Republic of Congo, Mali and Nigeria. Symptoms of psychological distress (IES-R or DASS21) and daily functioning (ICRC scale) were assessed before and after the intervention and logistical regression models were used to identify predictors of these symptoms. Results: The most predominant perpetrators were weapon-bearers (76%) and the most common type of violence was rape (46%). Victims of violence committed by weapon-bearers were more likely to show high levels of anxiety prior to MHPSS (aOR 3.51; p<0.0001). Also, victims of physical violence were more likely to show high levels of stress (aOR 1.49; p<0.0001) whereas victims who had witnessed physical violence were more like to report high levels of depression (aOR 2.54; <0.0001). Lack of social support stood out as a predictor of both high anxiety (aOR 2.10; p<0.0001) and post-traumatic stress (aOR 2.04; p<0.0001) prior to MHPSS. Following MHPSS, the vast majority of beneficiaries reported a reduction in distress on the DASS21 (96.58%) and the IES-R scales (92.70%) as well as an increase of functioning (82.26%). Adherence to group therapy (7 sessions on average) was stronger than individual therapy (4 sessions on average). A linear trend was found between length of treatment and likelihood of reporting reduced symptoms of depression. Having suffered destruction or loss of property or income was predicted less improvement of functioning following MHPSS (aOR 0.90; p=0.044). Conclusion: Community-level MHPSS is associated with increased well-being among the vast majority of beneficiaries. To further increase intended health outcomes, it is recommended to increase the number of sessions per beneficiary and address, where relevant, the financial consequences of violence. Also, a longitudinal study is recommended to assess the longer-term changes in symptoms.

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Psychological Distress in Iranian Military Personnel: A Qualitative Study

10.21203/rs.3.rs-95007/v1 ◽

2020 ◽

Author(s):

Azizeh Alizadeh1 ◽

Behnaz Dowran ◽

maryam azizi ◽

Seyed -Hossein Salimi

Keyword(s):

Mental Health ◽

Psychological Distress ◽

Qualitative Study ◽

Military Personnel ◽

Mental Health Problems ◽

Structured Interviews ◽

Military Organization ◽

Military Members ◽

Data Saturation ◽

The Military

Abstract Background: Military personnel are likely to encounter mental health problems due to High-risk occupations associated with significant levels of psychological distress. The aim of the present study was to explore psychological distress experienced by Iranian military personnel. Methods: The present qualitative study was conducted on 15 Iranian military personnel. Purposeful sampling was used to select the participants and continued until data saturation was reached. Data were collected using semi-structured interviews and then the qualitative data were analyzed through direct content analysis. Results: By analyzing show 395 primary codes, 2 main categories, including demands and resources were extracted from the experiences of military members. The categories included several sub-categories, which were classified according to their significant characteristics. Findings of this study ascertain that different factors affect the military member’s psychological distress.Conclusions: Military organization and leaders should consider the factors of psychological distress that raised by specialists, and assign policies to improve their mental health. According to the present results, it is recommended that the process of psychological distress in military members be investigated further.

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Association of dietary phytochemical index and mental health in women: a cross-sectional study

British Journal Of Nutrition ◽

10.1017/s0007114519000229 ◽

2019 ◽

Vol 121 (09) ◽

pp. 1049-1056 ◽

Cited By ~ 3

Author(s):

Manije Darooghegi Mofrad ◽

Fereydoun Siassi ◽

Bijan Guilani ◽

Nick Bellissimo ◽

Leila Azadbakht

Keyword(s):

Mental Health ◽

Psychological Distress ◽

Depressive Symptoms ◽

Dietary Assessment ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Symptoms Of Depression ◽

Daily Energy ◽

Study Participants

AbstractPrevious studies have shown that unhealthy dietary patterns are among the most important modifiable risk factors in the development of mental health disorders. We examined the association of dietary phytochemical index (DPI) with symptoms of depression, anxiety and psychological distress in Iranian women. In this cross-sectional study, a total of 488 women aged 20–50 years old attending health centres in the south of Tehran in 2018 were included. A validated and reliable FFQ was used for dietary assessment. Symptoms of depression, anxiety and psychological distress were assessed using a validated depression, anxiety, stress scales questionnaires with twenty-one-items. DPI was estimated using the following formula: (daily energy derived from phytochemical-rich foods (kJ)/total daily energy intake (kJ))×100. The mean age of the study participants was 31·9 (sd7·7) years. The prevalence of depressive symptoms, anxiety and psychological distress among study participants was 34·6, 40·6 and 42·4 %, respectively. After controlling for potential confounders, women in the highest tertile of DPI had a lower prevalence of depressive symptoms (OR 0·22; 95 % CI 0·12, 0·38) and anxiety (OR 0·33; 95 % CI 0·20, 0·55), as well as psychological distress (OR 0·30; 95 % CI 0·18, 0·49) compared with those in the lowest tertile. In conclusion, we found a significant association between DPI and mental health in women. Prospective studies are needed to confirm these findings.

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Psychological Distress in Nepalese Residents during COVID-19 Pandemic: A Community Level Survey

10.21203/rs.3.rs-42469/v2 ◽

2020 ◽

Author(s):

Dhan Bahadur Shrestha ◽

Bikash Bikram Thapa ◽

Nagendra Katuwal ◽

Bikal Shrestha ◽

Chiranjibi Pant ◽

...

Keyword(s):

Mental Health ◽

Psychological Distress ◽

Secondary Education ◽

Online Survey ◽

Psychosocial Support ◽

Univariate Analysis ◽

Health Centre ◽

Post Secondary Education ◽

Online Data ◽

Post Secondary

Abstract BackgroundCOVID-19 pandemic has created unprecedented health and economic impact. Psychological stress, anxiety and depression are affecting not only COVID-19 patients but also health professionals, and general population. Fear of contracting COVID-19, forced restrictive social measures, and economic hardship are causing mental trauma. Nepal is a developing country from South Asia where the COVID-19 pandemic is still evolving. This online survey has been carried out to understand impact of COVID- 19 on mental health of Nepalese community dwellers.MethodsThe COVID-19 Peritraumatic Distress Index (CPDI) questionnaire adapted from the Shanghai Mental Health Centre was used for online data collection from 11 April-17 May 2020. Collected data were extracted to Microsoft excel-13 and imported and analyzed using SPSS (Statistical Package for Social Sciences) version-22. An initial univariate analysis was conducted for all variables to assess the distribution. Logistic regression analyses were done to estimate the odds ratios of relevant predicting variables.ResultsA total of 410 participants completed the self-rated questionnaires. Mean age of study participants was 34.8 ±11.7 years with male preponderance. 88.5% of the respondents were not in distress (score less than 28) while, 11% had mild to moderate distress and 0.5% had severe distress. The prevalence of distress is higher among age group >45 years, female gender, and post-secondary education group. Health professional were more likely to get distressed. Respondents with post-secondary education had higher odds (OR= 3.32; p=0.020) of developing distress as compared to respondents with secondary education or lower.ConclusionThere is lower rate of psychological distress in city dwellers and people with low education. Adequate intervention and evaluation into mental health awareness, and psychosocial support focused primarily on health care workers, female and elderly individuals is necessary.

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Delivering mental health and psychosocial support interventions to women and children in conflict settings: a systematic review

BMJ Global Health ◽

10.1136/bmjgh-2019-002014 ◽

2020 ◽

Vol 5 (3) ◽

pp. e002014

Author(s):

Mahdis Kamali ◽

Mariella Munyuzangabo ◽

Fahad J Siddiqui ◽

Michelle F Gaffey ◽

Sarah Meteke ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Low Income ◽

Psychosocial Support ◽

Grey Literature ◽

Sub Saharan Africa ◽

Observational Research ◽

Intervention Coverage ◽

Conflict Settings ◽

Women And Children

BackgroundOver 240 million children live in countries affected by conflict or fragility, and such settings are known to be linked to increased psychological distress and risk of mental disorders. While guidelines are in place, high-quality evidence to inform mental health and psychosocial support (MHPSS) interventions in conflict settings is lacking. This systematic review aimed to synthesise existing information on the delivery, coverage and effectiveness of MHPSS for conflict-affected women and children in low-income and middle-income countries (LMICs).MethodsWe searched Medline, Embase, Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Psychological Information Database (PsycINFO)databases for indexed literature published from January 1990 to March 2018. Grey literature was searched on the websites of 10 major humanitarian organisations. Eligible publications reported on an MHPSS intervention delivered to conflict-affected women or children in LMICs. We extracted and synthesised information on intervention delivery characteristics, including delivery site and personnel involved, as well as delivery barriers and facilitators, and we tabulated reported intervention coverage and effectiveness data.ResultsThe search yielded 37 854 unique records, of which 157 were included in the review. Most publications were situated in Sub-Saharan Africa (n=65) and Middle East and North Africa (n=36), and many reported on observational research studies (n=57) or were non-research reports (n=53). Almost half described MHPSS interventions targeted at children and adolescents (n=68). Psychosocial support was the most frequently reported intervention delivered, followed by training interventions and screening for referral or treatment. Only 19 publications reported on MHPSS intervention coverage or effectiveness.DiscussionDespite the growing literature, more efforts are needed to further establish and better document MHPSS intervention research and practice in conflict settings. Multisectoral collaboration and better use of existing social support networks are encouraged to increase reach and sustainability of MHPSS interventions.PROSPERO registration numberCRD42019125221.

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Our people are our business

The APPEA Journal ◽

10.1071/aj11057 ◽

2012 ◽

Vol 52 (2) ◽

pp. 643

Author(s):

Bronwyn Struthers

Keyword(s):

Mental Health ◽

Positive Impact ◽

Health And Safety ◽

Cost Effective ◽

First Aid ◽

Health Issues ◽

Vehicle Accidents ◽

Proactive Approach ◽

The Right ◽

The Military

Every year in Australia, the number of people taking their own lives is more than those who die in vehicle accidents. Further, the most recent studies show industry workers are six times more likely to commit suicide than to die from a workplace accident. Simply put, mental health significantly impacts workplaces. Estimations suggest mental health issues cost Australian industry $14.8 billion. Further, an employee who is not mentally healthy presents fitness for work issues similar to those of a worker influenced by drugs or alcohol. Protecting the mental health and safety of our workforce is the right thing to do—for workers, their families and the wider community. A proactive approach to mental health has a positive impact on workplace culture, which further impacts safety outcomes and productivity. Moreover, training numerous psychologists is not required. Proven strategies that are practical, simple and cost-effective are available. Preventative approaches include strategies borrowed from the military to strengthen the resilience of workers and their families. From a mitigation perspective, a first-aid model means it is about providing support and care, and all levels of the workforce can be equipped with the skills to help. It is mostly about having the confidence to ask the question and to listen. De-mystifying mental health and making it okay to talk about significantly reduce the likelihood of depression, anxiety and self-harm. By following this first-aid model, a difference can be made.

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Psychological distress in Nepalese residents during COVID-19 pandemic: a community level survey

BMC Psychiatry ◽

10.1186/s12888-020-02904-6 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 2

Author(s):

Dhan Bahadur Shrestha ◽

Bikash Bikram Thapa ◽

Nagendra Katuwal ◽

Bikal Shrestha ◽

Chiranjibi Pant ◽

...

Keyword(s):

Mental Health ◽

Psychological Distress ◽

Secondary Education ◽

Online Survey ◽

Psychosocial Support ◽

Univariate Analysis ◽

Health Centre ◽

Post Secondary Education ◽

Online Data ◽

Post Secondary

Abstract Background COVID-19 pandemic has created unprecedented health and economic impact. Psychological stress, anxiety and depression are affecting not only COVID-19 patients but also health professionals, and general population. Fear of contracting COVID-19, forced restrictive social measures, and economic hardship are causing mental trauma. Nepal is a developing country from South Asia where the COVID-19 pandemic is still evolving. This online survey has been carried out to understand impact of COVID- 19 on mental health of Nepalese community dwellers. Methods The COVID-19 Peritraumatic Distress Index (CPDI) questionnaire adapted from the Shanghai Mental Health Centre was used for online data collection from 11 April-17 May 2020. Collected data were extracted to Microsoft excel-13 and imported and analyzed using SPSS (Statistical Package for Social Sciences) version-22. An initial univariate analysis was conducted for all variables to assess the distribution. Logistic regression analyses were done to estimate the odds ratios of relevant predicting variables. Results A total of 410 participants completed the self-rated questionnaires. Mean age of study participants was 34.8 ± 11.7 years with male preponderance. 88.5% of the respondents were not in distress (score less than 28) while, 11% had mild to moderate distress and 0.5% had severe distress. The prevalence of distress is higher among age group > 45 years, female gender, and post-secondary education group. Health professional were more likely to get distressed. Respondents with post-secondary education had higher odds (OR = 3.32; p = 0.020) of developing distress as compared to respondents with secondary education or lower. Conclusion There is lower rate of psychological distress in city dwellers and people with low education. Adequate intervention and evaluation into mental health awareness, and psychosocial support focused primarily on health care workers, female and elderly individuals is necessary.

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HUBUNGAN PSYCHOLOGICAL DISTRESS DAN KARAKTERISTIK INDIVIDU, KELUARGA DAN LINGKUNGAN KERJA PADA TENAGA KERJA WANITA (TKW) INDONESIA DI TAIWAN

Jurnal Muara Ilmu Sosial, Humaniora, dan Seni ◽

10.24912/jmishumsen.v3i1.3399 ◽

2019 ◽

Vol 3 (1) ◽

pp. 298

Author(s):

Bianca Marella

Keyword(s):

Mental Health ◽

Psychological Distress ◽

Women Workers ◽

Quantitative Methods ◽

Hypothesis Test ◽

Depression And Anxiety ◽

Snowball Sampling ◽

Symptoms Of Depression ◽

Convenience Sampling ◽

Family Activity

Belum banyak upaya dilakukan untuk mengetahui kesehatan mental tenaga kerja wanita yang berada di luar negeri. Penelitian ini bertujuan untuk melihat gambaran dan faktor-faktor yang berhubungan dengan kesehatan kesehatan mental pada Tenaga Kerja Indonesia yang bekerja di Taiwan. Data diambil menggunakan metode kuantitatif dengan alat ukur the Hopkins Symptoms Checklist-25 (HSCL-25) untuk mengetahui tingkat distres psikologis dan pertanyaan mengenai karakteristik sosiodemografik. Partisipan penelitian ini adalah 181 tenaga kerja wanita Indonesia yang sudah bekerja di Taiwan selama minimal enam bulan, dikumpulkan dengan teknik convenience sampling dan snowball sampling. Berdasarkan penghitungan statistik, sebanyak 17% dari total partisipan mengalami gejala depresi dan kecemasan. Dari uji hipotesis, diketahui terdapat hubungan positif signifikan antara distres psikologis dan komunikasi rutin dengan keluarga, keaktifan di komunitas, dan alasan kerja untuk mencari kesempatan lebih baik. Little effort has been made to find out the mental health of women workers who are abroad. This study aims to look at the picture and factors related to mental health health in Indonesian Workers who work in Taiwan. Data were collected using quantitative methods using the Hopkins Symptoms Checklist-25 (HSCL-25) to determine the level of psychological distress and questions about sociodemographic characteristics. The participants of this study were 181 Indonesian female workers who had worked in Taiwan for a minimum of six months, collected using convenience sampling and snowball sampling techniques. Based on statistical calculations, as many as 17% of the total participants experienced symptoms of depression and anxiety. From the hypothesis test, it is known that there is a significant positive relationship between psychological distress and routine communication with family, activity in the community, and the reasons for work to look for better opportunities.

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Upaya Mengatasi Anxiety Disorder pada Mahasiswa Kedokteran Universitas Sebelas Maret

10.31227/osf.io/nm7sj ◽

2019 ◽

Author(s):

Annisa Salsabila Shofiyah Syarif

Keyword(s):

Mental Health ◽

Anxiety Disorder ◽

Mental Health Problems ◽

Behavioral Therapy ◽

Daily Activities ◽

Symptoms Of Depression ◽

Patient Will ◽

Health Disorders ◽

The Right ◽

Severe Anxiety

Nowadays, mental health is something common to talk about. There have been many studies that discuss mental health problems. One of the mental health disorders that is usually experienced by someone is anxiety disorder. Anxiety disorder can be one of the symptoms of depression so that this disorder must get the right treatment as early as possible to avoid worse conditions. If left unresolved, this anxiety disorder can interfere with someone’s performance in running their daily activities. There are two types of treatment that can be done to overcome anxiety disorder. First, patient won’t be needing a therapist. This treatment is suggested only for patient with mild anxiety disorder. Secondly, patient will be needing a therapist to perform this treatment called Cognitive Behavioral Therapy. This type of treatment is recommended for patient who has severe anxiety disorder.

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Systematic review of cognitive behavior therapy to improve mental health of women living with HIV

Journal of Investigative Medicine ◽

10.1136/jim-2019-000996 ◽

2019 ◽

Vol 68 (1) ◽

pp. 30-36 ◽

Cited By ~ 2

Author(s):

Helen Pu ◽

Tahyna Hernandez ◽

John Sadeghi ◽

Joseph Steven Cervia

Keyword(s):

Mental Health ◽

Systematic Review ◽

Psychological Distress ◽

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

People Living With Hiv ◽

Cognitive Behavior ◽

Symptoms Of Depression ◽

Women Living With Hiv ◽

Living With Hiv

Psychological distress is highly prevalent in people living with HIV. Cognitive behavior therapy (CBT) has been associated with improved mental health outcomes in HIV-infected men who have sex with men (MSM); however, little is known of its effect in women living with HIV/AIDS (WLHA). We review current literature on CBT and its effects on depression, anxiety, stress and mental health quality of life (QOL) in WLHA. We undertook a systematic review of the literature indexed in PubMed, Medline, Psychiatry Online and ScienceDirect. Of the 273 relevant studies discovered, 158 contained duplicate data, and 105 studies did not meet the inclusion and exclusion criteria, yielding 10 studies for analysis. Data were independently extracted by each researcher, with differences resolved through discussion and consensus. For WLHA, CBT substantially improved QOL, symptoms of depression and stress, but appeared to have less impact on anxiety. Three of the six studies measuring depression outcomes showed statistically significant decreases in depression. Three of three studies measuring mental health QOL, and three of three studies measuring stress also demonstrated statistically significant improvement. Two of two studies measuring anxiety did not show statistically significant change. CBT is a promising therapy for WLHA. CBT may reduce psychological distress, improving symptoms of depression, stress and QOL. There is a need for additional, better standardized studies that examine CBT for WLHA.

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