scholarly journals “I Go up to the Edge of the Valley, and I Talk to God”: Using Mixed Methods to Understand the Relationship between Gender-Based Violence and Mental Health among Lebanese and Syrian Refugee Women Engaged in Psychosocial Programming

2021 ◽  
Vol 18 (9) ◽  
pp. 4500
Author(s):  
Rassil Barada ◽  
Alina Potts ◽  
Angela Bourassa ◽  
Manuel Contreras-Urbina ◽  
Krystel Nasr
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Focus Groups ◽  
Service Providers ◽  
Gender Based Violence ◽  
Community Members ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
International Research Institute ◽  
Gender Based

Lebanon’s intersecting economic and political crises exacerbate complex public health issues among both host and refugee populations. This mixed-methods study by a Lebanese service provider, in partnership with an international research institute, seeks to better understand how experiences of gender-based violence (GBV) and mental health intersect in the lives of Syrian and Lebanese women, and how to better meet these needs. It employs a randomized cross-sectional survey of 969 Abaad service users and focus groups with community members and service providers. There were significant associations between GBV and ill mental health; notably, respondents reporting transactional sex had 4 times the likelihood of severe distress (aOR 4.2; 95% CI 1.2–14.8; p ≤ 0.05). Focus groups emphasized less-visible forms of violence, such as emotional violence, and the importance of environmental factors in one’s ability to cope, noting “it always came back to the economy”. Recommendations include providing a more holistic and coordinated approach between GBV, mental health, livelihood, and basic assistance sectors; and sensitive, accessible, and higher-quality mental health services informed by GBV response actors’ experience putting in place survivor-centered programming and made available to both host and refugee community members.

Evaluation of an Online System for Routine Outcome Monitoring: A Cross-Sectional Survey (Preprint)

2021 ◽  
Author(s):  
Deanna Wiebe ◽  
Pria Nippak ◽  
Julien Meyer ◽  
Shannon Remers
Keyword(s):  
Mental Health ◽  
Outcome Measures ◽  
Service Providers ◽  
Routine Outcome Monitoring ◽  
Completion Rates ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Online System ◽  
Health Service Providers ◽  
Outcome Monitoring

BACKGROUND The use of Routine Outcome Monitoring (ROM) in the treatment of mental health has emerged as a method of improving psychotherapy treatment outcomes. Despite this, very few clinicians regularly use ROM in clinical practice. Online ROM has been suggested as a solution to increase adoption. OBJECTIVE To identify the influence of moving ROM online on client completion rates of self-reported outcome measures and to identify implementation and utilization barriers to online ROM by assessing clinicians’ views on their experience utilizing the online system over previous paper-based methods. METHODS Client completion rates of self-reported outcome measures were compared pre and post implementation of an online system of ROM. In addition, a survey questionnaire was administered to 340 mental health service providers regarding their perception of benefits with an online system of ROM. RESULTS Client completion rates of self-reported measures increased from 15% to 54% after moving online. Fifty-eight% of service providers found the new system less time consuming than previous paper-based ROM and 64% found that it helped monitor clients. However, the perceived value of the system remains in doubt as only 23% found it helped them identify clients at risk for treatment failure, and only 18% found it strengthened the therapeutic alliance. CONCLUSIONS Although the current study suggests mixed results regarding service providers’ views on their experience using an online system for ROM, it has identified barriers and challenges that are actionable for improvement.

scholarly journals Study protocol for a longitudinal study evaluating the impact of rape on women’s health and their use of health services in South Africa

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017296 ◽  
Author(s):  
Naeemah Abrahams ◽  
Soraya Seedat ◽  
Carl Lombard ◽  
Andre P Kengne ◽  
Bronwyn Myers ◽  
...  
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Longitudinal Study ◽  
Health Services ◽  
Health Outcomes ◽  
Service Providers ◽  
Adult Women ◽  
Gender Based Violence ◽  
Gender Based ◽  
The Impact

IntroductionSouth Africa is a country known for its high levels of HIV infection and sexual violence. Although the interface between gender-based violence, HIV and mental health has been described, there are substantial gaps in knowledge of the medium-term and long-term health impact. The 2010 Global Burden of Disease study excluded many health outcomes associated with rape and other forms of gender-based violence because systematic reviews revealed huge gaps in data and poor evidence of health effects. This study aims to describe the incidence and attributable burden of physical and mental health problems (including HIV acquisition) in adult women over a 2-year postrape period, through comparison with a cohort of women who have not been raped. The study will substantially advance our understanding of the impact of rape and will generate robust data to assist in the development of postrape health services and the delivery of evidence-based care.Methods and analysisThis longitudinal study seeks to recruit 1008 rape-exposed and 1008 rape non-exposed women. Women were recruited from health services, and assessments were carried out at baseline, 3, 6, 9, 12, 18 and 24 months. Outcome measures include exposure to risk factors; mental health status; cardio-metabolic risks; and biomarkers for HIV, sexually transmitted infections, pregnancy and stress. The primary analysis will be to compare HIV incidence in the two groups using log-rank tests. Appropriate models to predict health outcomes over time will also be applied.Ethics and disseminationThe South African Medical Research Council’s Ethics Committee approved the study. As rape is a key element of the study, the safety and protection of participants guides the research process. We will adopt a research uptake strategy to ensure dissemination to policy makers, service providers and advocacy groups. Peer-reviewed journal articles will be published.

scholarly journals A mixed-methods study exploring the characteristics and needs of long-stay patients in high and medium secure settings in England: implications for service organisation

2017 ◽  
Vol 5 (11) ◽  
pp. 1-234 ◽  
Author(s):  
Birgit Völlm ◽  
Rachel Edworthy ◽  
Jessica Holley ◽  
Emily Talbot ◽  
Shazmin Majid ◽  
...  
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Focus Groups ◽  
Research Network ◽  
Cross Sectional Survey ◽  
Prolonged Stay ◽  
Mental Health Act ◽  
High Resource ◽  
Secure Care ◽  
Common Diagnosis

BackgroundForensic psychiatric services provide care for those with mental disorders and offending behaviour. Concerns have been expressed that patients may stay for too long in too high levels of security. The economic burden of these services is high, and they are highly restrictive for patients. There is no agreed standard for ‘long stay’; we defined a length of stay exceeding 5 years in medium secure care, 10 years in high secure care or 15 years in a combination of both settings as long stay.ObjectivesTo (1) estimate the number of long-stay patients in secure settings; (2) describe patients’ characteristics, needs and care pathways and the reasons for their prolonged stay; (3) identify patients’ perceptions of their treatment and quality of life; and (4) explore stakeholders’ views on long stay.DesignA mixed-methods approach, including a cross-sectional survey (on 1 April 2013) of all patients in participating units to identify long-stay patients [work package (WP) 1], file reviews and consultant questionnaires for long-stay patients (WP2), interviews with patients (WP3) and focus groups with other stakeholders (WP4).SettingAll three high secure hospitals and 23 medium secure units (16 NHS and 9 independent providers) in England.ParticipantsInformation was gathered on all patients in participating units (WP1), from which 401 long-stay patients were identified (WP2), 40 patients (WP3), 17 international and 31 UK experts were interviewed and three focus groups were held (WP4).ResultsApproximately 23.5% of high secure patients and 18% of medium secure patients were long-stay patients. We estimated that there are currently about 730 forensic long-stay patients in England. The source of a patient’s admission and the current section of the Mental Health Act [Great Britain.Mental Health Act 1983 (as Amended by the Mental Health Act 2007). London: The Stationery Office; 2007] under which they were admitted predicted long-stay status. Long-stay patients had complex pathways, moving ‘around’ between settings rather than moving forward. They were most likely to be detained under a hospital order with restrictions (section 37/41) and to have disturbed backgrounds with previous psychiatric admissions, self-harm and significant offending histories. The most common diagnosis was schizophrenia, but 47% had been diagnosed with personality disorder. Only 50% had current formal psychological therapies. The rates of violent incidents within institutions and seclusion were high, and a large proportion had unsuccessful referrals to less secure settings. Most patients had some contact with their families. We identified five classes of patients within the long-stay sample with different characteristics. Patients differed in their attribution of reasons for long stay (internal/external), outlook (positive/negative), approach (active/passive) and readiness for change. Other countries have successfully developed specific long-stay services; however, UK experts were reluctant to accept the reality of long stay and that the medical model of ‘cure’ does not work with this group.LimitationsWe did not conduct file reviews on non-long-stay patients; therefore, we cannot say which factors differentiate between long-stay patients and non-long-stay patients.ConclusionsThe number of long-stay patients in England is high, resulting in high resource use. Significant barriers were identified in developing designated long-stay services. Without a national strategy, these issues are likely to remain.Future workTo compare long-stay patients and non-long-stay patients. To evaluate new service models specifically designed for long-stay patients.Study registrationThe National Institute for Health Research (NIHR) Clinical Research Network Portfolio 129376.FundingThe NIHR Health Services and Delivery Research programme.

scholarly journals Assessing Digital Risk in Psychiatric Patients: Mixed Methods Study of Psychiatry Trainees’ Experiences, Views, and Understanding

10.2196/19008 ◽  
2020 ◽  
Vol 7 (7) ◽  
pp. e19008 ◽  
Author(s):  
Golnar Aref-Adib ◽  
Gabriella Landy ◽  
Michelle Eskinazi ◽  
Andrew Sommerlad ◽  
Nicola Morant ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Focus Groups ◽  
Thematic Analysis ◽  
Internet Use ◽  
Child And Adolescent ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Data Set ◽  
Related Risk

Background The use of digital technology can help people access information and provide support for their mental health problems, but it can also expose them to risk, such as bullying or prosuicide websites. It may be important to consider internet-related risk behavior (digital risk) within a generic psychiatric risk assessment, but no studies have explored the practice or acceptability of this among psychiatrists. Objective This study aimed to explore psychiatry trainees’ experiences, views, and understanding of digital risk in psychiatry. We predicted that clinician awareness would be highest among trainees who work in child and adolescent mental health services. Methods We conducted a cross-sectional survey of psychiatry trainees attending a UK regional trainees’ conference to investigate how they routinely assess patients’ internet use and related risk of harm and their experience and confidence in assessing these risks. We conducted focus groups to further explore trainees’ understandings and experiences of digital risk assessment. Descriptive statistics and chi-squared tests were used to present the quantitative data. A thematic analysis was used to identify the key themes in the qualitative data set. Results The cross-sectional survey was completed by 113 out of 312 psychiatry trainees (response rate 36.2%), from a range of subspecialties and experience levels. Half of the trainees (57/113, 50.4%) reported treating patients exposed to digital risk, particularly trainees subspecializing in child and adolescent psychiatry (17/22, 77% vs 40/91, 44%;P=.02). However, 67.3% (76/113) reported not feeling competent to assess digital risk. Child and adolescent psychiatrists were more likely than others to ask patients routinely about specific digital risk domains, including reckless web-based behavior (18/20, 90% vs 54/82, 66%; P=.03), prosuicide websites (20/21, 95% vs 57/81, 70%; P=.01), and online sexual behavior (17/21, 81% vs 44/81, 54%; P=.02). Although 84.1% (95/113) of the participants reported using a proforma to record general risk assessment, only 5% (5/95) of these participants prompted an assessment of internet use. Only 9.7% (11/113) of the trainees had received digital risk training, and 73.5% (83/113) reported that they would value this. Our thematic analysis of transcripts from 3 focus groups (comprising 11 trainees) identified 2 main themes: barriers to assessment and management of digital risk, and the double-edged sword of web use. Barriers reported included the novelty and complexity of the internet, a lack of confidence and guidance in addressing internet use directly, and ongoing tension between assessment and privacy. Conclusions Although it is common for psychiatrists to encounter patients subject to digital risk, trainee psychiatrists lack competence and confidence in their assessment. Training in digital risk and the inclusion of prompts in standardized risk proformas would promote good clinical practice and prevent a potential blind spot in general risk assessment.

scholarly journals Risk of Gender-Based Violence and Poor Mental Health Among Nepalese Women During COVID-19 Pandemic: A Review

2020 ◽  
Vol 3 (2) ◽  
pp. 39-46
Author(s):  
Lalita Kumari Sah ◽  
Prabhu Sah ◽  
Manoj Kumar Yadav ◽  
Surya B. Parajuli ◽  
Rinku Shah
Keyword(s):  
Mental Health ◽  
Service Providers ◽  
Poor Mental Health ◽  
Service Access ◽  
Gender Based Violence ◽  
Health Service Access ◽  
Limited Health ◽  
Gender Based ◽  
And Gender ◽  
Financial Dependency

During Covid-19 pandemic, gender-based violence (GBV) against women and poor mental health with limited health service access for women have received paramount attention among researchers, policy makers, health professionals and healthcare service providers. This paper presents a review of published articles in an attempt to understand GBV and poor mental health among Nepalese women in the context of Covid-19. Evidence suggests that gender inequality and gender-based violence have played a significant role in increasing mental health issues among women during the pandemic. Social factors such as low education, financial dependency, lack of support system, limited access to healthcare, lack of awareness about the GBV laws, and cultural norms that put women in the lower position within the society are the realities of majority of Nepalese women. These factors intersect each other and present compounded risks that put women at more vulnerable position than others, which is further exacerbated during the COVID-19 pandemic putting Nepalese women at risks of GBV and poor mental health compared to men in the society. The paper also recommends actions that are required to address the GBV and poor mental health among Nepalese women.

scholarly journals PERCEPTION OF WOMEN ON SEXUAL AND GENDER BASED VIOLENCE IN NSUKKA, ENUGU STATE

2020 ◽  
Vol 7 (1) ◽  
pp. 257-270
Author(s):  
Oliver Eya ◽  
◽  
Adaoga Obuna ◽  
Grace Odinye ◽  
Christy Obi-Keguna ◽  
...  
Keyword(s):  
Physical Violence ◽  
Traditional Values ◽  
Gender Based Violence ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
Enugu State ◽  
Gender Based ◽  
And Gender ◽  
Study Participants

Sexual and gender issues have been a problem in Africa and in Nigeria in particular where females were considered less important than their male counterparts in their families, cooperatives, businesses, academic matters among others. Gender-Based Violence (GBV) is deeply rooted in many cultural and traditional values. It is regarded as a normal attitude, remains hidden and tacitly condoned. It has devastating health impacts on the women, as women are mostly controlled and dominated by their partners in a relationship and must never complain of sexual harassment and in the case of childlessness; the woman must accept it as her fault. This study was located in Nsukka Local Government area of Enugu State. A cross sectional survey of 200 study participants was conducted. The instruments used for data collection were structured 194 questionnaire and6 in-depth interview guide. The data was analyzed using Statistical Package for Social Sciences (SPSS), frequency distribution tables and chi-square (χ²) for hypotheses. The findings from the study stated that sexual/psychological, physical violence and preference of male child are the major forms of GBV in Nsukka, Enugu State. Majority of the respondents (55.7%) indicated that Spiritual manipulation and illiteracy/ignorance are the major causes of GBV. The study also concluded and recommended that mass sensitization/awareness, empowerment, advocacy by social workers, through domestication of the Convention to Eliminate All Forms of Discrimination against Women (CEDAW), will help curb GBV as indicated by 42.7% of the respondents.

scholarly journals Gender-based violence: a five-country, cross-sectional survey of health and social care students’ experience, knowledge and confidence in dealing with the issue

2020 ◽  
Author(s):  
Caroline Bradbury-Jones ◽  
Nutmeg Hallett ◽  
Dana Sammut ◽  
Helen Billings ◽  
Kelsey Hegarty ◽  
...  
Keyword(s):  
Social Care ◽  
Gender Based Violence ◽  
Health Care Education ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Clinical Placements ◽  
Health And Social Care ◽  
E Learning ◽  
The Subject ◽  
Gender Based

Health and social care professionals are well placed to identify and respond to those affected by gender-based violence; yet students across a range of health disciplines describe a lack of knowledge, preparation and confidence in dealing with the issue. Our study aimed to explore health and social care students’ perceptions of their own knowledge and confidence on the subject of gender-based violence, recollections of gender-based violence learning opportunities through university and clinical placements, and opinions about the content of future e-learning curricula on the subject. We designed and implemented a multinational, cross-sectional survey across six universities from five countries: Australia, Canada, England, New Zealand and Scotland. Responses were obtained from 377 students across seven health and social care disciplines. Principally, the study found that students were underprepared in their professional programmes in terms of dealing with gender-based violence. Many students had witnessed or heard about cases of gender-based violence on clinical placement, but reported feeling generally unconfident in dealing with the issue. Regarding future e-learning, students indicated that content should be inclusive and relate directly to clinical practice. We argue that there is a universal need for health care education programmes to include the issue of gender-based violence in curricula.<br /><br />Key messages<ul><li>Future generations of health and social care professionals are being insufficiently prepared to deal with gender-based violence.</li><br /><li>Students indicated that they would like gender-based violence learning to be practice-focused, patient-focused, inclusive and intersectional.</li><br /><li>Higher education institutions globally need to embed the subject of gender-based violence in health and social care curricula so that future professionals are sufficiently prepared to address this pervasive issue.</li></ul>

COVID-19 feminist framework and biopsychosocial-spiritual perspective for social workers and mental health practitioners to manage violence, abuse, and trauma against children, women, BIPOC, and LGBTQIA+ during and post-COVID-19

2021 ◽  
pp. 002087282110671
Author(s):  
Sonia Mukhtar
Keyword(s):  
Mental Health ◽  
Social Workers ◽  
Service Providers ◽  
Mental Health Practitioners ◽  
Gender Based Violence ◽  
Health Practitioners ◽  
Spiritual Perspective ◽  
Gender Based ◽  
And Gender ◽  
The Individual

This article explains the integrated implementation of a COVID-19 Feminist Framework (CFF) and biopsychosocial-spiritual perspective (BPSS-P) on the inclusive equitability of social service providers, practitioners, and policy-developers on global platforms. Mechanisms of CFF and BPSS-P entail the process to address/mitigate institutional inequities, mental health issues, violation of human rights, race/sex/gender-based violence, abuse, and trauma amid COVID-19. This discourse is about raising consciousness, collective liberation, wellbeing, and equality for women, children, BIPOC, LGBTQIA+, and gender-diverse people. This article further discusses social workers and mental health practitioners’ uniqueness for short-term and long-term support for emotional, cognitive-behavioral, and psychosocial repercussions on the individual and community levels.

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