DfID’s Last Stand

2021 ◽  
Vol 3 (1) ◽  
pp. 40-45
Author(s):  
Laura Davidson
Keyword(s):  
Mental Health ◽  
International Development ◽  
User Participation ◽  
Theory Of Change ◽  
Health Conditions ◽  
Middle Income ◽  
Mental Health Conditions ◽  
Psychosocial Disability ◽  
Scant Attention ◽  
Conflict Affected States

This article critiques the new Theory of Change (ToC) on mental health published by the UK’s Department for International Development (DfID) in the last fortnight of its existence. The ToC offers development actors a framework for better support of beneficiaries with mental health conditions and psychosocial disabilities – given disappointingly scant attention by the sector to date. Yet, 70 per cent of mental disorders occur in low- and middle-income countries (LMICs), with a 22 per cent prevalence in fragile and conflict-affected states. Globally, mental ill-health is estimated to affect almost one billion people. Its intersectionality with poverty and physical health has been brought into sharp focus by the current COVID-19 pandemic which has magnified the underlying social and environmental stressors of mental health. DfID’s ToC provides a conceptual framework for improving mental health globally, with an overarching vision of the full and equal exercise of all human rights by those affected by mental health conditions and psychosocial disability. The framework incorporates a rights-based approach with user-participation embedded in five critical change pathways to outcomes. The article analyses the ToC, provides an overview, highlights gaps and comments upon how DfID might have improved clarity for development actors seeking to realise its vision.

scholarly journals Challenges to peer support in low- and middle-income countries during COVID-19

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Richard Mpango ◽  
Jasmine Kalha ◽  
Donat Shamba ◽  
Mary Ramesh ◽  
Fileuka Ngakongwa ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Peer Support ◽  
Global Mental Health ◽  
Health Conditions ◽  
Middle Income ◽  
Low Resource Settings ◽  
Mental Health Conditions ◽  
Middle Income Countries

Abstract Background A recent editorial urged those working in global mental health to “change the conversation” on coronavirus disease (Covid-19) by putting more focus on the needs of people with severe mental health conditions. UPSIDES (Using Peer Support In Developing Empowering mental health Services) is a six-country consortium carrying out implementation research on peer support for people with severe mental health conditions in high- (Germany, Israel), lower middle- (India) and low-income (Tanzania, Uganda) settings. This commentary briefly outlines some of the key challenges faced by UPSIDES sites in low- and middle-income countries as a result of Covid-19, sharing early lessons that may also apply to other services seeking to address the needs of people with severe mental health conditions in similar contexts. Challenges and lessons learned The key take-away from experiences in India, Tanzania and Uganda is that inequalities in terms of access to mobile technologies, as well as to secure employment and benefits, put peer support workers in particularly vulnerable situations precisely when they and their peers are also at their most isolated. Establishing more resilient peer support services requires attention to the already precarious situation of people with severe mental health conditions in low-resource settings, even before a crisis like Covid-19 occurs. While it is essential to maintain contact with peer support workers and peers to whatever extent is possible remotely, alternatives to face-to-face delivery of psychosocial interventions are not always straightforward to implement and can make it more difficult to observe individuals’ reactions, talk about emotional issues and offer appropriate support. Conclusions In environments where mental health care was already heavily medicalized and mostly limited to medications issued by psychiatric institutions, Covid-19 threatens burgeoning efforts to pursue a more holistic and person-centered model of care for people with severe mental health conditions. As countries emerge from lockdown, those working in global mental health will need to redouble their efforts not only to make up for lost time and help individuals cope with the added stressors of Covid-19 in their communities, but also to regain lost ground in mental health care reform and in broader conversations about mental health in low-resource settings.

scholarly journals ‘Global mental health’: systematic review of the term and its implicit priorities

BJPsych Open ◽  
2019 ◽  
Vol 5 (3) ◽  
Author(s):  
Supriya Misra ◽  
Anne Stevenson ◽  
Emily E. Haroz ◽  
Victoria de Menil ◽  
Karestan C. Koenen
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Global Mental Health ◽  
Contextual Information ◽  
Empirical Studies ◽  
Sub Saharan Africa ◽  
Health Conditions ◽  
Middle Income ◽  
Mental Health Conditions ◽  
Sub Saharan

Background The term ‘global mental health’ came to the fore in 2007, when the Lancet published a series by that name. Aims To review all peer-reviewed articles using the term ‘global mental health’ and determine the implicit priorities of scientific literature that self-identifies with this term. Method We conducted a systematic review to quantify all peer-reviewed articles using the English term ‘global mental health’ in their text published between 1 January 2007 and 31 December 2016, including by geographic regions and by mental health conditions. Results A total of 467 articles met criteria. Use of the term ‘global mental health’ increased from 12 articles in 2007 to 114 articles in 2016. For the 111 empirical studies (23.8% of articles), the majority (78.4%) took place in low- and middle-income countries (LMICs), with the most in Sub-Saharan Africa (28.4%) and South Asia (25.5%) and none from Central Asia. The most commonly studied mental health conditions were depression (29.7%), psychoses (12.6%) and conditions specifically related to stress (12.6%), with fewer studies on epilepsy (2.7%), self-harm and suicide (1.8%) and dementia (0.9%). The majority of studies lacked contextual information, including specific region(s) within countries where studies took place (20.7% missing), specific language(s) in which studies were conducted (36.9% missing), and details on ethnic identities such as ethnicity, caste and/or tribe (79.6% missing) and on socioeconomic status (85.4% missing). Conclusions Research identifying itself as ‘global mental health’ has focused predominantly on depression in LMICs and lacked contextual and sociodemographic data that limit interpretation and application of findings. Declaration of interest None.

scholarly journals A systematic review of online interventions for mental health in low and middle income countries: a neglected field

2015 ◽  
Vol 2 ◽  
Author(s):  
R. Arjadi ◽  
M. H. Nauta ◽  
N. Chowdhary ◽  
C. L. H. Bockting
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Health Care ◽  
Mental Health Care ◽  
Health Conditions ◽  
Online Interventions ◽  
Middle Income ◽  
Mental Health Conditions ◽  
Middle Income Countries ◽  
Health Gap

Background.Low and middle income countries (LMICs) are facing an increase of the impact of mental health problems while confronted with limited resources and limited access to mental health care, known as the ‘mental health gap’. One strategy to reduce the mental health gap would be to utilize the internet to provide more widely-distributed and low cost mental health care. We undertook this systematic review to investigate the effectiveness and efficacy of online interventions in LMICs.Methods.We systematically searched the data-bases PubMed, PsycINFO, JMIR, and additional sources. MeSH terms, Thesaurus, and free text keywords were used. We included all randomized controlled trials (RCTs) of online interventions in LMICs.Results.We found only three articles reported results of RCTs on online interventions for mental health conditions in LMICs, but none of these interventions was compared with an active control condition. Also, the mental health conditions were diverse across the three studies.Conclusions.There is a dearth of studies examining the effect of online interventions in LMICs, so we cannot draw a firm conclusion on its effectiveness. However, given the effectiveness of online interventions in high income countries and sharp increase of internet access in LMICs, online interventions may offer a potential to help reduce the ‘mental health gap’. More studies are urgently needed in LMICs.

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