Development of a World Health Organization Programme for School Mental Health in the Eastern Mediterranean Region

Background: Schools provide an exceptional opportunity for mental health promotion and intervention. Aims: To describe the development of a World Health Organization (WHO) School Mental Health Program (SMHP) in the Eastern Mediterranean Region. Methods: Two tenets guided development of the SMHP: (1) it used a multitiered system of support framework including 3 tiers of interventions (universal, early and targeted); and (2) interventions must be feasible for implementation by non-mental health professionals. Results: The WHO SMHP is organized into a background section, followed by 3 modules: Social–Emotional Childhood Development; Mental Health Promoting Schools (Promotion and Prevention); and Addressing Student Mental Health Problems in Your Classroom, including specific classroom strategies and case examples. Conclusion: Developing an appropriate curriculum sensitive to the needs of individual countries requires involvement of those familiar with schooling in those countries, with mental health priorities and practices that promote mental health, and to coalesce school staff, parents and community members in the service of their children.

Symptomatology of reconstitution of trauma in adults with a history of childhood sexual abuse. An approach from the perspective of SONapp application

Adults with a history of childhood sexual abuse often experience symptoms derived from lived traumatic experiences, which are analogous to many of the criteria of diagnosis of Borderline Personality Disorder (BPD) but also with those of stress disorder post-traumatic stress disorder (PTSD). We will briefly examine these symptoms in the context of a framework trauma, to conclude later whether symptomatic behaviors may be indicative more accurate for a post-traumatic response, especially in terms of behavior reconstitution or re-experience of trauma. Recognition of self-harm behavior or masochistic tendencies in adult survivors of sexual abuse trauma as an attempt to reconstitution of sexual trauma suffered in childhood, rather than as a manifestation characteristic of personality disorders, serves to establish an appropriate diagnosis, mental health professionals can continue to focus on the consequences of trauma unresolved sexual issues rather than personality restructuring. (Standardized intervention model SON, Delcea C ., 2019) Thus, seek to We understand clients in a trauma setting can provide a more objective treatment climate and can minimize the stigma that may result potentially from making an inappropriate diagnosis borderline personality disorder (BPD).

Testing the Reliability and Construct Validity of Short-Term Assessment of Risk and Treatability (START) in Non-Western Forensic Psychiatric Inpatients

The Short-Term Assessment of Risk and Treatability (START) is deemed the most appropriate instrument for assessing violence risks and management because of its balanced approach between dynamic risk and protective factors. Although several facets of reliability and predictive validity of this tool were strong, its inter-rater reliability, construct validity, and implementation in Asian population were under-investigated. The objective of this research was to examine the inter-rater reliability and construct validity of the START: Thai version within forensic psychiatric inpatients. The participants consisted of 118 forensic psychiatric inpatients hospitalized at Galya Rajanagarindra Institute in Thailand. Trained mental health professionals (i.e., psychiatrists, forensic nurses, clinical psychologists, social workers, and occupational therapists) assessed each participant across twenty domains of the Thai START. The inter-rater reliability was examined using the intraclass correlation coefficient and a confirmatory factor analysis for ordinal data was used to test the construct validity of the scale. The main finding showed a good-to-excellent inter-rater reliability and supported two relational constructs (i.e., strength vs vulnerability subscales) of the Thai START. The Thai START is a promising tool for using in Thai forensic psychiatric setting but some items were not significant in contributing to the scale. This study also provides the guideline for implementing the tool in non-Western forensic psychiatric populations.

Loneliness, Complaining and Professional Burnout of Medical Personnel of Psychiatric Wards during COVID-19 Pandemic—Cross-Sectional Study

Background: Professional burnout in the medical community has been present for a long time, also among mental health professionals. The aim of the study was to examine the links between loneliness, complaining and professional burnout among medical personnel in psychiatric care during a pandemic. Loneliness and complaining of the medical staff are not documented in the literature well enough. Methods: Oldenburg Burnout Questionnaire, the Loneliness Scale, the Complaint Questionnaire and author’s questionnaire. The respondents: 265 medical employees—doctors (19.2%), nurses (69.8%), paramedics (4.9%), medical caregivers (5.7%). Results: Loneliness and complaining are significant predictors of exhaustion. The model explains 18% of exhaustion variance. Loneliness, complaining and job seniority are also predictors of disengagement; the model allows to predict 10% of the variance of disengagement. Women are more prone to complain. Complaining significantly correlates with direct support from management. A high rate of loneliness correlates, in a statistically significant way, with worse work organization, less management support, worse atmosphere in the team and with more irresponsible attitudes of colleagues. Conclusions: Loneliness and complaining can be used to predict occupational burnout. Women and people without management support complain more often. Loneliness is connected with bad work organization and bad cooperation in a team.

What role can a homoeopathic psychiatrist play in restoring mental health in an unequal world?

World Mental Health Day, observed on the 10 October, is an occasion for the mental health professionals to dedicate themselves to bringing succour to the numerous persons suffering from mental health disorders. The World Mental Health Federation has declared this year’s theme as ‘Mental Health in an Unequal world.’ The call is timely considering the distress wrought on different communities due to the pandemic and the social and economic distress which has affected all sections of the population, albeit with different intensities causing differing impacts. The article explores the theme in the historical context and outlines the various concerns which mental health professionals should concern themselves with. It is a common knowledge that they are in short supply all over the world. Homoeopaths, due to their approach to health, disease and individuals are uniquely equipped to fill this gap and thus make a difference. There are very few examples, at the institutional level, where community-based activities addressing the mental health issues have been successfully undertaken and have made an impact. The article draws on the almost two-decade-long experience of the Department of Homoeopathic Psychiatry, Dr. M. L. Dhawale Memorial Homoeopathic Institute in this area, thereby illustrating the possibility of incorporating similar practices in the District Mental Health Programme. Clinical activity needs to be reported in peer-reviewed journals and initiating research in priority areas would help homoeopathy to be recognised as a discipline which can be a part of Integrated Mental Health Care for mental disorders.

Combining Farmers’ Preferences With Evidence-Based Strategies to Prevent and Lower Farmers’ Distress: Co-design and Acceptability Testing of ifarmwell

Background Farming is physically and psychologically hazardous. Farmers face many barriers to help seeking from traditional physical and mental health services; however, improved internet access now provides promising avenues for offering support. Objective This study aims to co-design with farmers the content and functionality of a website that helps them adopt transferable coping strategies and test its acceptability in the broader farming population. Methods Research evidence and expert opinions were synthesized to inform key design principles. A total of 18 farmers detailed what they would like from this type of website. Intervention logic and relevant evidence-based strategies were mapped. Website content was drafted and reviewed by 2 independent mental health professionals. A total of 9 farmers provided detailed qualitative feedback on the face validity of the draft content. Subsequently, 9 farmers provided feedback on the website prototype. Following amendments and internal prototype testing and optimization, prototype usability (ie, completion rate) was examined with 157 registered website users who were (105/157, 66.9%) female, aged 21-73 years; 95.5% (149/156) residing in inner regional to very remote Australia, and 68.2% (107/157) “sheep, cattle and/or grain farmers.” Acceptability was examined with a subset of 114 users who rated at least module 1. Interviews with 108 farmers who did not complete all 5 modules helped determine why, and detailed interviews were conducted with 18 purposively sampled users. Updates were then made according to adaptive trial design methodology. Results This systematic co-design process resulted in a web-based resource based on acceptance and commitment therapy and designed to overcome barriers to engagement with traditional mental health and well-being strategies—ifarmwell. It was considered an accessible and confidential source of practical and relevant farmer-focused self-help strategies. These strategies were delivered via 5 interactive modules that include written, drawn, and audio- and video-based psychoeducation and exercises, as well as farming-related jokes, metaphors, examples, and imagery. Module 1 included distress screening and information on how to speak to general practitioners about mental health–related concerns (including a personalized conversation script). Modules were completed fortnightly. SMS text messages offered personalized support and reminders. Qualitative interviews and star ratings demonstrated high module acceptability (average 4.06/5 rating) and suggested that additional reminders, higher quality audio recordings, and shorter modules would be useful. Approximately 37.1% (52/140) of users who started module 1 completed all modules, with too busy or not got to it yet being the main reason for non-completion, and previous module acceptability not predicting subsequent module completion. Conclusions Sequential integration of research evidence, expert knowledge, and farmers’ preferences in the co-design process allowed for the development of a self-help intervention that focused on important intervention targets and was acceptable to this difficult-to-engage group. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12617000506392; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372526

Mandated Child Abuse Reporting in a Multicultural Environment

The abuse and neglect of children has been linked to their cognitive, academic, psychological, and behavioral demise. As a result of the deleterious effects that abuse can have on children’s development and well-being, all 50 states, including the District of Columbia, have enacted child abuse reporting laws for mental health professionals. These laws typically require a mandated child abuse report when child maltreatment has been reasonably suspected. Although mandated child abuse reporting laws appear straight-forward, mandated reporting often entails complex and nuanced decision-making, particularly when a child is from a diverse cultural background. Thus, this article offers a discussion for mental health professionals (e.g., psychologists, psychiatrists, counselors, social workers) regarding mandated child abuse reporting within a multicultural environment.