International Journal of Mental Health Systems最新文献

{"title":"Evaluating Pakistan's mental healthcare system using World Health Organization's assessment instrument for mental health system (WHO-AIMS).","authors":"Komal Dayani, Mekaiel Zia, Onaiza Qureshi, Maria Baig, Taha Sabri","doi":"10.1186/s13033-024-00646-6","DOIUrl":"10.1186/s13033-024-00646-6","url":null,"abstract":"<p><strong>Background: </strong>Pakistan faces profound mental health challenges, which necessitate the urgent need for a comprehensive assessment of its mental healthcare system. A holistic understanding of the mental health landscape is essential to identify strengths, weaknesses, and existing gaps within the system, which can inform targeted interventions and policy enhancements to improve mental healthcare accessibility.</p><p><strong>Objective: </strong>The primary objective of this desk research is to conduct an in-depth analysis of Pakistan's mental healthcare system across various dimensions, guided by the World Health Organization's Assessment Tool for Mental Health Systems (WHO-AIMS).</p><p><strong>Methods: </strong>Data for this desk research and scoping was obtained through desk research, including an examination of existing policies and legislation and consultations with various health facilities across Pakistan. This comprehensive analysis focused on six critical domains within the WHO-AIMS framework: policy and legislation, mental health services, integration of mental health into primary care, public awareness and collaboration with other sectors, human resources, and monitoring and research initiatives.</p><p><strong>Results: </strong>The findings provides a snapshot of strength and opportunities for improvement in Pakistan's mental healthcare system that can serve as the foundation for revising and updating national priorities. Key areas of focus include enhancing policy and legislation, expanding access to mental health services, improving existing initiatives for better integration of mental health into primary care, improving public awareness and sector collaboration, addressing human resource challenges, and strengthening monitoring and research initiatives.</p><p><strong>Conclusion: </strong>This desk research provides a roadmap for refining and enhancing Pakistan's mental health ecosystem and informs the prioritization of mental health campaigning efforts.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"18 1","pages":"32"},"PeriodicalIF":3.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A process study of early achievements and challenges in countries engaged with the WHO Special Initiative for Mental Health.","authors":"Alastair Ager, Sabrina Hermosilla, Alison Schafer, Dévora Kestel","doi":"10.1186/s13033-024-00652-8","DOIUrl":"10.1186/s13033-024-00652-8","url":null,"abstract":"<p><strong>Background: </strong>There is increasing awareness of the importance of the transformation of mental health systems. Launched in 2019, the WHO Special Initiative for Mental Health seeks to accelerate access to quality and affordable care for mental health conditions as an integral component of Universal Health Coverage. Nine countries are currently engaged with the initiative.</p><p><strong>Methods: </strong>This study reviewed processes of implementation-and progress achieved-across all settings by late 2022. It involved review of 158 documents provided by WHO relating to Special Initiative activities and 42 interviews with country-level stakeholders, WHO Regional and HQ personnel engaged with the initiative, and core donors. Documents were thematically coded using a template based upon the WHO framework of health system building blocks. Responses to structured interviews were coded based on an emergent thematic framework.</p><p><strong>Results: </strong>Documentation reported similar achievements across all domains; however challenges were reported most frequently in relation to service delivery, leadership and governance, and workforce. Issues of financing were notable in being twice as likely to be reported as a challenge than a success. Interviews indicated four major areas of perceived achievement: establishing a platform and profile to address mental health issues; convening a multi-stakeholder, participatory engagement process; new, appropriate services being developed; and key developments in law, policy, or governance around mental health. The planning process followed for the initiative, senior country-level buy-in and the quality of key personnel were the factors considered most influential in driving progress. Ambivalent political commitment and competing priorities were the most frequently cited challenges across all interviewees.</p><p><strong>Conclusions: </strong>The role of the Special Initiative in raising the profile of mental health on national agendas through a participatory and inclusive process has been widely valued, and there are indications of the beginnings of transformational shifts in mental health services. To secure these benefits, findings suggest three strategic priorities: increasing political prioritisation and funding for systems-level change; clearly articulating sustainable, transformed models of care; and promoting feasible and contextualised measures to support accountability and course correction. All are of potential relevance in informing global strategies for mental health systems transformation in other settings.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"18 1","pages":"31"},"PeriodicalIF":3.1,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11492481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and long-term change in alcohol consumption: results from a population-based cohort in Southern India.","authors":"S Mahasampath Gowri, Antonisamy Belavendra, Senthil K Vasan, S Keerthi, Sven Andreasson","doi":"10.1186/s13033-024-00650-w","DOIUrl":"10.1186/s13033-024-00650-w","url":null,"abstract":"<p><strong>Background: </strong>Alcohol consumption in India is below the global average, with limited data on long-term effects. The current study aims to examine changes over time among alcohol consumers, the pattern of drinking and help-seeking for alcohol problems among South Indian men.</p><p><strong>Method: </strong>Data on the intake of various alcohol types were collected through standard questionnaires in two adult follow-ups [Baseline: 1998-2002, Follow-up: 2016-2019] from male participants in the Vellore birth cohort (VBC). Alcohol intake was converted to weekly standard drink units for analysis. Data on drinking patterns using the Alcohol Use Disorder Identification Test (AUDIT) and information on help-seeking among problem drinkers were collected during follow-up. Socio-demographic associations with alcohol consumption were determined using logistic regression.</p><p><strong>Results: </strong>The prevalence of alcohol consumption was 54.5% and 47.7% at the baseline and follow-up, respectively. Over two decades, 12% of men reported to have newly started drinking and 18% quit drinking. Lower education and lower socio-economic status (SES) were the strongest predictors of alcohol consumption. The AUDIT assessment among drinkers reported hazardous drinking of 38.4%, harmful drinking of 4.7% and 3.7% probable alcohol dependence. Among the persons with high AUDIT scores, 25% were concerned about high consumption, and 9% sought help to stop their alcohol consumption.</p><p><strong>Conclusion: </strong>Our results showed a decline in alcohol consumption in this cohort over two decades. Among drinkers, a high proportion report hazardous and harmful consumption. Low levels of education and SES are significant predictors of alcohol consumption. A low proportion of help-seeking reflects alcohol-related stigma in the community.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"18 1","pages":"30"},"PeriodicalIF":3.1,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of informal employment on individuals’ psychological well-being: microevidence from China","authors":"Deshui Zhou, Qingqing Zhang, Jingshan Li","doi":"10.1186/s13033-024-00648-4","DOIUrl":"https://doi.org/10.1186/s13033-024-00648-4","url":null,"abstract":"The number of workers engaged in informal employment in China has reached 200 million individuals, constituting a substantial contribution to the pursuit of high-quality development and the attainment of stable employment objectives. Nevertheless, the psychological well-being of informal workers cannot be overlooked. Therefore, this study aims to investigate the impact of informal employment on individuals’ psychological well-being. Drawing on data from the 2020 China Family Panel Studies (CFPS) survey, this work employs ordinary least squares (OLS) models and instrumental variable analysis to empirically examine the impact of informal employment on the psychological well-being. Furthermore, different tests were utilised to analyse the mediating pathway through which informal employment affects the psychological well-being. Informal employment exhibits a significant negative impact on the psychological well-being, particularly among samples characterised by low educational levels, limited financial resources, and non-agricultural household registration. The exploration of the underlying mechanisms indicates that informal employment negatively affects the psychological well-being of workers through pathways that include reduced access to health entitlements, increased working hours, and decreased job satisfaction, particularly with the work environment. A recommendation is proposed; namely, to further establish a social security system that caters to the needs of the informal employment population and supports and regulates the development of flexible employment forms, with the aim of protecting and enhancing the psychological well-being of the informal employment population.","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"5 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-creating community wellbeing initiatives: what is the evidence and how do they work?","authors":"Nicholas Powell, Hazel Dalton, Joanne Lawrence-Bourne, David Perkins","doi":"10.1186/s13033-024-00645-7","DOIUrl":"10.1186/s13033-024-00645-7","url":null,"abstract":"<p><strong>Background: </strong>Addressing wellbeing at the community level, using a public health approach may build wellbeing and protective factors for all. A collaborative, community-owned approach can bring together experience, networks, local knowledge, and other resources to form a locally-driven, place-based initiative that can address complex issues effectively. Research on community empowerment, coalition functioning, health interventions and the use of local data provide evidence about what can be achieved in communities. There is less understanding about how communities can collaborate to bring about change, especially for mental health and wellbeing.</p><p><strong>Method: </strong>A comprehensive literature search was undertaken to identify community wellbeing initiatives that address mental health. After screening 8,972 titles, 745 abstracts and 188 full-texts, 12 exemplar initiatives were identified (39 related papers).</p><p><strong>Results: </strong>Eight key principles allowed these initiatives to become established and operate successfully. These principles related to implementation and outcome lessons that allowed these initiatives to contribute to the goal of increasing community mental health and wellbeing. A framework for community wellbeing initiatives addressing principles, development, implementation and sustainability was derived from this analysis, with processes mapped therein.</p><p><strong>Conclusion: </strong>This framework provides evidence for communities seeking to address community wellbeing and avoid the pitfalls experienced by many well-meaning but short-lived initiatives.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"18 1","pages":"28"},"PeriodicalIF":3.1,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, attitudes, and practices on child and adolescent mental health among healthcare workers in sub-Saharan Africa: a scoping review.","authors":"Beatrice Mkubwa, Vibian Angwenyi, Brenda Nzioka, Charles R Newton, Marit Sijbrandij, Amina Abubakar","doi":"10.1186/s13033-024-00644-8","DOIUrl":"10.1186/s13033-024-00644-8","url":null,"abstract":"<p><strong>Introduction: </strong>Child and adolescent mental health is a global priority. In sub-Saharan Africa, despite the high burden, there is a gap in health services for children and adolescents with mental health disorders. To bridge this gap, healthcare workers require a good understanding of child and adolescent mental health, the right attitude, and practices geared to improving child and adolescent mental health. This scoping review examined the knowledge, attitudes, and practices related to child and adolescent mental health among sub-Saharan African healthcare workers.</p><p><strong>Methods: </strong>The search was restricted between January 2010, the year when the Mental Health Gap Action Programme guidelines were launched, and April 2024. The review followed the methodological framework proposed by Arksey and O'Malley for conducting scoping reviews. The databases searched included CINHAL, PubMed, Web of Science, PsycINFO, and grey literature databases. Additional articles were identified through cited references of the studies included. A data extraction template was used to retrieve relevant text. A narrative synthesis approach was adopted to explore the relationships within and between the included studies.</p><p><strong>Results: </strong>The literature search yielded 4658 studies. Among these, 817 were identified as duplicates, and 3740 were excluded after screening. Only twenty-one articles met the criteria for inclusion in the review. The findings showed that healthcare workers have insufficient knowledge of child and adolescent mental health, hold negative attitudes toward children and adolescents with mental health problems, and exhibit poor practices related to child and adolescent mental health.</p><p><strong>Conclusion: </strong>It is crucial to build capacity and improve healthcare workers' practices, knowledge, and attitudes toward child and adolescent mental health in sub-Saharan Africa. This could lead to better access to mental health services for children and adolescents in the region.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"18 1","pages":"27"},"PeriodicalIF":3.1,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11253363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141628031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic pattern of mental, neurological and substance use disorders at primary health care facilities in Uganda.","authors":"Byamah B Mutamba, Gad Twikirize, Jimmy Ssemalulu, Roseline Babirye, Lynn Semakula, David Cappo","doi":"10.1186/s13033-024-00643-9","DOIUrl":"10.1186/s13033-024-00643-9","url":null,"abstract":"<p><p>Integration of diagnosis and treatment for mental, neurological, and substance use (MNS) disorders into primary health care is a recommended strategy to improve access to services in low-and middle-income countries. Despite numerous initiatives for integration of mental health care in Uganda, there has not been an evaluation of health management information system (HMIS) records to determine whether MNS disorders are routinely diagnosed. We sought to determine diagnostic pattern of MNS disorders at primary health facilities in Wakiso and Kampala districts, the most populous regions of Uganda. Lower-level primary health facilities were visited to obtain records from HMIS registers, to document diagnoses of MNS disorders. Secondary data analysis was conducted and descriptive statistics reported. A total of 40 primary health care facilities were visited representing 58.6% of the health facilities in the study districts. More than half (54.8%) and almost all (87.5%) of the lower-level health facilities in Wakiso district and Kampala district respectively were visited. The proportion of MNS disorders diagnosed at lower-level primary health facilities in Uganda is very low with Epilepsy the most common MNS diagnosis recorded. Reasons for such low numbers of diagnoses at primary health facilities are discussed as are possible solutions.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"18 1","pages":"26"},"PeriodicalIF":3.1,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11247730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of common mental disorder and its association with perceived stigma and social support among people living with HIV/AIDS in Ethiopia: a systematic review and meta-analysis.","authors":"Bereket Duko, Yitagesu Belayhun, Asres Bedaso","doi":"10.1186/s13033-024-00641-x","DOIUrl":"10.1186/s13033-024-00641-x","url":null,"abstract":"<p><strong>Background: </strong>When common mental disorders (CMD) co-occur with HIV/AIDS, they can complicate patient diagnosis, help-seeking behaviors, quality of life, treatment outcomes, and drug adherence. Thus, estimating the pooled prevalence of CMD and its association with perceived stigma and social support among people living with HIV/AIDS (PLWHA) in Ethiopia could potentially support policymakers and health professionals to understand the disease burden and set a solution to improve the mental well-being of PLWHA.</p><p><strong>Methods: </strong>Popular databases such as PubMed, SCOPUS, EMBASE, and Psych-INFO as well as Google Scholar, AJOL, CINAHL, PILOTS and Web of Science were searched for the relevant articles conducted in Ethiopia. We included cross-sectional, case-control, and cohort studies in the review. The Comprehensive Meta-Analysis software version 3.0 was used to pool the results of the included studies. The Q- and I²-statistics were used to assess the heterogeneity between the included studies. We employed a random-effects meta-analysis model to estimate the pooled prevalence of CMD and to account for heterogeneity among the included studies. We also conducted a leave-one-out analyses, and stratified meta-analyses by gender (male and female).</p><p><strong>Results: </strong>The studies included in this systematic review and meta-analysis were published between 2009 and 2021, recruiting a total of 5625 participants. The pooled estimated prevalence of CMD among PLWHA in Ethiopia was 26.1% (95% CI 18.1-36.0). The pooled estimated prevalence of CMD was significantly higher among females, at 39.5% (95% CI 21.2-39.0), compared to males, 26.9% (95% CI 15.6-31.7). Moreover, the pooled estimated prevalence of CMD in PLWHA ranged from 23.5 to 28.9% in the leave-one-out sensitivity analysis, indicating that the removal of any single study did not significantly affect the pooled estimate. The pooled effects (AOR) of Perceived HIV stigma and poor perceived social support on common mental disorder were 2.91, 95% CI (1.35-6.29) and 5.56, 95% CI (1.89-16.39), respectively.</p><p><strong>Conclusion: </strong>People living with HIV/AIDS (PLWHA) who received poor social support and those with HIV-related perceived stigma were found to have strong association with CMD. Therefore, it is advisable that all PLWHA attending ART clinic should be screened for CMD, social support and HIV-related perceived stigma.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"18 1","pages":"25"},"PeriodicalIF":3.1,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial interventions for depression among young people in Sub-Saharan Africa: a systematic review and meta-analysis.","authors":"Lotenna Olisaeloka, Echezona Udokanma, Asma Ashraf","doi":"10.1186/s13033-024-00642-w","DOIUrl":"10.1186/s13033-024-00642-w","url":null,"abstract":"<p><strong>Background: </strong>Depression among young people is a global health problem due to its rising prevalence and negative physical and social outcomes. The prevalence of depression and the treatment gap among young people in Sub-Saharan Africa (SSA) is higher than global estimates. Most psychosocial interventions for adolescent and youth depression were developed in high-income countries and less is known about their effectiveness in SSA. Due to contextual differences, findings from High-Income Countries (HICs) are less applicable to SSA. Yet, no systematic review of psychosocial interventions for depression among young people in SSA has been conducted.</p><p><strong>Methods: </strong>A systematic literature search of four databases (Medline, Web of Science, PsycInfo, and Cochrane library) was conducted. Experimental studies published before May 2024 that evaluated the effect of psychosocial interventions on depressive symptoms among young people (aged 10-24 years) in SSA were included in the systematic review. Effect sizes (Hedge's g (g)) indicating differences between intervention and control groups were calculated using a random effects model.</p><p><strong>Results: </strong>Twenty-two eligible studies were identified for the systematic review, of which eighteen randomized control trials (RCTs) involving 2338 participants were included in the meta-analysis. The findings revealed that psychosocial interventions significantly reduced depressive symptoms (g = -1.55, 95% CI -2.48, -0.63), although heterogeneity was high (I² = 98.8%). Subgroup analysis revealed that efficacy differed significantly by intervention type, with Cognitive Behavioural Therapy (9 studies) showing the strongest effect (g = -2.84, 95% CI -4.29; -1.38). While Wise Interventions (a form of positive psychology interventions; 2 studies) had a moderate effect (g = -0.46, 95% C.I -0.53, -0.39), Interpersonal Psychotherapy (2 studies; g = -0.08, 95% CI -1.05, 0.88) and Creative Psychological Interventions (3 studies; g = -0.29, 95% CI -1.38, 0.79) showed smaller, non-significant effects. Sensitivity analysis excluding studies at high risk of bias strengthened the effect size. Few studies assessed factors affecting intervention efficacy and showed mixed effects of age, gender, and adherence levels.</p><p><strong>Conclusion: </strong>Psychosocial interventions, particularly CBT, significantly reduced depressive symptoms among young people in SSA. However, it is crucial to acknowledge the high heterogeneity which likely stems from variations in study populations and intervention delivery modalities. This highlights the need for further research to identify the specific intervention components and delivery methods that work best for distinct subpopulations. Future research should also explore how long intervention effects are maintained and factors affecting efficacy.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"18 1","pages":"24"},"PeriodicalIF":3.1,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11193191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141440977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived feasibility, acceptability and impact of the family involvement intervention for severe mental illness: a qualitative study in Masaka - Uganda.","authors":"Andrew Kampikaho Turiho, Seggane Musisi, Racheal Alinaitwe, Elialilia S Okello, Victoria Jane Bird, Stefan Priebe, Nelson Sewankambo","doi":"10.1186/s13033-024-00634-w","DOIUrl":"10.1186/s13033-024-00634-w","url":null,"abstract":"<p><strong>Background: </strong>The burden of severe mental illness is high in low-resource settings like Uganda. But most affected people are not treated due to inadequacy of sectoral funding and trained mental health professionals. Medication has hitherto been the main method of treatment for severe mental illness worldwide. However, there is a growing realization that the use of community-based resource-oriented interventions like the family involvement are more effective and suitable for under-resourced settings. But there is a paucity of information about its applicability in Uganda.</p><p><strong>Methods: </strong>We based the intervention at the mental health unit of Masaka Regional Referral Hospital, involving 30 patients with SMI, 60 family members and friends, and 6 mental health clinicians. It was delivered through regular monthly meetings of 5 patients, 10 caretakers, and 2 clinicians each, for six months. A purposive sample of 15 patients, 15 caretakers, and 6 clinicians participated in this qualitative evaluation study after 6 months. Data was collected using in-depth interviews. Atlas.Ti (version 7.0.82) computer software was used in data analysis. Both priori and grounded codes were used to code data.</p><p><strong>Results: </strong>We evaluated perceived feasibility, acceptability and impact of the intervention in the Ugandan context. The findings were largely positive. Feasibility was mainly driven by: the training of group facilitators, field support and supervision, prior relationship between participants, and scheduling and timing of meetings. Acceptability was supported by: anticipation of knowledge about mental illness, process and content of meetings, safety of meeting environment, and choice of participants and venue. Impact was majorly in domains of: knowledge about mental illness, psychosocial aspects of mental illness, networking and bonding, and patients' quality of life. The success of the intervention would further be enhanced by its decentralization and homogenized composition of groups.</p><p><strong>Conclusions: </strong>The intervention promises to spur improvement in the following main aspects of mental health services: accessibility since the meeting environment is more neutral and friendlier than the clinical setup; knowledge of mental illness; recognition of the important role of the family in management of mental illness; adoption of holistic approaches to mental illness; and quality of life of patients.</p>","PeriodicalId":47752,"journal":{"name":"International Journal of Mental Health Systems","volume":"18 1","pages":"23"},"PeriodicalIF":3.6,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11184698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}