Nigerian schoolchildren, as with Nigerian adults and young people in Western countries, show stigma towards mental illness. This may be underpinned by a lack of knowledge regarding mental health problems. Educational interventions need to be appropriate to area, age and gender to effectively improve mental health literacy, which in turn will influence attitudes and social distance. However, the fact that the schoolchildren were optimistic about recovery is a strength that could be built upon.

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The results suggest that, similar to findings elsewhere, stigmatization of mental illness is highly prevalent among Nigerian children. This may be underpinned by lack of knowledge regarding mental health problems and/or fuelled by the media. Educational interventions and encouraging contact with mentally ill persons could play a role in reducing stigma among schoolchildren.

BackgroundDefining quality in health presents many challenges. The Institute of Medicine (IOM) defined quality clinical care as care that is equitable, timely, safe, efficient, effective and patient centred. However, it is not clear how different stakeholders within a child and adolescent mental health service (CAMHS) understand and/or apply this framework. This project aims to identify key stakeholders“ understanding of the meaning of quality in the context of CAMHS.MethodThe study sample comprised of three groups: (i) patients and carers, (ii) CAMHS clinical staff, and (iii) commissioners (Total N = 24). Semi-structured interviews were used to collect data and thematic analysis was applied to explore participant’s views on the meaning and measurement of quality and how these might reflect the IOM indicators and their relevance in CAMHS.ResultsAn initial barrier to implementing quality care in CAMHS was the difficulty and limited agreement in defining the meaning of quality care, its measurement and implementation for all participants. Clinical staff defined quality as personal values, a set of practical rules, or clinical discharge rates; while patients suggested being more involved in the decision-making process. Commissioners, while supportive of adequate safeguarding and patient satisfaction procedures, did not explicitly link their view on quality to commissioning guidelines. Identifying practical barriers to implementing quality care was easier for all interviewees and common themes included: lack of meaningful measures, recourses, accountability, and training. All interviewees considered the IOM six markers as comprehensive and relevant to CAMHS.ConclusionsNo respondent individually or within one stakeholder group identified more than a few of the indicators or barriers of a quality CAMHS service. However, the composite responses of the respondents enable us to develop a more complete picture of how to improve quality care in practice and guide future research in the area.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2080-z) contains supplementary material, which is available to authorized users.

Attention to children/young people and their parents/carers' expectations of services is needed to improve therapeutic relationships and engagement. Improvement in mental health literacy and practitioners' guidance is required to allow service users to set realistic and achievable treatment goals.

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RESUMOHá cada vez mais evidências de associações abordando a percepção de discriminação e seu impacto prejudicial como perpetuador de disparidades de saúde física e mental. O objetivo é usar métodos descritivos para contribuir em uma melhor compreensão das relações entre diferentes categorias de percepção de discriminação e grupos específicos de sintomas mentais e comportamentais. Este é um estudo transversal, realizado na Universidade de Campinas (UNICAMP), uma instituição pública brasileira, com a coleta de diversas variáveis independentes sociodemográficas e as variáveis dependentes foram os resultados da saúde mental, cuja presença foi avaliada através da utilização de instrumentos quantitativos. Os dados pareados foram digitados e analisados usando SPSS, versão 16.0 (SPSS, Inc., Chicago, IL, EUA). Foram realizadas análises de regressão logística, com ambos os modelos uni e multivariada para estudo da associação das variáveis experiências percebidas de discriminação foram frequentemente relatadas (69,4%). Graduandos negros/pardos relataram mais discriminação com base na cor da pele e desempenho acadêmico. A partir dos resultados da avaliação da saúde mental, as queixas de depressão, ansiedade e abuso de substância eram muito comuns. Queixas psicológicas, uso de substâncias psicoativas e consequentes comportamentos

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