Despite being globally recognised as an important public health issue, mental health is still less prioritised as a disease burden in many Low-and Middle-Income Countries (LMICs). More than 70% of the global mental health burden occurs in these countries. We discussed mental health issues in LMICs under themes such as abuse and mental illness, cultural influence on mental health, need for dignity in care, meeting financial and workforce gaps and the need for national health policy for the mental health sector. We highlighted that although mental health education and health care services in most LMICs are poorly resourced; there is an urgent need to address issues beyond funding that contribute to poor mental health. In order to meet the increasing challenge of mental health illness in LMICs, there is a need for effort to address cultural and professional challenges that contribute to poor mental health among individuals. We have a notion that mental health should be integrated into primary health care in LMICs. Creating awareness on the impact of some cultural attitudes/practices will encourage better uptake of mental health services and increase the ease when discussing mental health issues in these countries which can contribute to reducing the poor mental health in LMICs.
The study indicates that the development of nurse-patient relationships and working in a supportive team are perceived as protective factors against risk. Implications of the research are discussed in relation to nurse-patient relationships, particularly in the context of the current nursing climate and the way in which violent behaviour may lead to an erosion of these relationships. The importance of 'working in a team' is discussed, as is the consequence of the findings for education and development. Methodological limitations of the study are also discussed.
Anabolic Androgenic Steroids (AAS) are commonly used for their anabolic effects and potential detrimental consequences are well documented. Most studies focus on the motivations of increased muscle development and report increased libido as a secondary motivation. This paper aims to explore users' reports of libido as a motivator for starting and restarting AAS use. This mixed-methods study comprised questionnaires with 133 adult male AAS users (38% of selected increased libido as motivation for using), and 23 semi-structured interviews with a sub-sample. Thematic analysis identified four interlinked themes: increased libido as a motivation for starting/re-starting AAS; increased libido/sexual performance as a beneficial effect; mixed experiences with physicians regarding libido changes and hypogonadism and reduced sexual functioning and fertility after AAS cessation.Increased libido was identified as a benefit by 90% but motivations for use changed over time. Reasons for AAS use included mitigating the effects of aging particularly linked to the concept of virility. AAS as self-medication for low testosterone needs further investigation as does the idea of hegemonic masculinity as a reinforcing driver for AAS use. This study highlights the need to consider how AAS users' views of medical support impact on selfmedication choices.
Anabolic Androgenic Steroids (AAS) are used by the general population (particularly male gym users) for their anabolic effects (increased muscle mass). Few studies have sought AAS users' views on what information and support they need. This study focuses on ideal support wanted by people who use AAS. Interviews were conducted with 23 self-declared adult AAS users. Using thematic analysis, six themes were identified aligned to support and information wanted by AAS users: (1) specific types of information wanted: managing risks, (2) mechanisms for communication of advice, (3) specific types of support wanted: medical and emotional, (4) stigmatisation of people who use AAS, (5) paying for support services, (6) legality of AAS use.Integral to the support was that it should be considered within the context of use and identity. Support needs to be specific, targeted towards AAS users ensuring that balanced and evidenced-based advice is given. Sensitivity to AAS users' perceptions of their drug-use and the stigma of being classified in the same sub-set as other illicit drug users is relevant to facilitating successful engagement. Furthermore, there is a need to consider the emotional issues surrounding AAS use and how to meet these needs.
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