Mental health literacy: focus on developing countries

Ganasen, K.A.; Parker, Shireen; Hugo, Charmaine; Stein, Dan J.; Emsley, Robin; Seedat, Soraya

doi:10.4314/ajpsy.v11i1.30251

Cited by 120 publications

(108 citation statements)

References 34 publications

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“…Studies investigating explanatory models of mental illness in Africa have revealed that depression, for example, is not seen as an illness but rather a result of psychological difficulties resulting from a number of external factors, such as poverty, alcoholism, or poor marital relations, which are highly prevalent in the developing world (46). The few such studies conducted in South Africa (34) revealed that psychosocial stress is cited more frequently than biological etiology as a cause of psychiatric disorders, and treatments for psychiatric disorders are often perceived as ineffective. Low mental health literacy may not only decrease perceived need for treatment but also lead to stigma and perceptions that treatment is ineffective (47,48).…”

Section: Discussionmentioning

confidence: 99%

“…In South Africa, barriers to treatment have not been researched as extensively as in other countries; however, low levels of mental health literacy (34,35), poorly developed mental health services, a limited supply of mental health professionals and staff (36–39), and a reliance on traditional medicine have been noted as contributing factors (40). We used the SASH data set to examine both structural and attitudinal barriers to treatment initiation among individuals with a mental disorder, as well as demographic and clinical predictors of treatment dropout.…”

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confidence: 99%

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Barriers to Mental Health Care and Predictors of Treatment Dropout in the South African Stress and Health Study

Bruwer¹,

Sorsdahl²,

Harrison³

et al. 2011

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Objective This study used data from the South African Stress and Health Study (SASH) to examine both structural and attitudinal barriers to treatment initiation among South Africans with mental disorders and to investigate predictors of treatment dropout. Methods Face-to-face interviews were conducted with 4,315 adult South Africans living in households or hostel quarters. The interview included a core diagnostic assessment of past-12-month mental disorders and assessments of disorder severity, service use, and barriers to treatment. Multivariate logistic regression models were used to determine predictors of not seeking treatment in relation to disorder severity and sociodemographic characteristics, as well as factors that were predictive of premature treatment discontinuation by participants who had received mental health treatment in the previous 12 months. Predictors of dropout were identified by cross-tabulation and discrete-time survival analysis. Results Of the 4,315 adults, 729 (16.9% weighted) met criteria for a mental disorder in the past 12 months. Across all levels of severity, the most frequently cited reason for not seeking professional treatment was a low perceived need for treatment. Among those who recognized the need but did not access treatment during the past 12 months (7.2%), attitudinal barriers to treatment seeking were reported more commonly than structural barriers (100% and 34%, respectively). Of the 182 respondents who received treatment (25% weighted), 20% discontinued prematurely. Various factors, such as substance use disorders and absence of health insurance, increased the odds of treatment dropout. Conclusions Low rates of treatment seeking and high treatment dropout rates for common mental disorders among South Africans are a major concern. Public health efforts to improve treatment of mental disorders should consider the multiple influences on treatment initiation and discontinuation.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Barriers to Mental Health Care and Predictors of Treatment Dropout in the South African Stress and Health Study

Bruwer¹,

Sorsdahl²,

Harrison³

et al. 2011

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“…These include societal, institutional and individual factors (Collins, Holman, Freeman, & Patel, 2006). Individual level factors include patients' own knowledge and attitudes towards psychiatric disorders (Ganasen et al, 2008). When knowledge about psychiatric disorders (or mental health literacy) is decreased, and stigma associated with such conditions is high, a lower rate of help-seeking is often reported (Angermeyer, Beck, Dietrich, & Holzinger, 2004;Jorm et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

Perspectives towards mental illness in people living with HIV/AIDS in South Africa

2010

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Psychiatric disorders are more common in people living with HIV/AIDS (PLWHA) than in the general population and they exert a significant effect on many health-related outcomes. Low levels of mental health literacy and stigma may contribute to delayed treatment seeking and poorer outcomes. A convenience sample of 400 HIV-positive respondents were selected from three health clinics in Cape Town. Respondents' mental health literacy and attitudes towards psychiatric disorders were investigated. Psychiatric disorders were viewed as stress-related 70-91% of the time. Seeking help from a medical professional was often endorsed as an effective treatment option, while taking medication was rarely endorsed. Respondents held negative attitudes towards people with psychiatric disorders. In particular, people with substance abuse and PTSD were stigmatised more than those with depression and schizophrenia. The understanding of the psychobiological nature of psychiatric disorders and of existing effective treatments in PLWHA in South Africa is limited. Interventions designed to increase mental health literacy and reduce the stigma associated with psychiatric disorders may increase the likelihood of PLWHA seeking treatment should they suffer from these conditions.

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“…5 Mental health literacy of the community, clinicians, and decisionmakers must be increased. 21 We are optimistic about the future: psychiatry has moved to the centre of health sciences faculties globally and locally. Nevertheless, the future of psychiatry globally has many uncertainties.…”

Section: Towards the Futurementioning

confidence: 99%

No health without mental health: Establishing psychiatry as a major discipline in an African Faculty of Health Sciences

et al. 2012

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Psychiatry is an important discipline within medicine. The contribution of psychiatric disease to burden of illness continues to increase.1 The doctor-patient relationship is key to clinical practice. 2Psychiatric disorders influence behaviours such as adherence to medication, and affect basic physiological processes, so influencing outcomes in medical disorders. 3 Basic and clinical neuroscience will benefit from future research in genetics and proteomics. 4 Psychiatry is not always viewed as a major medical specialty. The associated morbidity and mortality is often overlooked.5 Many aspects of psychiatry are viewed as 'non-medical' . 6 The doctor-patient relationship is not necessarily seen as key, the impact of psychiatric disorder on outcomes is not always recognised, and underdiagnosis and undertreatment of psychiatric disorders persists.7 Psychiatric treatments are often perceived as ineffective or inappropriate. 8 We review these debates through the lens of the history of psychiatry that often begins with the asylum and predates the university Medical School. We outline the progression to university department of psychiatry, and a larger department achieving parity with other medical disciplines. Such disjunctures reflect views of mental illness, and contribute to the marginalisation of psychiatry as a medical specialty, and to the treatment gap for mental disorders. Phase 1: The asylumIn South Africa, the Robben Island Lunatic Asylum was established in 1846 by the colonial government as part of a larger general infirmary that housed 'lepers, lunatics, and the chronic sick' . 10 Concerns were expressed about conditions on the island so that by the 1870s the asylum had a reputation for being a humane institution, employing non-restraint methods, 10 and having a high attendant-to-patient ratio. 10However, racial segregation was practised.It was a typical early asylum as it was cut off geographically and reserved for disruptive patients, 10 those with common mental disorders being largely ignored. Expertise in various psychiatric subdisciplines had little scope, interaction with other medical disciplines was lacking and there was no concept of a multidisciplinary team. Phase 2: Specialist psychiatric hospitalThe turn of the 20th century saw advances in psychiatry internationally. In 1891 in the Cape, Valkenberg Hospital, the first local institution specifically designed for the mentally ill, was opened.11 Attempts to establish scientific and humane care for patients were made.12 Dodds, the colony's first Inspector of Asylums, held strong views about the therapeutic effects of regular outings, contact with the community, and visits from family and friends, 11 and emphasised the facility's geographical accessibility.Nevertheless, Valkenberg was on the outskirts of Cape Town, 11 and the Medical School, founded in 1912, paid little attention to psychiatry. The focus at Valkenberg remained severe psychotic disorders, with little teaching and research, and limited scope for developing subspecialty interests. 13 P...

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Mental health literacy: focus on developing countries

Cited by 120 publications

References 34 publications

Barriers to Mental Health Care and Predictors of Treatment Dropout in the South African Stress and Health Study

Barriers to Mental Health Care and Predictors of Treatment Dropout in the South African Stress and Health Study

Perspectives towards mental illness in people living with HIV/AIDS in South Africa

No health without mental health: Establishing psychiatry as a major discipline in an African Faculty of Health Sciences

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