Psychological and social interventions for mental health issues and disorders in Southeast Asia: a systematic review

Abstract

Background Mental health issues and disorders are major public health challenges, particularly in low- and middle-income countries in Southeast Asia, where chronic shortages in mental health services and human resources exist. The development of effective and accessible mental health systems in Southeast Asia will require evidence based psychological and social interventions. This systematic review provides a narrative synthesis of the evidence on the effectiveness of such interventions for mental health issues and disorders in Southeast Asia. Methods A comprehensive literature search of 7 electronic databases (PsycINFO, Medline (Ovid), Cochrane library, EMBASE, SCOPUS, APA PsycArticles, and Social Care Online) was undertaken. Results Thirty two studies employing RCT designs to evaluate the effectiveness of a range of psychological and social mental health interventions on a number of different mental health outcomes were included in this review. The disparate intervention programmes reviewed were categorised as: lay delivered, yoga, aerobic and/or meditation based, cognitive behavioural therapy oriented, eye movement desensitization and reprocessing based (EMDR), health worker delivered, and hybrid programmes. The majority of the studies included in this review were of low to moderate quality due to the variability in the quality of the study design. The highest quality, and most promising evidence came from the evaluations of lay delivered interventions. This evidence demonstrates the feasibility and potential sustainability of implementing such interventions in resource constrained contexts. Conclusions The review findings indicate that a disparate array of mental health interventions can be implemented effectively in a range of Southeast Asian mental health and health settings. There is a clear need for significantly more research however, through higher quality and larger scale RCTs before it will be known more definitively, if these interventions are effective, and for whom they are most effective in different Southeast Asian contexts.

Rates and correlates of psychological distress and PTSD among persons with physical disabilities in Cambodia

“…Our findings were also supported by Gibert et al [19] who in a 4.5 year prospective cohort study of terrorist attack survivors, found that levels of mindfulness were significantly associated with PTSD symptoms. These results, again provide promising preliminary evidence that should a person with a physical impairment in Cambodia, engage in a mental health intervention or programme of support e.g., eye movement desensitization and reprocessing (EMDR) and/or mindfulnessbased programmes [31], which could reduce pathological worry and facets of mindfulness, that they may experience improvements in their PTSD symptoms.…”

“…Both worry and rumination have been identified as cognitive avoidant coping strategies, which may relieve stress, anxiety, or low mood in the short term, but if relied upon in the longer term, will likely increase psychological distress, as the underlying reasons for the worry or rumination e.g., not approaching and engaging with difficult emotions, are unlikely to change [30,32,33]. These results provide promising preliminary evidence that should a person with disabilities in Cambodia engage in a mental health intervention or programme of support, which could reduce worry and rumination e.g., mindfulness-based programmes, Cognitive Behavioural Therapy or task shifted health worker counselling support programmes [31], that they are likely to experience improvements in psychological distress.…”

“…Also, in line with UN SDG Goal 3 and 10 [2] there is a need to extend mental health services to community-based, primary care settings using task-shifted programmes of mental health support. Such programmes should be informed and evidenced by epidemiological trends and efficacy data [31,56]. There is however a significant lack of data on what the potential predictors of psychological distress and PTSD symptoms of persons with disabilities in Cambodia might be [26].…”

Dukungan Kader kepada Orang dengan Gangguan Jiwa

“…Negara-negara di Asia Tenggara menurut pembagian wilayah oleh WHO (Bangladesh, Bhutan, Republik Korea, India, Indonesia, Maldives, Myanmar, Nepal, Srilanka, Thailand dan Timor-Leste) memiliki prevalensi depresi 27% dan kecemasan 23% (3). Gangguan kesehatan jiwa akan menimbulkan beban psikologi, sosial dan ekonomi namun masih banyak penderita yang belum mendapatkan pengobatan (3). Negara Indonesia memiliki kesenjangan pemberian perawatan ODGJ sebesar 90% sedangkan di daerah pedesaan kesenjangan terhadap perawatan ODGJ mencapai 95% (4).…”

Depression, Self-Esteem, and Lifestyle Factors Among University Students in Singapore and Malaysia

“…According to World Health Organization (WHO), the prevalence rate for depression is at 10.4% and affects more than 300 million people globally; nearly half of these people live in the Southeast Asia region (SEA; WHO, 2018). Research evidence has shown that Southeast Asia has the highest rate of depression, with a lifetime risk of 12% for males and 25% for females (Maddock et al, 2021). Along with a high prevalence rate, depression is associated with high economic costs.…”