The effect of cash transfers on mental health: Opening the black box – A study from South Africa

Ohrnberger, Julius; Anselmi, Laura; Fichera, Eleonora; Sutton, Matt

doi:10.1016/j.socscimed.2020.113181

Cited by 18 publications

(14 citation statements)

References 50 publications

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“…For example, for stages 0-1, we draw attention to existing interventions designed to reduce CM prevalence through action on social drivers such as poverty and isolation, as they also potentially contribute to mental health promotion. For example, the Bangladeshi Association for Life Skills, Income, and Knowledge for Adolescents (BALIKA) program which successfully reduced risk of CM [87] targets social drivers also linked to poor mental health that when addressed have improved mental health outcomes for young women living in adversity elsewhere [88,89]. In working at stages 2-4, mental health interventions should not exclude spaces to address the wider contexts that drive or deepens distress.…”

Section: Discussionmentioning

confidence: 99%

Overlooked and unaddressed: A narrative review of mental health consequences of child marriages

Burgess

Jeffery

Odero

et al. 2022

PLOS Glob Public Health

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Child Marriage (before the age of 18) affects over 12 million young women globally, annually. Despite acknowledgement of the negative impacts of the practice on reproductive health, mental health consequences are largely overlooked. Given the ability for poor mental health to intensify other health and social challenges, understanding the mental health consequences linked to child marriage is vital. Our study is the first to examine how mental health is approached in current literature on child marriage. Our conceptual framework was informed by a rapid assessment of key issues in the field. Systematic searches of papers published between 2000–2020 were completed on four electronic databases with no language restrictions. Our protocol was registered on Prospero (CRD42019139685). Articles were assessed using PRISMA guidelines, and their quality assessed using the Joanna Briggs Institute Critical Appraisal Tools. Of the 4,457 records identified, 21 papers meeting inclusion criteria were analysed using narrative synthesis. The final sample included 5 qualitative, 1 mixed-methods and 15 quantitative studies (14 cross-sectional and 1 longitudinal study) reporting on data from 12 countries, largely in the global south. Intimate partner violence, poverty, challenges in childbirth and isolation were identified as social factors linked to emotional distress by those married as children. Depression was the most reported mental disorder. Anxiety, phobias, psychological distress, substance misuse, negative well-being and anti-social personality disorder were reported less frequently. Findings highlight that while significant emotional distress and specific mental health conditions are linked to child marriage, gaps in our understanding remain. Future studies are needed to; clarify directionality in these relationships; understand the mental health needs of young men, LGBTQI communities and those in humanitarian settings. Given the well documented cyclical relationship between social determinants and mental health conditions, we outline a series of community-oriented interventions which blend psychological, social and structural support to promote mental health and wellbeing in the contexts of child marriage.

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Section: Discussionmentioning

confidence: 99%

Overlooked and unaddressed: A narrative review of mental health consequences of child marriages

Burgess

Jeffery

Odero

et al. 2022

PLOS Glob Public Health

View full text Add to dashboard Cite

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“…Current research indicates a relationship between poverty and mental ill-health in LMIC widely ( Lund et al., 2018 ; Ohrnberger et al, 2020 ), and in South Africa ( Lund & Cois, 2018 ). Debates remain over the most appropriate ways to tackle the complex interplay of poverty and mental ill-health.…”

Section: Discussionmentioning

confidence: 99%

Exploring the impact of a complex intervention for women with depression in contexts of adversity: A pilot feasibility study of COURRAGE-plus in South Africa

Burgess

Jeske

Rasool

et al. 2021

Int J Soc Psychiatry

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Background: Depression is a leading cause of disease burden worldwide but is often undertreated in low- and middle-income countries. Reasons behind the treatment gap vary, but many highlight a lack of interventions which speak to the socio-economic and structural realties that are associated to mental health problems in many settings, including South Africa. The COURRAGE-PLUS intervention responds to this gap, by combining a collective narrative therapy (9 weeks) intervention, with a social intervention promoting group-led practical action against structural determinants of poor mental health (4 weeks), for a total of 13 sessions. The overall aim is to promote mental health, while empowering communities to acknowledge, and respond in locally meaningful ways to social adversity linked to development of mental distress. Aim: To pilot and evaluate the effectiveness of a complex intervention – COURRAGE-PLUS on symptoms of depression as assessed by the Patient Health Questionnaire (PHQ-9) among a sample of women facing contexts of adversity in Gauteng, South Africa. Methods: PHQ-9 scores were assessed at baseline, post collective narrative therapy (midline), and post social intervention (endline). Median scores and corresponding interquartile ranges were computed for all time points. Differences in scores between time points were tested with a non-parametric Friedman test. The impact across symptom severities was compared descriptively to identify potential differences in impact across categories of symptom severity within our sample. Results: Participants’ ( n = 47) median depression score at baseline was 11 (IQR = 7) and reduced to 4 at midline (IQR = 7) to 0 at endline (IQR = 2.5). The Friedman test showed a statistically significant difference between depression scores across time points, [Formula: see text](2) = 49.29, p < .001. Median depression scores were reduced to 0 or 1 Post-Intervention across all four severity groups. Conclusions: COURRAGE-PLUS was highly effective at reducing symptoms of depression across the spectrum of severities in this sample of women facing adversity, in Gauteng, South Africa. Findings supports the need for larger trials to investigate collective narrative storytelling and social interventions as community-based interventions for populations experiencing adversity and mental distress.

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“…More recently, research studies evaluating the impact of unconditional cash transfer programs in South Africa, Tanzania and Malawi found that unconditional cash transfers have stronger benefits for improving mental health, reducing symptoms of depression, and improving education and social support than conditional cash transfer programs (30)(31)(32). These are promising ways to address the socio-economic determinants of mental health, and highlight the importance of a multi-pronged approach to AMH research.…”

Section: Adolescent Mental Health Research and Intervention Developme...mentioning

confidence: 99%

Adolescent Health Series: The status of adolescent mental health research, practice and policy in sub‐Saharan Africa: A narrative review

Sequeira

Singh

Fernandes

et al. 2022

Tropical Med Int Health

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Sub-Saharan Africa (SSA) has the fastest growing adolescent population in the world. In addition to developmental changes, adolescents in SSA face health and socioeconomic challenges that increase their vulnerability to mental illhealth. This paper is a narrative review of adolescent mental health (AMH) in SSA with a focus on past achievements, current developments, and future directions in the areas of research, practice and policy in the region. We describe the status of AMH in the region, critical factors that negatively impact AMH, and the ways in which research, practice and policy have responded to this need. Depression, anxiety and post-traumatic stress disorders are the most common mental health problems among adolescents in SSA. Intervention development has largely been focused on HIV/AIDS service delivery in school or community programs by non-specialist health workers. There is a severe shortage of specialised AMH services, poor integration of services into primary health care, lack of a coordinated intersectoral collaboration, and the absence of clear referral pathways. Policies for the promotion of AMH have been given less attention by policymakers, due to stigma attached to mental health problems, and an insufficient understanding of the link between mental health and social determinants, such as poverty. Given these gaps, traditional healers are the most accessible care available to help-seeking adolescents. Sustained AMH research with a focus on the socioeconomic benefits of implementing evidence-based, contextually adapted psychosocial interventions might prove useful in advocating for much needed policies to improve AMH in SSA.

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The effect of cash transfers on mental health: Opening the black box – A study from South Africa

Cited by 18 publications

References 50 publications

Overlooked and unaddressed: A narrative review of mental health consequences of child marriages

Overlooked and unaddressed: A narrative review of mental health consequences of child marriages

Exploring the impact of a complex intervention for women with depression in contexts of adversity: A pilot feasibility study of COURRAGE-plus in South Africa

Adolescent Health Series: The status of adolescent mental health research, practice and policy in sub‐Saharan Africa: A narrative review

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