The Movement for Global Mental Health

Patel, Vikram; Collins, Pamela Y.; Copeland, J. R. M.; Kakuma, Ritsuko; Katontoka, Sylvester; Lamichhane, Jagannath; Naik, Smita; Skeen, Sarah

doi:10.1192/bjp.bp.109.074518

Cited by 86 publications

(50 citation statements)

References 6 publications

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“…These include low socioeconomic status, poverty, financial stress, social and economic inequalities (Aneshensel, 2009; Flisher et al, 2007; Lund, Breen, et al, 2010; Lund et al, 2011; Patel et al, 2011; Patel & Kleinman, 2003), low education levels (Patel, Araya, Lima, Ludermir, & Todd, 1999; Saxena, Thornicroft, Knapp, & Whiteford, 2007), pregnancy (Cooper et al, 1999; Hartley et al, 2011), HIV status (Berger-Greenstein et al, 2007; Kagee & Martin, 2010), food insecurity (Lund et al, 2011; Lund, Kleintjes, Kakuma, & Flisher, 2010), noncommunicable diseases (Collins, Insel, Chockalingam, Daar, & Maddox, 2013; World Health Organisation [WHO], 2008) substance abuse, and exposure to violence and abuse (WHO, 2012). …”

Section: Background and Rationalementioning

confidence: 99%

“The sun has set even though it is morning”: Experiences and explanations of perinatal depression in an urban township, Cape Town

Davies

Schneider

Nyatsanza

et al. 2016

Transcult Psychiatry

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This study examined experiences and explanations of depression amongst Xhosa-speaking pregnant women, mothers, and health workers in an urban township in Cape Town, South Africa. The study was conducted as part of formative research for a randomised controlled trial to develop and evaluate a task-sharing counselling intervention for maternal depression in this setting. We conducted qualitative semistructured interviews with 12 depressed and 9 nondepressed pregnant women and mothers of young babies, and 13 health care providers. We employed an in-depth framework analysis approach to explore the idioms, descriptions, and perceived causes of depression particular to these women, and compared these with the ICD-10 and DSM-5 criteria for major depression. We found that symptoms of major depression are similar in this township to those described in international criteria (withdrawal, sadness, and poor concentration), but that local descriptions of these symptoms vary. In addition, all the symptoms described by participants were directly related to stressors occurring in the women’s lives. These stressors included poverty, unemployment, lack of support from partners, abuse, and death of loved ones, and were exacerbated by unwanted or unplanned pregnancies and the discovery of HIV positive status at antenatal appointments. The study calls attention to the need for specifically designed counselling interventions for perinatal depression that are responsive to the lived experiences of these women and grounded in the broader context of poor socioeconomic conditions and living environments in South Africa, all of which have a direct impact on mental health.

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Section: Background and Rationalementioning

confidence: 99%

“The sun has set even though it is morning”: Experiences and explanations of perinatal depression in an urban township, Cape Town

Davies

Schneider

Nyatsanza

et al. 2016

Transcult Psychiatry

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“…However, such treatments are often designed to be conducted by specialists and thus will require considerable adaptation and resources to be of use in resource-limited settings [52]. To bridge the gap between clinical research and local practice, research must examine how prevention, assessment, and treatment interventions can be transmitted and translated for specific low-resource settings [53, 54].…”

Section: Barriers To Closing the Global Mental Health Gapmentioning

confidence: 99%

“…And still, though precise figures are unknown, the mental health treatment gap is believed to be sizable [52, 61]. Yet there is strong political will in the Mozambican Ministry of Health (Ministerio da Saúde [MISAU]) to develop, evaluate, and implement evidence-based mental health interventions that can be scaled up within its developing public health system.…”

Section: A Case Example: Mozambiquementioning

confidence: 99%

Closing the Mental Health Gap in Low-income Settings by Building Research Capacity: Perspectives from Mozambique

Sweetland

Oquendo

Sidat

et al. 2014

Annals of Global Health

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Neuropsychiatric disorders are the leading cause of disability worldwide, accounting for 22.7% of all years lived with disability (YLDs). Despite this global burden, fewer than 25% of affected individuals ever access mental health treatment; in low-income settings, access is much lower, though non-allopathic interventions through traditional healers are common in many venues. Three main barriers to reducing the gap between individuals who need and those who have access to mental health treatment include stigma and lack of awareness, limited material and human resources, and insufficient research capacity. We argue that investment in dissemination and implementation research is critical to face these barriers. Dissemination and implementation research can improve mental health care in low-income settings by facilitating the adaptation of effective treatment interventions to new settings, particularly when adapting specialist-led interventions developed in high-resource countries to settings with few, if any, mental health professionals. In Mozambique, the World Health Organization estimates only 0.04 psychiatrists per 100,000 population, representing 30 times less than the global median, and more than 150 times lower than the median in high income countries. Emerging evidence from other low-income settings suggests that lay providers can be trained to detect mental disorders and deliver basic psychotherapeutic and psychopharmacological interventions when supervised by an expert. Mozambique has both the political commitment and available resources for mental health, but inadequate research capacity and workforce limits the country’s ability to assess local needs, adapt and test interventions, and identify implementation strategies that can be used to effectively bring evidence-based mental health interventions to scale within the public sector. Global training and research partnerships are critical to building capacity, promoting bilateral learning between and among low- and high-income settings, ultimately reducing the mental health treatment gap worldwide. Through new research partnership between Universidade Eduardo Mondlane (Mozambique), Columbia University (USA), Vanderbilt University (USA), and Universidade Federal de São Paulo (Brazil), we are working towards a North-South and South-South collaboration to build research capacity in Mozambique and other Portuguese-speaking African countries.

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“…The Movement for Global Mental Health [15-17] has recently emerged in response to the Call for Action [18] for the scaling up of coverage of services for mental disorders globally. The Movement aims to improve the availability, accessibility, and quality of services for people with mental disorders worldwide, but particularly in low- and middle-income countries where effective services are frequently scarce, through the scaling up of services based on scientific evidence and human rights [19].…”

Section: Introductionmentioning

confidence: 99%

Core concepts of human rights and inclusion of vulnerable groups in the mental health policies of Malawi, Namibia, and Sudan

Mannan

Eltayeb

MacLachlan

et al. 2013

Int J Ment Health Syst

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BackgroundOne of the most crucial steps towards delivering judicious and comprehensive mental health care is the formulation of a policy and plan that will navigate mental health systems. For policy-makers, the challenges of a high-quality mental health system are considerable: the provision of mental health services to all who need them, in an equitable way, in a mode that promotes human rights and health outcomes.MethodEquiFrame, a novel policy analysis framework, was used to evaluate the mental health policies of Malawi, Namibia, and Sudan. The health policies were assessed in terms of their coverage of 21 predefined Core Concepts of human rights (Core Concept Coverage), their stated quality of commitment to said Core Concepts (Core Concept Quality), and their inclusion of 12 Vulnerable Groups (Vulnerable Group Coverage). In relation to these summary indices, each policy was also assigned an Overall Summary Ranking, in terms of it being of High, Moderate, or Low quality.ResultsSubstantial variability was identified across EquiFrame’s summary indices for the mental health policies of Malawi, Namibia, and Sudan. However, all three mental health policies scored high on Core Concept Coverage. Particularly noteworthy was the Sudanese policy, which scored 86% on Core Concept Coverage, and 92% on Vulnerable Group Coverage. Particular deficits were evident in the Malawian mental health policy, which scored 33% on Vulnerable Group Coverage and 47% on Core Concept Quality, and was assigned an Overall Summary Ranking of Low accordingly. The Overall Summary Ranking for the Namibian Mental Health Policy was High; for the Sudanese Mental Health Policy was Moderate; and for the Malawian Mental Health Policy was Low.ConclusionsIf human rights and equity underpin policy formation, it is more likely that they will be inculcated in health service delivery. EquiFrame may provide a novel and valuable tool for mental health policy analysis in relation to core concepts of human rights and inclusion of vulnerable groups, a key practical step in the successful realization of the Millennium Development Goals.

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The Movement for Global Mental Health

Cited by 86 publications

References 6 publications

“The sun has set even though it is morning”: Experiences and explanations of perinatal depression in an urban township, Cape Town

“The sun has set even though it is morning”: Experiences and explanations of perinatal depression in an urban township, Cape Town

Closing the Mental Health Gap in Low-income Settings by Building Research Capacity: Perspectives from Mozambique

Core concepts of human rights and inclusion of vulnerable groups in the mental health policies of Malawi, Namibia, and Sudan

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