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Background: Scarce are the studies focusing on initiation of new mental health service use (MHSU) and distinguishing individuals who have sought services but have been unsuccessful in accessing these. Aims: Assessing the factors associated with initiating new MHSU as compared to no MHSU due to self-reported no need, no MHSU due to health system and personal barriers and MHSU using resources already in place. Methods: The sample included participants (n = 16,435) in the five established regional cohorts of the Canadian Partnership for Tomorrow's Health (CanPath) who responded to the CanPath COVID-19 health surveys (May–December 2020 and January–June 2021). Multinomial regression analyses were carried out to study MHSU since the pandemic (March 2020) as a function of predisposing, enabling and need factors. Analyses were carried out in the overall sample and restricted to those with moderate and severe symptoms (MSS) of depression and/or anxiety (n = 2,237). Results: In individuals with MSS of depression and/or anxiety, 14.4% reported initiating new MHSU, 22.0% had no MHSU due to barriers and personal reasons and 36.7% had no MHSU due to self-reported no need. Age, living alone, lower income, a decrease in income during the pandemic and health professional status were associated with MHSU. Younger adults were more likely to initiate MHSU during the pandemic than older adults who reported not being comfortable to seek mental health care or self-reported no need. Individuals living alone and with lower income were more likely to report not being able to find an appointment for mental health care. Conclusions: Awareness campaigns focusing on older adults that explain the importance of seeking treatment is needed, as well as sensitising health professionals as to the importance of informing and aiding individuals at risk of social isolation and lower socio-economic status as to available mental health resources and facilitating access to care. [ABSTRACT FROM AUTHOR]

Background: Although stigma and caregiving burden are important in relation to mental health recovery, few studies have been conducted on affiliate stigma and caregiving burden among family caregivers of persons with schizophrenia (FCPWS) in rural China. Aims: This study aimed to examine the severity level of affiliate stigma and caregiving burden, and identify the correlates among FCPWS in rural China. Methods: A mental health survey was conducted (N = 253 FCPWS) in Xinjin county, Sichuan province, China. Affiliate Self-Stigma Scale and Zarit Burden Interview Short Form were used. The regression analysis was performed to explore the correlates of stigma and burden. Results: Most FCPWS reported experiencing high and severe level of affiliate stigma (78.66%) and caregiving burden (95.26%). Family caregivers who were middle aged, unemployed, with high caregiving burden and low quality of life (QoL), showed more severe affiliate stigma. Family caregivers who were female, older, with low income, high affiliate stigma and low QoL, experienced greater caregiving burden. Conclusions: The large majority of FCPWS in rural China experienced severe affiliate stigma, caregiving burden and poor QoL. It is crucial to develop culture-specific anti-stigma interventions to reduce caregivers' stigma and caregiving burden, and improve QoL. Specific risk factors of family caregivers' affiliate stigma and caregiving burden should be considered for development of health policy and community-based mental health services. [ABSTRACT FROM AUTHOR]

Background: Financial inequalities appear to be increasing and poverty is becoming ubiquitous. Poverty affects mental health but its impact on mental health and wellbeing is rarely highlighted within health research. Aims: The Covid-19 pandemic, the Ukrainian invasion and other international and national events have led to a cost-of-living crisis for many people. This is likely to lead to an increase in related referrals and therefore active consideration of the relevant issues relating to poverty appears vital. This paper reports a study which sought to understand how therapists experienced their work with clients who self-refer due to living in poverty. Method: Eight therapists participated in semi-structured interviews analysed using Interpretative Phenomenological Analysis (IPA). Results: Three superordinate themes were elicited: firstly 'Resilience in the struggle to engage with therapeutic work', secondly 'Struggling to promote social activism' and thirdly, 'Navigating multiple challenges and barriers'. Each superordinate theme contains two or three sub themes. Conclusions: Issues of structural inequality (including but not limited to poverty) impact significantly on people's lives but are often ignored or minimised in therapeutic work. It is important that therapists are aware of poverty and take this into account when working with clients. [ABSTRACT FROM AUTHOR]

Background: There is a current crisis in children's mental health. Defining social determinants of mental health (SDMH) facilitates investigations of social impact on mental health. Aims: To examine associations between nine SDMH and adolescent depression and anxiety in a U.S. nationally representative sample. Methods: Poor access to health care, caregiver underemployment, food insecurity, poorly built environment, housing insecurity, household dysfunction adverse childhood experiences (ACEs), racism, caregiver poor education, and poverty/income inequality were assessed from the 2018 to 2019 National Survey of Children's Health (NSCH) (N = 24,817). Results: The likelihood of reporting adolescent depression and/or anxiety was assessed for each SDMH using multinomial logistic regressions. All SDMH, besides caregiver underemployment, were associated with increased odds of reporting adolescent anxiety, depression, or anxiety and depression. Only household dysfunction ACEs and racism had statistically significant associations for all three mental health outcomes. Conclusions: Interventions targeting ACEs and racism may be more impactful in mitigating mental health challenges associated with SDMH during adolescence. The NSCH may provide an important public health tool to investigate SDMH in children. [ABSTRACT FROM AUTHOR]

Background: South Africa (SA) has one of the highest rates of youth unemployment and youth who are not in employment, education or training (NEET), even higher among Black South Africans. SA's NEET rates are 3 times those of UK; 5.4 times of Germany; 1.3 times of Brazil; and 2.5 times of Malaysia. Given that youths between 15 and 24 years of age make up 24% of the total population, these are significant challenges for the economy and further fuel the cyclical, pervasive and enduring nature of poverty. We hypothesised that rural youth who are NEET would have a greater prevalence of mental disorders and higher rates of substance use compared to their non-NEET counterparts. The objective of the study is to determine the differences in rates of psychological distress and substance use between NEET and non-NEET rural African 14- to 24-year-old young men. Methods: The study took place in a remote and rural district municipality in KwaZulu-Natal, South Africa. We divided the district's five sub-municipalities into two clusters (large and small) and randomly selected one from each cluster for inclusion in the study. We further randomly selected wards from each sub-municipality and then rural settlements from each ward, for inclusion in the study. We recruited young men as part of a larger study to explore sociocultural factors important in gender-based violence in rural SA. We compared 15- to 19-year old and 20- to 24-year old youth NEET and non-NEET on rates of psychological distress symptoms (depression, anxiety, suicidal thoughts, hopelessness and worthlessness) and substance misuse (including alcohol, cannabis, other recreational drugs) using a Multivariate Analysis of Variance (MANOVA) statistics at p <.005 level of significance level. Results: About 23% of the 355 male participants were NEET. There were no statistically significant differences in psychological distress or substance use between youth NEET and non-NEET, controlling for age. Conclusion: The study highlights difficult transitions to post-secondary education and work for Black youth in rural SA where opportunities for employment are limited. Education, training and employment appear to offer limited benefit. [ABSTRACT FROM AUTHOR]

An editorial is presented on the impact of multinational companies (MNCs) on mental health, namely how they change policies, surroundings, and social variables that affect people's well-being. It focuses on how MNC advertising and marketing methods, notably in areas such as food, drink, and gambling, lead to physical and mental health difficulties, with a specific emphasis on the rise of obesity in the U.K. as a result of the fast-food business.

Background: While employment programs were not created with the intent to improve common mental disorders (CMDs), they may have a positive impact on the prevalence, incidence, and severity of CMD by reducing poverty and increasing access to economic mobility. Aim: To examine and synthesize the available quantitative evidence of the impact of employment programs on outcomes of CMD. Methods: Embase, Econlit, Global Health, MEDLINE, APA PsychINFO, and Social Policy and Practice were searched for experimental and quasi-experimental studies which investigated the impact of employment programs on primary and secondary outcomes of a CMD. A narrative synthesis according to Popay was conducted. The methodological quality of studies was assessed with the Cochrane Risk of Bias tool and the Newcastle-Ottawa Assessment Scale. Results: Of the 1,327 studies retrieved, two randomized controlled trials, one retrospective cohort, one pilot study with a non-randomized experimental design, and one randomized field experiment were included in the final review. Employment programs generally included multiple components such as skills-based training, and hands-on placements. Depression and anxiety were the CMDs measured as primary or secondary outcomes within included studies. Findings regarding the impact of employment programs on CMD were mixed with two studies reporting significantly positive effects, two reporting no effects, and one reporting mixed effects. The quality among included studies was good overall with some concerns regarding internal validity. Conclusion: Employment programs may support a decrease in the prevalence, incidence, and severity of CMDs. However, there is high heterogeneity among study effects, designs, and contexts. More research is needed to gain further insight into the nature of this association and the mechanisms of impact. This review highlights the potential for employment programs and other poverty-reduction interventions to be utilized and integrated into the wider care, prevention, and treatment of common-mental disorders. [ABSTRACT FROM AUTHOR]

Background: Common mental disorders (CMD) cause a range of health, social and economic burden, and disorders like depression and anxiety are more prevalent among women. Prevalence and factors contributing to increased vulnerability for CMDs have regional variation. Identification of factors contributing to the vulnerability is essential to both psychiatric epidemiology and in addressing mental health challenges in the community. Methods: This cross-sectional study aimed at understanding the burden of CMD and its association with social determinants of mental health. Women hailing from urban slum attending the outpatient family care facility for their medical problems constituted the sample. Data was collected using a clinical research form with variables such as sociodemographic profile, health profile, and psychosocial profile. The questionnaire had specific questions on indicators of poverty, certain stressors, and support system. Presence of CMD was assessed using Clinical Interview Schedule-Revised (CIS-R), a standard tool for CMD research in primary care settings. A cut off score of 12 and above was considered for detecting CMD. Research ethical principles were adhered to and data was analyzed using SPSS 21.0. Results: Among 172 women, 77 (44.8%) were diagnosed to have CMDs. Univariate analysis revealed a significant association between age, marital status, living arrangement, educational level, difficulty with buying food, presence of debt, chronic medical illness, husband's alcohol use, marital satisfaction, experiencing abuse, family support, religious participation, and a diagnosis of CMD. Multivariate analysis showed high burden with nuclear family arrangement, difficulty to buy food, experiencing abuse and, low burden with higher educational level, family support, and religious participation. Conclusion: Considering the high prevalence and the treatment gap of CMDs in primary setting, family-physician should be sensitized for detection and management of CMDs. Social interventions targeting poverty, women's education and empowerment, and support system are likely to decrease the burden of CMDs in this population. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has spread across the globe, resulting in significant changes in virtually every aspect of life. Mitigation efforts, like shelter-in-place orders, have taken a particular toll on parents who have had to navigate disruptions in work and/or school schedules. Research from high-income countries demonstrates increased parental anxiety, stress, depression, and burnout resulting from the pandemic. It is unclear if these outcomes are the same for parents in high-risk communities in low-income countries where pre-pandemic conditions were deleterious. This study addresses this gap and examines the mental health impact of the pandemic on parents in high-risk communities in Guatemala. Methods: A total of 330 individuals from 11 districts in Guatemala participated in the study and were assessed for sociodemographic characteristics and mental health impairment. Chi-squares were conducted for bivariate analysis. Multivariate analysis was conducted using binary logistic regression. Results: Bivariate analysis revealed differences between groups on burnout, with parents more often reporting feelings of burnout than nonparents (p <.001). Binary regression demonstrated that non-parents were 70% less likely to endorse feelings of stress as compared to parents (OR =.285; p =.014). Conclusion: Our findings underscore the importance of identifying the unique mental health impact of the COVID 19 pandemic on parents in high-risk communities. In high-risk communities, parental stress is a pressing problem that, if unaddressed, has the potential to result in even greater psychological distress and child maltreatment. Training community healthcare providers to assess and address parental stress can lead to increased community capacity and the development of a community-based network to serve as a first line of support for parents and their children. [ABSTRACT FROM AUTHOR]

Background: The effects of Sars-Cov-2 pandemic may increase vulnerability of migrants. Aims: To investigate the effects of the governmental lockdown on the mental health of vulnerable migrants in treatment at an outpatient department. Method: In a telephone survey post-migration living difficulties and psychopathological symptoms were investigated, particularly post-traumatic thoughts and nightmares, anxiety, depression, feelings of tension and irritability, other sleep problems, as well as COVID-19 related fears. Psychopathological changes during the lockdown were detected and rated by clinicians. Rates of treatment discontinuation and reasons why were also recorded. Results: Of 103 eligible patients, 81 answered the phone call and were included in the study. Mental symptoms were frequent but not as severe as expected. About 32% of patients in psychopharmacological treatment and almost 52% of patients in psychotherapy had discontinued treatment. Patients who were globally considered to have worsened if compared to their pre-coronavirus mental health conditions had in fact higher scores on several mental symptoms but mild specific fears about coronavirus issues, similar to those of patients improved or stable. Worsening was significantly associated with unemployment, lack of VISA, and treatment discontinuation. Shifting the way of providing psychotherapy into a web-based modality was significantly more frequent in stable/improved patients. Conclusion: Findings suggest that concrete life problems and treatment discontinuation more than the coronavirus fear, have predominantly affected the mental health conditions of our patients. [ABSTRACT FROM AUTHOR]

Background: It is unknown whether and how poverty influences the long-term outcome of persons with severe mental illness (SMI). Aims: To explore the change of poverty status in persons with SMI from 1994 to 2015 and examine the impact of poverty status on patients' outcome in rural China. Method: Two mental health surveys using identical methods and International Classification of Disease (ICD-10) were conducted in 1994 and 2015 in the same six townships of Xinjin County, Chengdu, China. Results: The annual net income per person was 19.8% and 100.2% higher for the general population than for persons with SMI in 1994 and 2015 respectively. Compared with 1994 (48.2%), persons with SMI in 2015 had significantly higher rates of poor family economic status (

An editorial is presented on the influence of political, economic, and cultural determinants on mental health, with a particular focus on the impact of neoliberal policies in the U.S. It mentions rising rates of psychiatric disorders, increased antidepressant use, and the imperative for clinicians to advocate for patients and conduct cross-country comparisons to evaluate the effects of different policies on mental health and overall well-being.

Background: An outbreak of global pandemic COVID-19 profoundly affects life around the globe. Prolonged isolation, contact restriction and economic shutdown impose a deeply change to the psychosocial environment. These indicate a tendency to threaten the mental health of adolescents' significantly. Detecting adolescents' psychosocial risk during Pandemic COVID-19, particularly when they stay at home, may be helpful to better understand their mental health well- being. Aims: The current study aimed to explore psychosocial risk factors associated with mental health of adolescents' in the midst of the outbreak. Method: This research uses a qualitative approach which focuses on focus group discussions interviews. This research took 6 weeks via online communication platform involving (n = 15) adolescents from the Low Income Household. Result: The participants adolescents' psychosocial risk experience during amidst of Outbreak Covid-19 Pandemic are composed of (1) self- conflict (develop negative thought at home, unplanned of daily activities, changing sleep pattern and irregular wake up time and massively use internet) (2) Family Members (Conflict between parent and miscommunication between siblings) (3) School (Piling up on homework, Inadequate guidance for homework and Inability to comprehend online learning). These psychosocial risk factors have caused disruption to daily life adolescents' during outbreaks and almost inevitably trigger a spike in mental health issues. Conclusion: Overall of study emphasized that psychosocial risks are important factors that can be addressed in order to reduce mental health problem. [ABSTRACT FROM AUTHOR]

Background: Socio-political circumstances, including security, poverty, national wealth, income inequality, social integration and political conflicts, determine population health. Anticipated socio-political developments refer to the perceived improvement/deterioration in these circumstances in the future year. Aims: This study tested relationships between this anticipation and population mental health (probable depression/depressive symptoms and life satisfaction) and the mediation roles of negative personal responses toward socio-political situations (frustration, emotional disturbance, self-efficacy in political involvement, perceived sense of security, and satisfaction about societal ability in fulfilling individuals' needs) in explaining these relationships. Method: The telephone survey randomly interviewed 420 (59.5% female) adults in Hong Kong. Questionnaire included scales assessing the aforementioned variables. Results: Most participants (71.7%) had pessimistic anticipations over socio-political developments; 11.3% of the participants were classified as having probable depression. Anticipated deterioration in socio-political developments was significantly associated with depressive symptoms and life satisfaction; emotional disturbance, sense of security and need satisfaction were partial mediators of these relationships. Need satisfaction and sense of security showed the strongest mediation effects both for mediations that involved depressive symptoms and life satisfaction. Conclusion: Both politicians' awareness and mental health promotion are required to alleviate the negative impact of negative socio-political perception on mental health. [ABSTRACT FROM AUTHOR]

The article discusses the challenges faced by mental health professionals working with clients who have mental health disorders and are living in poverty, emphasizing need for training in social inequality issues and advocacy skills to improve the quality of care and well-being of professionals.

The article highlights challenges in linking poverty and mental illness in clinical settings, urging clinicians to be advocates, incorporate socioeconomic status into training.

The article highlights challenges in therapeutic work with mentally ill patients living in poverty, emphasizing the need to address social determinants, promote social justice, and provide support to improve their well-being.

Background: With India enacting the Mental Health Care Act (MHCA; No. 10 of 2017a), Psychiatric Advance Directives (PADs) have been legalised and have become binding orders for psychiatrists treating patients. There is a paucity of research into acceptability of PADs in Indian mental health care, likely due to a lack of awareness. There are no educational measures about PADs provided for in this Act. Facilitators and facilitation methods have not been elaborated upon as well. Aim: The aim of this study is (a) to develop/evaluate the effectiveness of a structured Education-cum-Assessment Tool (EAT) in providing information regarding PADs and (b) to evaluate modes of facilitation required by patients to complete PADs. Methods: A tool was developed as per provisions regarding PADs in the Mental Health Care Bill of 2013. This tool was administered to patients (n = 100), purposively sampled from the adult psychiatry review out-patient department (OPD). Patients were evaluated on retention of information, completion of PADs, modes of facilitation and time taken to write one. Results: Mean years of education was 8.28 (±5.74) years and mean duration of illness was 8.30 (±7.04) years. In all, 65% had Below-Poverty Line (BPL) status. All participants completed valid PADs in an average of 15 minutes. About 93% required facilitation via assistance in writing and reminding. The mean EAT scores implied above 70% retention but did not relate to types of facilitation. Conclusions: EAT scores can be used as an approximate measure of the patient's ability to understand and retain information which is a part of decisional capacity. Types of facilitation can help in understanding patient's ability to communicate their choices. Service providers may find EAT a time-effective tool for uniformly educating service users regarding PADs and indirectly assessing competence. [ABSTRACT FROM AUTHOR]

Background: In sub-Saharan Africa, mental and substance-related disorders account for 19% of all years lived with disability, yet the intersection between poverty and mental distress is poorly understood since most psychiatric research is conducted in high-income countries. Aims: To examine the prevalence of and associations between food insecurity, mental distress and suicidal ideation in three rural village clusters in sub-Saharan Africa. Method: Cross-sectional multivariate analysis of sociodemographic variables associated with mental distress and suicidal ideation in three countries. The sample included 1,142 individuals from three rural village clusters in Nigeria (n = 380), Uganda (n = 380) and Ghana (n = 382). Food insecurity was measured based on the number of months in the previous year that the respondent's family reported being 'unable to eat two square meals per day'. Mental distress was assessed using the Kessler non-specific psychological distress scale (K6) and suicidal ideation was measured using an item from PRIME-MD. Other sociodemographic variables included gender, age, literacy and occupation. Results: The prevalence of individuals with moderate or severe mental distress in Nigeria, Uganda and Ghana were higher than previously reported in the literature: 35.5%, 30.8% and 30.4%, respectively, and suicidal ideation rates were 29.7%, 21.3% and 10.9%. No differences were observed in mental distress between men and women in any of the sites. Being a farmer (vs student or other) was protective for mental distress in two sites (Uganda and Ghana) but no other social indicators, such as age, gender, literacy and food insecurity, were significantly associated with mental distress. Risk for suicidal ideation differed across sites: it was associated with food insecurity in Nigeria, female gender in Uganda, and older age in Uganda. Conclusions: Mental distress and suicidal ideation were highly prevalent in three settings of extreme poverty across all groups, in ways that were not always consistent with the global literature. These findings suggest that more research is needed in to better understand the social etiology of mental distress in sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

Background: Little is known about the influence of contextual characteristics on comorbid substance use and serious mental illness (SMI). Aims: To explore the role of poverty on comorbid SMI and cannabis use. Methods: We used data from the 2015 National Survey on Drug Use and Health, considering those in poverty, with income under 100% of the US poverty threshold. Results: People in poverty were more likely to suffer from concurrent SMI and cannabis use (3.07%, 95% confidence interval (CI):1.84%; 5.07%), even controlling for gender, age, tobacco and alcohol use (odds ratio (OR) = 2.77, 95% CI: 1.27; 6.03, p = .010). Conclusion: The magnitude of the association between SMI and cannabis use is influenced by poverty status. More research on potential mediators like income inequality and impoverished social capital is needed. [ABSTRACT FROM AUTHOR]

The article informs about COVID-19, India, lockdown and psychosocial challenges. Topics include pandemic threat COVID-19 mitigation is crucial to the human life and for reducing distortion of livelihood; countries with considerable confirmed cases and deaths and has caused public panic and mental health stress; and current outbreak of COVID-19 is heavily impacting the global health and mental health.

Background: Little is known about whether family economic status might influence the long-term (e.g. over 10 years) outcome of persons with schizophrenia in the community. Aim: To examine the differences in outcome at 14-year follow-up of persons with schizophrenia from high versus low family economic status backgrounds in a Chinese rural area. Method: A prospective 14-year follow-up study was conducted in six townships in Xinjin County, Chengdu, China. All participants with schizophrenia (n = 510) were identified in an epidemiological investigation of 123,572 people aged 15 years and older and followed up from 1994 to 2008. Results: Individuals from low family economic status (

Background: In South Korea, societal perceptions on occupation are distinct, with people favouring white collar jobs. Hence both occupation type and income can have mental health effects. Aim: To examine the relationship between occupational classification and depression, along with the combined effect of occupational classification and household income. Methods: Data were from the Korean Welfare Panel Study (KOWEPS), 2010–2013. A total of 4,694 economically active participants at baseline were followed. Association between occupational classification and depression, measured using the Center for Epidemiological Studies Depression (CES-D) scale 11, was investigated using the linear mixed effects model. Results: Blue collar (β: 0.3871, p = .0109) and sales and service worker groups (β: 0.3418, p = .0307) showed higher depression scores than the white collar group. Compared to the white collar high-income group, white collar low income, blue collar middle income, blue collar middle-low income, blue collar low income, sales and service middle-high income, sales and service middle-low income and sales and service low-income groups had higher depression scores. Conclusion: Occupational classification is associated with increasing depression scores. Excluding the highest income group, blue collar and sales and service worker groups exhibit higher depression scores than their white collar counterparts, implying the importance of addressing these groups. [ABSTRACT FROM AUTHOR]

The article discusses a study to determine the rate of psychological distress in the most disadvantaged area of Berlin and explore which characteristics usually associated with psychological distress in population-based studies were associated within socially extremely disadvtantaged multi-ethnic neighbourhood. It suggests that living in a disadvantaged neighbourhood and being exposed to social isolation can lead to increased levels of mental distress regardless of the person's social status.

Background and aims: There is a dearth of studies investigating the prevalence and factors associated with unmet needs in people with schizophrenia from low- and middle-income countries. We aimed to study prevalence and risk factors for unmet need.Method: A case-control study design was employed. One hundred and one (101) consecutive patients attending a psychiatric hospital were assessed using Camberwell Assessment of Need Short version (CANSAS) and Positive and Negative Syndrome Scale (PANSS). Multivariate analysis was employed to adjust for confounders.Results: The majority of patients had many unmet needs. These unmet needs were significantly associated with lower education, poverty and persistent psychopathology on multivariate analysis.Conclusion: Unmet needs are associated with poverty, lower education and persistent psychopathology. There is a need to manage unmet needs, in addition to addressing psychopathology and poverty. [ABSTRACT FROM AUTHOR]

Background: Self-stigmatizing women who avoid seeking treatment for depression could believe that they have pragmatic personal reasons for their decision. As a preliminary step towards testing this hypothesis, the aim of this study was to assess diverse, low-income working women for shared self-stigmatizing beliefs about depression. Methods: Depression and depression self-stigma were assessed in a targeted sample of African American, Caucasian and Latina women who qualify for public health services and have access to health care services. Results: Depression and self-stigmatizing beliefs about depression were positively correlated (r = .30-.64). Over one third of the women in the study (37.5%) said they would do what they could to keep their depression secret. Over half (55%) indicated that the person they normally would disclose depression to is their best friend. A majority (80%) of the women in the study said they would choose not to disclose personal depression to a health care professional. Pairwise t tests for group differences showed that Caucasian women, women recently seen by a health care professional and women with more years of education had higher self-stigma scores. Conclusion: Self-stigmatizing women who feel depressed could knowingly decide to keep their depression secret with the hope of avoiding loss. [ABSTRACT FROM AUTHOR]

Background: Many men diagnosed with mental health problems are also fathers. This literature review addresses issues relating to both the fathering role taken on by men who have mental health problems as well as the impact of their mental health on their children.Material: An integrative review of the literature was conducted from studies originating in four countries, resulting in an analysis of 31 journal articles.Discussion and conclusions: Most of the quantitative literature focuses on the many risks and negative outcomes for children. However, qualitative studies suggest positive outcomes such as strong parent–child relationships, which demand further attention both in research and in practice. [ABSTRACT FROM PUBLISHER]

Background: There is little evidence to describe the feasibility and outcomes of services for the care of street children and youth in low-income countries.Aims: To describe the outcomes of a multidisciplinary case management approach delivered in a drop-in centre for street children and youth.Methods: A longitudinal study of street children and youth followed in an urban drop-in centre. Four hundred (400) street children and youth received a multidisciplinary case management therapeutic package based on the community reinforcement approach. The main outcomes were changes in psychological distress, substance abuse and social situation scores.Results: The median follow-up time for the cohort was 18 months. There were reductions in the levels of psychological distress (p = 0.0001) and substance abuse (p ≤ 0.0001) in the cohort as well as an improvement in the social situation of street children and youth (p = 0.0001). There was a main effect of gender (p < 0.001) and a significant interaction of gender over time (p < 0.001) on improvements in levels of psychological distress. Survival analysis showed that the probability of remaining on substances at 12 months was 0.76 (95% CI: 0.69–0.81) and 0.51 (95% CI: 0.42–0.59) at 24 months. At 12 months, fewer female patients remained using substances compared to male (p < 0.01).Conclusion: To be most effective, programmes and strategies for children and youth in street situations in developing countries should target both their health and social needs. [ABSTRACT FROM PUBLISHER]

Background: Numerous observational studies demonstrate associations between social context and depressive symptoms, yet few intervention trials exist in this arena.Aims: This review examines intervention trials that explore the impact of contextual change on depressive symptoms.Methods: Electronic literature databases of PubMed and PsycINFO, bibliographies of retrieved articles and the publicly available internet were searched for English-language articles published between 1997 and 2008. Peer-reviewed studies were eligible for inclusion if they reported contextual interventions and depressive symptoms measures in adult populations without other significant underlying medical or psychological illness. In total, 2,128 studies met search term criteria. Of these, 13 studies meeting inclusion criteria were classified by type of intervention. Qualitative synthesis was used to interpret the mental health impact of contextual interventions.Results: The interventions focused on employment, housing, poverty, parenting and violence. Eight of these studies reported a decrease in depressive symptoms and/or psychological distress in intervention groups. Interventions varied in focus, length of follow-up and measures of depressive symptoms.Conclusions: Contextual interventions for the prevention and treatment of depressive symptoms and psychological distress can be effective, though very limited data exist in this field. Policy implications include a greater emphasis on improving context to decrease depression and other mental disorders. [ABSTRACT FROM PUBLISHER]

Aims: Social phobia in the environment of poverty and major social inequalities, as observed in most developing countries, has received little attention. This population-based study was carried out in a poor community in Brazil (15,000 inhabitants), aiming at determining the prevalence of social phobia and its associated factors. Method: The Composite International Diagnostic Interview was applied in a random sample of 1037 residents aged ≥ 18 years. Results: The 1-month, 1-year and lifetime prevalence of social phobia were 7.9, 9.1 and 11.8%, respectively. One-month social phobia was independently associated with age (45-64 years), marital status (divorced/separated), worse socio-economic indicators (family income and education), number of months worked, worse health status and use of health services and medications. Conclusion: There was an important burden of social phobia in the study community, due to its high prevalence (similar or superior to those observed in most developed countries), and due to its association with worse health status and use of health services and medications. The strong association between social phobia and socioeconomic circumstance, even in a small and poor community, is certainly a reflex of the major social inequalities in Brazil. [ABSTRACT FROM AUTHOR]

Presents a study that examined the common mental disorders among primary care attenders in Vellore, South India. Nature and prevalence of the disorders; Factors associated with the disorders; Association of illiteracy and poverty with caseness.

On 1 September 1967, the Nobel Prize-winning civil rights leader Martin Luther King Jr. delivered a speech entitled ‘The role of the behavioral scientist in the civil rights movement’ to the American Psychological Association (APA, 1999; King, 1968). With eloquence and passion, Martin Luther King championed the civil rights struggle and spoke to the interests of his audience. He stressed how behavioural scientists could and should support the civil rights movement. King’s eloquent and passionate speech is still relevant today – explaining how psychologists and other mental health professionals could help address today’s pressing social issues. [ABSTRACT FROM PUBLISHER]

The author talks about the concept of micro-migration, which involves the youth going away from the traditional cultural values of their parents and society, discussing the role of internet-driven information in micro-migration and the increasing inter-generational gap and conflict.

Background: Traditional healing methods are considered central to mental health care in low-income countries such as Ghana, because they are perceived to be more easily accessible, more affordable and generally ascribe similar causal beliefs to those of the patients. However, not much is known about the work of traditional healers largely because their methods are shrouded in mysticism and secrecy. There is a need to understand the ideology and beliefs of traditional healers surrounding mental disorders, including knowledge about their practices in mental health care., Aims: In this article, we discuss the causal beliefs and treatment methods of traditional medicine-men from Accra, Ghana. We also describe their diagnostic and treatment methods for mental disorders., Methods: Eight medicine-men, indigenous to the Greater Accra Region, were interviewed through individual semi-structured interviews. The data were analysed through thematic analysis., Results: The medicine-men's beliefs about mental illness were dominated by supernatural ideas. Mental illness was also seen as a form of punishment or resulting from envy, and there was a strong reliance on spiritual direction from the gods for diagnosis and treatment., Conclusion: These themes are discussed with emphasis on their potential implications for patients, as well as for collaborative efforts.

Background: Migrants with mental hospital orders according to section 63 of the German criminal code are overrepresented in relation to their numbers in the general population. Subgroups originating from certain world regions are diagnosed with schizophrenia at a much higher rate than others. In the present literature, there is a strong evidence for a substantial correlation between migration, social disadvantage and the prevalence of schizophrenia., Aims: This study investigates the relationship between countries of origin, the risk of becoming a forensic patient and the proportion of schizophrenia spectrum disorders., Method: Data from a comprehensive evaluation tool of forensic inpatients in the German federal state of Baden-Württemberg (FoDoBa) were compared with population statistics and correlated with the Human Development Index (HDI) and Multidimensional Poverty Index (MPI)., Results: For residents with migration background, the risk ratio to receive a mental hospital order is 1.3 in comparison to non-migrants. There was a highly significant correlation between the HDI of the country of origin and the risk ratio for detention in a forensic psychiatric hospital. The proportion of schizophrenia diagnoses also correlated significantly with the HDI. In contrast, the MPI country rankings were not associated with schizophrenia diagnoses., Conclusion: Two lines of explanations are discussed: first, higher prevalence of schizophrenia in migrants originating from low-income countries, and second, a specific bias in court rulings with regard to involuntary forensic treatment orders for these migrant groups.

Background: Self-harm (defined here as an act of intentionally causing harm to own self, irrespective of the type, motive or suicidal intent) is one of the strongest antecedents of suicide in youth. While there have been a number of studies of youth self-harm in low- and middle-income countries (LMICs), there is currently no systematic review of studies of prevalence rates and risk and protective factors., Aim: To systematically review the evidence relating to the prevalence rates and forms of self-harm in youth in LMICs and its relationship to family economic status, family functioning, relationship with the peer group, social relationships and academic performance., Methods: Electronic searches of three databases, MEDLINE, PsycINFO and Scopus, were performed. In total, 27 school-, community- and hospital-based studies evaluating self-harm in LMICs with youth focus (with participants between 12 and 25 years) were included., Results: The self-harm was divided into suicidal and non-suicidal depending on the nature of self-harm. The 12-month prevalence rates of non-suicidal self-harm varied from 15.5% to 31.3%, and the range of suicidal behaviour rates was from 3.2% to 4.7%. Banging and hitting were the most common in the community-based studies, followed by cutting, scratching and wound picking. Self-poisoning with pesticides was most commonly reported in hospital-based studies. Risk factors for self-harm were family conflict, peer groups with members indulging in self-harm, truancy and school absenteeism. Protective factors were having an understanding family, having friends and higher school competence. Risk factors for suicidal thoughts and attempts were lack of close friends and history of suicide by a friend., Conclusion: The 12-month prevalence rates of youth self-harm in LMICs are comparable to high-income countries (HICs). The profile of risk and protective factors suggests that family-based interventions could be useful in treatment and prevention. Future studies should aim for greater consistency in assessment methods and the constructs under evaluation.

Background: The mental health treatment gap for youth in low- and middle-income countries (LMICs) is substantial; strategies for redress are urgently needed to mitigate the serious health and social consequences of untreated mental illness in youth., Aims: To estimate the burden of major depressive episode (MDE) and posttraumatic stress disorder (PTSD) as well as utilization of care among Haitian youth in order to describe the mental health treatment gap in a LMIC setting., Methods: We estimated the point prevalence of MDE, PTSD, and subthreshold variants in a school-based sample of youth ( n = 120, ages 18-22 years) using a modified Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID)-based interview and examined treatment utilization among those receiving one of these diagnoses. We assessed additional psychopathology with self-report measures to examine validity of study diagnostic assignments., Results: The combined prevalence of full-syndrome or subthreshold MDE or PTSD was high (36.7%). A large majority of affected individuals (88.6%) had accessed no mental health services in the health sector, and 36.4% had accessed no care of any kind in either the health or folk sectors in the past year., Conclusion: Findings demonstrate a high mental health burden among Haiti's youth and that many youth with MDE and PTSD are not accessing mental health care.

Background: Due to the economic recession, several people in Europe became unemployed. This situation may risk their mental health., Aim: This study explored parents' perceptions about their unemployment's effects in daily life during the recession., Methods: A total of 59 unemployed parents (40.7% fathers and 59.3% mothers), ageing 44.4 years (±6.2), answer a question on how the unemployment affected their family lives. Thematic analysis was used to analyse data., Results: The findings suggest that unemployment is a source of adult and youth mental distress and of economic hardship and changes in family relations., Conclusion: Support to unemployed individuals and their families could benefit from these insights when granting the needed financial and socioemotional assistance., (© The Author(s) 2016.)

Background: Socioeconomically disadvantaged adults experience greater healthcare disparities and increased risk of depression compared to higher-income groups., Aim: To create a depression care model for disadvantaged adults utilizing service agencies, through a community-academic partnership., Methods: Using participatory research methods, an organizational needs assessment was performed to ascertain depression care needs, identify barriers to clients receiving treatment, and marshal resources. Interviews and surveys were conducted with community organizational leaders. Focus groups were conducted with clients who used the service agencies., Results: Interviews and surveys identified barriers including discontinuity of care and unmet basic needs for food, housing, health insurance and transportation. Focus groups enriched the understanding of barriers including lack of motivation to seek depression care, lack of social support and needed resources for the uninsured, underinsured and homeless. The findings were used to develop a depression care model combining depression management with motivational interviewing to evaluate and meet needs, and peer education to motivate and provide support., Conclusions: This partnership facilitated the development of a community-driven intervention that academic researchers acting alone could not realize. To provide depression care to socioeconomically disadvantaged individuals, the intervention must include mitigating solutions to barriers.

Background: The 2004 tsunami seriously affected millions of families in several developing countries by destroying their livelihoods, houses and communities, subsequently damaging social and physical resources. Disaster studies have documented that both post-traumatic stress disorder (PTSD) and depression develop during the first six months following disaster exposure for the majority of those afflicted., Aims: and, Methods: Using data from 325 tsunami-affected families living in southern Sri Lanka, the current study investigates whether community social resources such as residents' perceived community participation in tsunami recovery efforts reduce mental health risks (PTSD and depressive symptoms) of tsunami-affected mothers. The analysis is based on structural equation modelling., Results: and, Conclusions: The findings of structural equation modelling supports the main hypothesis that residents' perceived community participation directly and indirectly (through collective family functioning and mental health service use) reduces mental health risks (both PTSD and depressive symptoms) of tsunami-affected mothers after controlling for pre-tsunami family adversities. In addition, the results show that residents' perceived community participation buffers the influence of trauma exposure on PTSD symptom levels of mothers. The identification of specific social and family processes that relate to mental health can be useful for post-disaster interventions and recovery programmes.

Background: Suicidal behaviour, primarily through self-poisoning, is a major public health problem among youth in Sri Lanka., Methods: This article describes a qualitative study of student perspectives on suicidal behaviour and its prevention. Focus groups were held with students 17-20 years of age. A discussion of the perceived causes of suicidal behaviour provided the context for discussing prevention efforts., Conclusion: Participants identified pathways to suicidal behaviour and emphasized experiential aspects and the variability of fatal intent. Suggestions for prevention tended to emphasize the strengthening of community-oriented actions in order to better realize lethal means restrictions.

This paper reports on a study of the living environment of 64 psychiatric patients discharged from half-way houses in Hong Kong. The majority were living in a deprived situation compared to that of their neighbours. They were leading a very monotonous life throughout the year; the walls of their homes were dirty and very plain; and some even ate scraps from a neighbouring bakery. Many did not have any social life at all, and their hobbies were smoking, watching television and gambling. Their neighbours, by comparison, had hobbies such as floriculture, birds and goldfish; decorated their walls with pictures and had newspapers and periodicals in their houses; more often had telephone facilities, wardrobes and sofas; used town gas rather than kerosene stoves; and were more likely to have electrical appliances, especially an iron, refrigerator and shaver. Judged by their income from employment or from public assistance, the 'quality of life' (QOL) of these patients should not have been in such a desperate state. They lacked guidance and instruction in their management of money, and the care of their homes. It is proposed that an aftercare worker might improve the QOL of these discharged psychiatric patients.

The present study explores the extent to which early school failure may be related causally to female delinquency. Parental interview and school record data were collected on 59 girls (and their families) placed on probation. The results suggest that in a relatively poor urban environment school failure does not play an important etiologic role in female delinquency but rather both the school failure and the delinquency arise from common or co-existing adverse family influences.

In learning to understand the particular problems of old age, in focusing our attention on losses and decompensation, we developed an approach which was concrete and situational rather than (life-long) developmental. In most cases, brief crisis-orientated interventions were sufficient to reduce symptomatology and restore the patient to a healthier level of functioning. Such interventions involved not only the psychogeriatric team but other health and social agencies as well. More so than in other fields of psychiatry, psychogeriatrics concerns itself with a wide spectrum of psychosocial factors; thus the integration of the pyschogeriatric unit into the existing network of community services becomes and important concern.