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Engaging with children and adolescents in mental health settings who are exhibiting behaviours that challenge can often result in the use of seclusion, restraint and coercive practices. It is recognised that more therapeutic ways to engage this population are needed, adopting trauma informed interventions may provide a solution. The aim of this systematic review is to synthesize the evidence in relation to the effect of trauma-informed interventions on coercive practices in child and adolescent residential settings. The review is guided by elements of the Cochrane Handbook for Systematic Reviews of Interventions and reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) checklist. Results were synthesized and reported narratively. Nine studies met the eligibility criteria for this review. There was a lack of homogeneity amongst the studies. The trauma-informed interventions used were typically multi-faceted, underpinned by a variety of approaches and sought to bring about changes to clinical practice. Most studies (n = 8) reported significant reductions in the use of restrictive practices following the implementation of a trauma informed approach. The use of a trauma-informed approach, underpinned by an organisational change or implementation strategy, have the potential to reduce coercive practices with children and adolescents. However, the included interventions were insufficiently described to draw strong conclusions.

In developing countries, mental health literacy (MHL) still needs to be improved due to the high prevalence of mental disorders. It is widely recognized that MHL can improve health outcomes for both individuals and populations. Healthcare professionals' development in MHL is crucial to the prevention of mental disorders. The aim of this study was to assess MHL of primary healthcare (PHC) workers in South Africa (SA) and Zambia and determinants thereof. Limited evidence is available on the levels of MHL among PHC workers in the sub-Saharan Africa region, which faces a large burden of mental disorders.The study population for this cross-sectional survey comprised PHC workers (n = 250) in five provinces of SA and Zambia. MHL was measured with the Mental Health Literacy Scale (MHLS). We conducted a multivariate analysis to explore determinants of MHL.Results showed moderate MHL among PHC professionals, but with a wide range from low to high MHL. Knowledge-related items had a greater dispersion than other attributes of MHL. PHC workers with more education showed a greater ability to recognize mental health-related disorders. Those who had experience in the use of mental health-related assessment scales or screening tools reported a higher total MHL. The results confirmed strong internal consistency for the MHLS.The results highlighted varying mental health perceptions and knowledge in PHC. Implementation of specifically developed formal training programs and interventions to improve MHL in PHC workers to strengthen their competence may help bridge the treatment gap.

Encounters between individuals with a mental disorder and police forces can be harmful and dangerous for both parties involved. Previous research explored mostly police officers’ subjective experience of these encounters and focused on their recommendations. The present study takes the perspective of individuals with a mental disorder and investigates their subjective experience of dealing with the police. Thirteen semi-structural interviews were conducted with individuals with a history of mental health problems who have had encounters with the police and experienced contact-based anti-stigmatization interventions as consultants. Interviews revolved around the subjective experience of these police encounters. Questionnaires were used to inquire about context factors, individuals’ perceptions of police officers, and their sense of security during these encounters. Furthermore, individuals were asked to rate police officers’ ability to recognize signs and symptoms of ill mental health and give recommendations in regard to adequate communication strategies, interventions, and police training. The results indicate that encounters were experienced predominantly as positive and non-threatening. Participants emphasized the importance of communication strategies with a focus on empathy and respect. Keeping personal space and satisfying basic needs was recommended. Contact-based anti-stigmatization interventions were regarded as an effective approach to reduce stigma. Empathy and respect are perceived as key strategies for police officers when dealing with individuals with a mental disorder. To promote these strategies, trialogical anti-stigmatization interventions and crisis intervention training, including communication skills and face-to-face contact, are promising approaches.

The recognition of certain mental health conditions is important as this requires police officers to communicate and behave in an adjusted manner with affected individuals. The objective of the present study was to test police officers’ knowledge about mental health symptoms as a component of their mental health literacy (MHL) and to examine if police officers’ perceived knowledge corresponds with their actual knowledge. A questionnaire was used to assess for MHL representing mental health conditions which occur frequently in police requests (schizophrenia, bipolar disorder, depression, post-traumatic stress disorders, and emotionally unstable personality disorder). Furthermore, the questionnaire assessed the frequency of police requests, the officers’ perceived knowledge regarding mental disorders and their sense of feeling sufficiently trained to deal with these kinds of requests. Eighty-two police officers participated in the study. Police officers’ actual knowledge about mental health conditions did not correspond with their perceived knowledge. Participants revealed a moderately high level of overall knowledge which differed with regard to symptoms of each of the five mental health conditions. The mental status of a paranoid schizophrenia was best identified by the police officers and the majority correctly allocated the symptoms. Post-traumatic stress disorders and manic episodes were only identified by a minority of police offers. Police training geared to prepare for requests involving individuals with mental disorders should expand this limited knowledge transfer and focus on a broader variety of mental health conditions that police officers frequently encounter in requests.

Literature indicates a high prevalence and burden of mental illness in youths world-wide, which may be even higher in low- and middle-income countries (LMIC), such as South Africa and Zambia. Additionally, there is a lack of knowledge regarding youth depression amongst many primary health care (PHC) practitioners. The principal goal of the MEGA project is to provide youth with better access to mental health services and appropriate care, by developing a mental health screening mobile application tool to be used in PHC settings in South Africa and Zambia. In this study, we will use a mixed methods multi-center study design. In phase one, we will investigate the mental health literacy of PHC practitioners to identify areas in need of development. Based on the needs identified, we will develop and test a mobile health application to screen for common youth mental health problems in phase two. In phase three, we will implement and evaluate a tiered education and training program in the use of the m-health application. In the final phase, we will evaluate the acceptability and feasibility of the m-health application in PHC centres across South Africa and Zambia. Evidence suggests that PHC practitioners should routinely consider mental illness when assessing youth. However, common psychiatric disorders remain largely undetected and untreated in PHC settings. By identifying limitations in PHC workers knowledge with regard to youth mental health, we aspire to improve the depression care provided to youth in Southern Africa and Zambia by developing and implementing a locally relevant m-health application.

Despite the progress made in HIV treatment and prevention, HIV remains a major cause of adolescent morbidity and mortality in sub-Saharan Africa. As perinatally infected children increasingly survive into adulthood, the quality of life and mental health of this population has increased in importance. This review provides a synthesis of the prevalence of mental health problems in this population and explores associated factors. A systematic database search (Medline, PsycINFO, Scopus) with an additional hand search was conducted. Peer-reviewed studies on adolescents (aged 10–19), published between 2008 and 2019, assessing mental health symptoms or psychiatric disorders, either by standardized questionnaires or by diagnostic interviews, were included. The search identified 1461 articles, of which 301 were eligible for full-text analysis. Fourteen of these, concerning HIV-positive adolescents, met the inclusion criteria and were critically appraised. Mental health problems were highly prevalent among this group, with around 25% scoring positive for any psychiatric disorder and 30–50% showing emotional or behavioral difficulties or significant psychological distress. Associated factors found by regression analysis were older age, not being in school, impaired family functioning, HIV-related stigma and bullying, and poverty. Social support and parental competence were protective factors. Mental health problems among HIV-positive adolescents are highly prevalent and should be addressed as part of regular HIV care.

Im Rahmen des EU-Projektes RESME wurden in einer explorativen, qualitativen Studie Fachkräfte der stationären Jugendhilfe und der Kinder- und Jugendpsychiatrie zur gegenseitigen Kooperation befragt. Mit Hilfe umfassender leitfadengestützter Interviews wurden exemplarische Erfahrungen und Einschätzungen gesammelt, um die besonderen Herausforderungen in der Zusammenarbeit besser zu verstehen, Bedingungen und Beispiele für gelungene Kooperation zusammen zu tragen und Ansätze für Verbesserungen zu finden. Zentrale Ergebnisse der Interviews mit Sozialarbeitern und -pädagogen, Kinder- und Jugendpsychiatern und Psychologen werden zusammenfassend dargestellt. Es zeigen sich verschiedene Ansatzpunkte zur Verbesserung der systemübergreifenden und interdisziplinären Zusammenarbeit. Als wesentlich für eine gelungene Kooperation werden neben Fachlichkeit und Wissen, individuelle Einstellungen und Werte, Aspekte der persönlichen Kontakt- und Beziehungsgestaltung sowie organisatorische Rahmenbedingungen und Entwicklungen erachtet. Die Ergebnisse werden zur Entwicklung eines Curriculums genutzt, das sich zur Förderung der Zusammenarbeit gleichzeitig an Mitarbeiter psychiatrisch-psychotherapeutischer Einrichtungen und der Jugendhilfe richtet.

Selbstverletzendes Verhalten und andere selbstgefahrdende Verhaltensweisen von Jugendlichen stellen fur alle helfenden Professionen und beteiligten Fachkrafte eine besondere Herausforderung dar. Nicht selten strapazieren sie auch die Zusammenarbeit der Kinder- und Jugendhilfe und der Kinder- und Jugendpsychiatrie. Verbindliche Kooperationsstrukturen, gemeinsam abgestimmte Hilfen und insbesondere Notfallkonzepte sowie ein verstehender Zugang und verlassliche Beziehungsangebote konnen die Versorgung der jungen Menschen verbessern.