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Purpose: This paper describes and documents an innovative blended learning Global Mental Health: Trauma and Recovery certificate training course. This course combines a two-week face-to-face training in Orvieto, Italy with a five-month follow-up online virtual training as a learning experience for global health care practitioners. Continuing medical education (CME) accreditation is offered upon completion. This course utilized an innovative blended learning model with a community of practice approach, a combination of lectures and discussions, and online in-depth group case study discussions.

Background: Little is known about gender differences among people exposed to war related trauma. Aim of this study is to explore gender differences in health status and comorbidity of mental and physical disorders in a cohort of Bosnian refugees followed up for 3 years (1996–1999). Methods: This longitudinal study included 534 subjects followed up for 3 years. The interviews were conducted in refugee camps in Varaždin, Croatia in Bosnian language. Data were collected using Harvard Trauma Questionnaire (Bosnian version) and Hopkins Checklist-25, respectively. Physical health disorders were self-reported. Results: In both assessments there was a statistically significant difference between men and women in the number of physical health disorders, even when results were controlled for educational status. Although there was no difference in total number of symptoms in both assessments (F = 0.32; df = 1; p > 0.05 and F = 1.15; df = 1; p > 0.05), important physical health disorders were significantly more frequent among women than in men in different educational groups, namely high blood pressure and cardiovascular diseases, arthritis, and anaemia. Asthma, tuberculosis, cirrhosis of the liver, ulcer and epilepsy were more frequent in men than in women. There were no differences in frequencies of psychiatric disorders at baseline, but frequency of psychiatric disorders in women was higher at endpoint for uneducated respondents. There was significant difference compared to men in group of respondents without formal education, but only in comorbidity of PTSD and depression which was more often present in females (22.1%) than in males (3.6%). Conclusion: Our findings indicate the importance of gender and education on mental and physical health of people exposed to warrelated trauma. Long term health monitoring and programs, especially related to women's health are needed in order to avoid lasting consequences. [ABSTRACT FROM AUTHOR]

Many of the Cambodian refugees interviewed in a refugee camp in Thailand had psychological problems that may predict future difficulty in readjusting to life in Cambodia. More than half of the 993 Cambodian refugees who participated in the study had symptoms that correlated with a diagnosis of major depression. Many also had symptoms of post-traumatic stress disorder. Participants in the study were randomly selected from five regions in the Site 2 refugee camp on the Thailand-Cambodia border. Interviews were conducted in Khmer. From 1975 to 1979, under the Khmer Rouge regime, 83% of all participants lacked food or water. Many reported being forced into labor, separated from their families, unable to get needed medical treatment and subjected to brainwashing. More than 53% also reported the murder of a family member or friend. Social programs and health programs designed to aid the Cambodians after repatriation must take into account the very high levels of psychological and physical trauma endured by the refugees both during the time of the Khmer Rouge and during their stay at the refugee camp., Objective.--To assess the long-term impact of trauma and confinement on the functional health and mental health status of Cambodian displaced persons living on the Thailand-Cambodia border. Design.--Household survey of 993 adults randomly selected from household rosters. Household sample selection by multistage area probability sample. Setting.--Site 2, the largest Cambodian displaced-persons camp on the Thailand-Cambodia border. Participants.--Adults 18 years of age and older selected at random within households; 98% of eligible persons selected agreed to participate. Results.--From 1975 through 1975 (Khmer Rouge regime), more than 85% reported lack of food, water, shelter, and medical care, brainwashing, and forced labor; 54% reported murder of a family member or friend; 36% reported torture; 18% reported head injury; and 17% reported rape or sexual abuse. During the refugee period between 1980 and 1990, 56% reported lack of food or water, 44% reported lack of shelter, 28% reported lack of medical care, 24% reported brainwashing, and 8% reported torture. Since 1980, reports of murder of a family member, head injury, and rape/sexual abuse have decreased to 5%. Reports of experiencing combat situations and shelling attacks have remained consistent between the two time periods, approximately 44% and 30%, respectively. From 1989 to 1990, 25% reported experiencing lack of food or water, and 5% to 10% reported serious injury, combat, and shelling conditions. More than 80% said they were in fair or poor health, felt depressed, and had a number of somatic complaints despite good access to medical services. Fifty-five percent and 15% had symptom scores that correlate with Western criteria for depression and posttraumatic stress disorder respectively. Fifteen percent to 20% reported health impairments limiting activity, and moderate or severe bodily pain. Despite reported high levels of trauma and symptoms, social and work functioning were well preserved in the majority of respondents. Conclusions.--Reports of extensive trauma, poor health status, and depressive symptoms of this population are of concern in predicting future morbidity and mortality. The health and mental health needs of Cambodian displaced persons and their impact on social and economic behavior should be addressed now that the Cambodians have been repatriated.

A doctor acknowledges that most health care professionals avoid the reality of torture survivors. Physicians should identify and treat torture survivors in a holistic manner.

The article discusses the mental health issues linked to the global refugee crisis. Also cited are the scientific and cultural advances that led to reduced cost of care for common illnesses like anxiety, depression and stigma due to mental health disorders, and other topics like ecocide, climate change, and the COVID-19 pandemic.