Suchergebnisse

Preventing torture and rehabilitating survivors in a country that practices torture is difficult but possible. The Center for the Victims of Torture Nepal (CVICT) documents and treats torture survivors in four ways: (a) fact-finding teams, (b) referrals to its clinic in Kathmandu, (c) prison visits, and (d) a community-based rehabilitation program for Bhutanese refugees. In addition, the center also conducts research in four ways: (a) a quantitative matched-control study of tortured refugees to identify consequences of torture, (b) a case note survey, (c) a narrative study to identify local idioms of distress, and (d) focus groups to identify issues pertinent in the local context.

The purpose of this article is to present a model to promote and assess interculturalization of mental healthcare services in western multicultural society. We define interculturalization as the adaptation of mental health services to suit clients from different cultures. The suggested measures aim to introduce changes in four contexts: (i) the clinical interface or the relations between the immigrant patient and the healthcare workers and the treatment team; (ii) organizational adaptations required in the treatment context of the mental healthcare facility; (iii) the relation between the mental health facility and the ethnic communities; and (iv) the relation between the mental healthcare system, other facilities and society at large. To monitor the desired changes, the model describes qualitative and quantitative criteria and indicators to be applied in the four contexts.

This article presents a model for research that aims to address challenges in transcultural psychiatric epidemiology. The model involves eclectic application of quantitative and qualitative techniques, namely: focus groups, in-depth interviews, snowball sampling and population surveys. The qualitative methods help provide information on the context of symptoms, illness experience and disease. These methods provide the background information needed to shape research questions, to modify instruments for local situations, and to interpret collected epidemiological data. Examples are provided.

The probe flow chart of the Composite International Diagnostic Interview (CIDI) was designed to assess psychiatric somatic complaints in various cultures. The CIDI's probe flow chart does not appear to function properly in the Nepali context as the chart contains two assumptions that do not hold in Nepali culture, namely that: (i) respondents attribute their symptoms to mental, physical or substance-related processes, and (ii) doctors communicate diagnoses to their patients. The cultural validity of the CIDI is questioned.

BACKGROUND: Existing WHO estimates of the prevalence of mental disorders in emergency settings are more than a decade old and do not reflect modern methods to gather existing data and derive estimates. We sought to update WHO estimates for the prevalence of mental disorders in conflict-affected settings and calculate the burden per 1000 population. METHODS: In this systematic review and meta-analysis, we updated a previous systematic review by searching MEDLINE (PubMed), PsycINFO, and Embase for studies published between Jan 1, 2000, and Aug 9, 2017, on the prevalence of depression, anxiety disorder, post-traumatic stress disorder, bipolar disorder, and schizophrenia. We also searched the grey literature, such as government reports, conference proceedings, and dissertations, to source additional data, and we searched datasets from existing literature reviews of the global prevalence of depression and anxiety and reference lists from the studies that were identified. We applied the Guidelines for Accurate and Transparent Health Estimates Reporting and used Bayesian meta-regression techniques that adjust for predictors of mental disorders to calculate new point prevalence estimates with 95% uncertainty intervals (UIs) in settings that had experienced conflict less than 10 years previously. FINDINGS: We estimated that the prevalence of mental disorders (depression, anxiety, post-traumatic stress disorder, bipolar disorder, and schizophrenia) was 22·1% (95% UI 18·8–25·7) at any point in time in the conflict-affected populations assessed. The mean comorbidity-adjusted, age-standardised point prevalence was 13·0% (95% UI 10·3–16·2) for mild forms of depression, anxiety, and post-traumatic stress disorder and 4·0% (95% UI 2·9–5·5) for moderate forms. The mean comorbidity-adjusted, age-standardised point prevalence for severe disorders (schizophrenia, bipolar disorder, severe depression, severe anxiety, and severe post-traumatic stress disorder) was 5·1% (95% UI 4·0–6·5). As only two studies provided epidemiological ...

The widening recognition of mental health as a significant international public health issue has led to an increasing need to demonstrate that investment of resources into service development is both required and also worthwhile. In particular, there is a need to generate evidence on mental health care strategies that are not only effective and appropriate but are also cost-effective and sustainable. Aimed at health policy-makers and service researchers with an interest in strengthening mental health systems, this publication sets out to highlight the need for and relevance of an economic dime