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Publisher: Cambridge University Press   (Total: 387 journals)

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Showing 1 - 200 of 387 Journals sorted alphabetically
Acta Neuropsychiatrica     Hybrid Journal   (Followers: 6, SJR: 0.733, CiteScore: 2)
Acta Numerica     Hybrid Journal   (Followers: 5, SJR: 6.709, CiteScore: 10)
Advances in Animal Biosciences     Full-text available via subscription   (Followers: 13)
Advances in Applied Mathematics and Mechanics     Full-text available via subscription   (Followers: 2, SJR: 0.441, CiteScore: 1)
Aeronautical J., The     Hybrid Journal   (Followers: 7)
Africa     Hybrid Journal   (Followers: 20, SJR: 0.582, CiteScore: 1)
African Studies Review     Full-text available via subscription   (Followers: 20, SJR: 0.437, CiteScore: 1)
Ageing & Society     Hybrid Journal   (Followers: 44, SJR: 0.756, CiteScore: 2)
Agricultural and Resource Economics Review     Open Access   (Followers: 6, SJR: 0.414, CiteScore: 1)
AI EDAM     Hybrid Journal   (Followers: 2, SJR: 0.375, CiteScore: 1)
AJIL Unbound     Open Access  
AJS Review     Full-text available via subscription   (Followers: 4, SJR: 0.128, CiteScore: 0)
American Political Science Review     Hybrid Journal   (Followers: 318, SJR: 5.587, CiteScore: 4)
Anatolian Studies     Full-text available via subscription   (Followers: 5, SJR: 0.528, CiteScore: 1)
Ancient Mesoamerica     Hybrid Journal   (Followers: 12, SJR: 0.478, CiteScore: 1)
Anglo-Saxon England     Hybrid Journal   (Followers: 36, SJR: 0.1, CiteScore: 0)
animal     Hybrid Journal   (Followers: 4, SJR: 0.842, CiteScore: 2)
Animal Health Research Reviews     Hybrid Journal   (Followers: 3, SJR: 0.69, CiteScore: 2)
Animal Science     Full-text available via subscription   (Followers: 10)
Annals of Actuarial Science     Full-text available via subscription   (Followers: 1)
Annual of the British School at Athens     Full-text available via subscription   (Followers: 17, SJR: 0.177, CiteScore: 0)
Annual Review of Applied Linguistics     Hybrid Journal   (Followers: 43, SJR: 3.223, CiteScore: 4)
Antarctic Science     Hybrid Journal   (Followers: 1, SJR: 0.643, CiteScore: 1)
Antichthon     Full-text available via subscription   (Followers: 3, SJR: 0.101, CiteScore: 0)
Antiquaries J., The     Full-text available via subscription   (Followers: 12, SJR: 0.106, CiteScore: 0)
Antiquity     Hybrid Journal   (Followers: 33)
ANZIAM J.     Open Access   (Followers: 1, SJR: 0.216, CiteScore: 0)
Applied Psycholinguistics     Hybrid Journal   (Followers: 25, SJR: 0.945, CiteScore: 2)
APSIPA Transactions on Signal and Information Processing     Open Access   (Followers: 9, SJR: 0.404, CiteScore: 2)
Arabic Sciences and Philosophy     Hybrid Journal   (Followers: 9, SJR: 0.101, CiteScore: 0)
Arbor Clinical Nutrition Updates     Full-text available via subscription   (Followers: 5)
Archaeological Dialogues     Hybrid Journal   (Followers: 38, SJR: 0.898, CiteScore: 1)
Archaeological Reports     Full-text available via subscription   (Followers: 5, SJR: 0.128, CiteScore: 0)
Architectural History     Full-text available via subscription  
arq: Architectural Research Quarterly     Hybrid Journal   (Followers: 7, SJR: 0.123, CiteScore: 0)
Art Libraries J.     Full-text available via subscription  
Asian J. of Comparative Law     Hybrid Journal   (Followers: 11, SJR: 0.129, CiteScore: 0)
Asian J. of Intl. Law     Hybrid Journal   (Followers: 18, SJR: 0.135, CiteScore: 0)
Asian J. of Law and Society     Hybrid Journal   (Followers: 7, SJR: 0.195, CiteScore: 0)
Astin Bulletin     Full-text available via subscription   (Followers: 1, SJR: 0.878, CiteScore: 1)
Australasian J. of Organisational Psychology     Hybrid Journal   (Followers: 9, SJR: 0.154, CiteScore: 1)
Australian J. of Environmental Education     Full-text available via subscription   (Followers: 9, SJR: 0.403, CiteScore: 1)
Australian J. of Indigenous Education, The     Full-text available via subscription   (Followers: 10, SJR: 0.26, CiteScore: 1)
Australian J. of Rehabilitation Counseling     Full-text available via subscription   (Followers: 6, SJR: 0.144, CiteScore: 0)
Austrian History Yearbook     Full-text available via subscription   (Followers: 11, SJR: 0.161, CiteScore: 0)
Behavioral and Brain Sciences     Hybrid Journal   (Followers: 39, SJR: 0.595, CiteScore: 1)
Behaviour Change     Full-text available via subscription   (Followers: 13, SJR: 0.508, CiteScore: 1)
Behavioural and Cognitive Psychotherapy     Hybrid Journal   (Followers: 186, SJR: 0.976, CiteScore: 2)
Bilingualism: Language and Cognition     Hybrid Journal   (Followers: 42, SJR: 1.446, CiteScore: 2)
Biofilms     Full-text available via subscription   (Followers: 2)
Bird Conservation Intl.     Hybrid Journal   (Followers: 25, SJR: 0.581, CiteScore: 1)
BJPsych Advances     Full-text available via subscription   (Followers: 57, SJR: 0.275, CiteScore: 0)
BJPsych Intl.     Open Access   (Followers: 2)
BJPsych Open     Open Access   (Followers: 3)
Brain Impairment     Full-text available via subscription   (Followers: 2, SJR: 0.321, CiteScore: 1)
Breast Cancer Online     Full-text available via subscription   (Followers: 4)
Britannia     Full-text available via subscription   (Followers: 11, SJR: 0.111, CiteScore: 0)
British Actuarial J.     Full-text available via subscription  
British Catholic History     Hybrid Journal   (Followers: 2, SJR: 0.133, CiteScore: 1)
British J. for the History of Science     Hybrid Journal   (Followers: 24, SJR: 0.235, CiteScore: 0)
British J. of Anaesthetic and Recovery Nursing     Full-text available via subscription   (Followers: 8)
British J. of Music Education     Hybrid Journal   (Followers: 24, SJR: 0.564, CiteScore: 1)
British J. Of Nutrition     Hybrid Journal   (Followers: 90, SJR: 1.612, CiteScore: 4)
British J. of Political Science     Hybrid Journal   (Followers: 218, SJR: 4.661, CiteScore: 4)
British J. of Psychiatry     Hybrid Journal   (Followers: 228, SJR: 2.844, CiteScore: 3)
Bulletin of Entomological Research     Hybrid Journal   (Followers: 13, SJR: 0.805, CiteScore: 2)
Bulletin of Symbolic Logic     Full-text available via subscription   (Followers: 2, SJR: 0.555, CiteScore: 1)
Bulletin of the Australian Mathematical Society     Full-text available via subscription   (Followers: 2, SJR: 0.44, CiteScore: 0)
Bulletin of the School of Oriental and African Studies     Hybrid Journal   (Followers: 21, SJR: 0.146, CiteScore: 0)
Business and Human Rights J.     Full-text available via subscription   (Followers: 4, SJR: 0.536, CiteScore: 1)
Business Ethics Quarterly     Full-text available via subscription   (Followers: 18, SJR: 1.098, CiteScore: 2)
Business History Review     Hybrid Journal   (Followers: 16, SJR: 0.347, CiteScore: 1)
Cambridge Archaeological J.     Hybrid Journal   (Followers: 152, SJR: 1.121, CiteScore: 1)
Cambridge Classical J.     Full-text available via subscription   (Followers: 24, SJR: 0.101, CiteScore: 0)
Cambridge J. of Postcolonial Literary Inquiry     Hybrid Journal   (Followers: 7)
Cambridge Law J.     Hybrid Journal   (Followers: 202, SJR: 0.213, CiteScore: 0)
Cambridge Opera J.     Hybrid Journal   (Followers: 4, SJR: 0.14, CiteScore: 0)
Cambridge Quarterly of Healthcare Ethics     Hybrid Journal   (Followers: 11, SJR: 0.299, CiteScore: 1)
Cambridge Yearbook of European Legal Studies     Full-text available via subscription  
Camden Fifth Series     Full-text available via subscription   (Followers: 3)
Canadian Entomologist     Hybrid Journal   (Followers: 5, SJR: 0.482, CiteScore: 1)
Canadian J. of Emergency Medicine     Hybrid Journal   (Followers: 13, SJR: 0.624, CiteScore: 1)
Canadian J. of Law & Jurisprudence     Full-text available via subscription   (Followers: 11, SJR: 0.237, CiteScore: 0)
Canadian J. of Law and Society     Hybrid Journal   (Followers: 20, SJR: 0.259, CiteScore: 1)
Canadian J. of Mathematics / J. canadien de mathématiques     Hybrid Journal  
Canadian J. of Neurological Sciences     Full-text available via subscription   (SJR: 0.549, CiteScore: 1)
Canadian J. of Political Science/Revue canadienne de science politique     Full-text available via subscription   (Followers: 25, SJR: 0.385, CiteScore: 1)
Canadian J. on Aging     Hybrid Journal   (Followers: 13, SJR: 0.426, CiteScore: 1)
Canadian Mathematical Bulletin     Hybrid Journal  
Canadian Yearbook of Intl. Law / Annuaire canadien de droit international     Full-text available via subscription   (Followers: 3)
Cardiology in the Young     Hybrid Journal   (Followers: 34, SJR: 0.372, CiteScore: 1)
Central European History     Full-text available via subscription   (Followers: 33, SJR: 0.159, CiteScore: 0)
Children Australia     Partially Free   (Followers: 2, SJR: 0.255, CiteScore: 0)
China Quarterly     Hybrid Journal   (Followers: 52, SJR: 2.289, CiteScore: 3)
Chinese J. of Agricultural Biotechnology     Full-text available via subscription   (Followers: 4)
Church History : Studies in Christianity and Culture     Full-text available via subscription   (Followers: 75, SJR: 0.106, CiteScore: 0)
Classical Quarterly     Full-text available via subscription   (Followers: 35, SJR: 0.204, CiteScore: 0)
Classical Review     Full-text available via subscription   (Followers: 29)
CNS Spectrums     Hybrid Journal   (Followers: 3, SJR: 1.391, CiteScore: 3)
Cognitive Behaviour Therapist     Hybrid Journal   (Followers: 14)
Combinatorics, Probability and Computing     Hybrid Journal   (Followers: 4, SJR: 0.839, CiteScore: 1)
Communications in Computational Physics     Full-text available via subscription   (Followers: 3, SJR: 1.048, CiteScore: 2)
Comparative Studies in Society and History     Full-text available via subscription   (Followers: 49, SJR: 0.585, CiteScore: 1)
Compositio Mathematica     Full-text available via subscription   (SJR: 3.139, CiteScore: 1)
Contemporary European History     Hybrid Journal   (Followers: 35, SJR: 0.263, CiteScore: 1)
Continuity and Change     Hybrid Journal   (Followers: 12, SJR: 0.107, CiteScore: 0)
Dance Research J.     Full-text available via subscription   (Followers: 16, SJR: 0.211, CiteScore: 0)
Development and Psychopathology     Hybrid Journal   (Followers: 9, SJR: 2.068, CiteScore: 4)
Dialogue Canadian Philosophical Review/Revue canadienne de philosophie     Full-text available via subscription   (Followers: 5, SJR: 0.156, CiteScore: 0)
Diamond Light Source Proceedings     Full-text available via subscription   (Followers: 1)
Disaster Medicine and Public Health Preparedness     Hybrid Journal   (Followers: 14, SJR: 0.471, CiteScore: 1)
Du Bois Review: Social Science Research on Race     Full-text available via subscription   (Followers: 10, SJR: 0.561, CiteScore: 1)
Early China     Hybrid Journal   (Followers: 3)
Early Music History     Hybrid Journal   (Followers: 9, SJR: 0.101, CiteScore: 0)
Earth and Environmental Science Transactions of the Royal Society of Edinburgh     Hybrid Journal   (Followers: 5)
East Asian J. on Applied Mathematics     Full-text available via subscription   (SJR: 0.418, CiteScore: 1)
Ecclesiastical Law J.     Full-text available via subscription   (Followers: 6, SJR: 0.114, CiteScore: 0)
Econometric Theory     Hybrid Journal   (Followers: 18, SJR: 2.915, CiteScore: 1)
Economics and Philosophy     Hybrid Journal   (Followers: 18, SJR: 0.622, CiteScore: 1)
Edinburgh J. of Botany     Hybrid Journal   (SJR: 0.283, CiteScore: 1)
Educational and Developmental Psychologist     Full-text available via subscription   (Followers: 10, SJR: 0.146, CiteScore: 0)
Eighteenth-Century Music     Hybrid Journal   (Followers: 15, SJR: 0.113, CiteScore: 0)
English Language and Linguistics     Hybrid Journal   (Followers: 24, SJR: 0.52, CiteScore: 1)
English Profile J.     Hybrid Journal   (Followers: 2)
English Today     Hybrid Journal   (Followers: 13, SJR: 0.279, CiteScore: 0)
Enterprise & Society : The Intl. J. of Business History     Hybrid Journal   (Followers: 18, SJR: 0.245, CiteScore: 1)
Environment and Development Economics     Hybrid Journal   (Followers: 40, SJR: 0.617, CiteScore: 1)
Environmental Conservation     Hybrid Journal   (Followers: 60, SJR: 1.028, CiteScore: 2)
Environmental Practice     Full-text available via subscription   (Followers: 3, SJR: 0.145, CiteScore: 0)
Epidemiology & Infection     Hybrid Journal   (Followers: 18, SJR: 1.128, CiteScore: 2)
Epidemiology and Psychiatric Sciences     Hybrid Journal   (Followers: 3, SJR: 1.494, CiteScore: 2)
Episteme     Hybrid Journal   (Followers: 12, SJR: 0.756, CiteScore: 1)
Ergodic Theory and Dynamical Systems     Hybrid Journal   (Followers: 2, SJR: 1.193, CiteScore: 1)
Ethics & Intl. Affairs     Full-text available via subscription   (Followers: 17, SJR: 0.557, CiteScore: 1)
European Constitutional Law Review (EuConst)     Full-text available via subscription   (Followers: 35, SJR: 1.009, CiteScore: 1)
European J. of Applied Mathematics     Hybrid Journal   (SJR: 0.52, CiteScore: 1)
European J. of Intl. Security     Hybrid Journal   (Followers: 1)
European J. of Sociology     Hybrid Journal   (Followers: 36, SJR: 0.643, CiteScore: 1)
European Political Science Review     Hybrid Journal   (Followers: 27, SJR: 1.816, CiteScore: 2)
European Review     Hybrid Journal   (Followers: 19, SJR: 0.131, CiteScore: 0)
Evolutionary Human Sciences     Open Access  
Experimental Agriculture     Hybrid Journal   (Followers: 14, SJR: 0.542, CiteScore: 1)
Expert Reviews in Molecular Medicine     Hybrid Journal   (Followers: 1, SJR: 1.647, CiteScore: 4)
Fetal and Maternal Medicine Review     Hybrid Journal   (Followers: 6)
Financial History Review     Full-text available via subscription   (Followers: 15, SJR: 0.238, CiteScore: 1)
Foreign Policy Bulletin     Hybrid Journal   (Followers: 6)
Forum of Mathematics, Pi     Open Access   (Followers: 1)
Forum of Mathematics, Sigma     Open Access   (Followers: 1)
Genetics Research     Hybrid Journal   (Followers: 4, SJR: 0.483, CiteScore: 1)
Geological Magazine     Hybrid Journal   (Followers: 16, SJR: 0.966, CiteScore: 2)
Glasgow Mathematical J.     Full-text available via subscription   (SJR: 0.604, CiteScore: 0)
Global Constitutionalism     Hybrid Journal   (Followers: 17)
Global Mental Health     Open Access   (Followers: 9)
Global Sustainability     Open Access   (Followers: 1)
Government and Opposition     Full-text available via subscription   (Followers: 24, SJR: 0.965, CiteScore: 2)
Greece & Rome     Partially Free   (Followers: 30, SJR: 0.113, CiteScore: 0)
Hague J. on the Rule of Law     Full-text available via subscription   (Followers: 14, SJR: 0.271, CiteScore: 1)
Harvard Theological Review     Full-text available via subscription   (Followers: 78, SJR: 0.165, CiteScore: 0)
Health Economics, Policy and Law     Hybrid Journal   (Followers: 29, SJR: 0.745, CiteScore: 1)
Hegel Bulletin     Full-text available via subscription   (Followers: 2)
High Power Laser Science and Engineering     Open Access   (Followers: 3, SJR: 0.901, CiteScore: 3)
Historical J.     Hybrid Journal   (Followers: 39, SJR: 0.247, CiteScore: 1)
History in Africa     Full-text available via subscription   (Followers: 9)
Horizons     Partially Free   (Followers: 1, SJR: 0.129, CiteScore: 0)
Industrial and Organizational Psychology     Hybrid Journal   (Followers: 27, SJR: 0.916, CiteScore: 1)
Infection Control and Hospital Epidemiology     Full-text available via subscription   (Followers: 42, SJR: 1.97, CiteScore: 3)
Intl. & Comparative Law Quarterly     Full-text available via subscription   (Followers: 259, SJR: 0.369, CiteScore: 1)
Intl. Annals of Criminology     Full-text available via subscription  
Intl. J. of Asian Studies     Hybrid Journal   (Followers: 13, SJR: 0.143, CiteScore: 0)
Intl. J. of Astrobiology     Hybrid Journal   (Followers: 4, SJR: 0.548, CiteScore: 1)
Intl. J. of Cultural Property     Full-text available via subscription   (Followers: 13, SJR: 0.253, CiteScore: 1)
Intl. J. of Disability Management Research     Full-text available via subscription   (Followers: 9, SJR: 0.105, CiteScore: 0)
Intl. J. of Law in Context     Hybrid Journal   (Followers: 17, SJR: 0.275, CiteScore: 1)
Intl. J. of Legal Information     Full-text available via subscription   (Followers: 340)
Intl. J. of Microwave and Wireless Technologies     Hybrid Journal   (Followers: 10, SJR: 0.184, CiteScore: 1)
Intl. J. of Middle East Studies     Hybrid Journal   (Followers: 72, SJR: 0.434, CiteScore: 0)
Intl. J. of Technology Assessment in Health Care     Hybrid Journal   (Followers: 14, SJR: 0.714, CiteScore: 1)
Intl. Labor and Working-Class History     Full-text available via subscription   (Followers: 14, SJR: 0.182, CiteScore: 0)
Intl. Organization     Full-text available via subscription   (Followers: 106, SJR: 8.527, CiteScore: 5)
Intl. Psychogeriatrics     Hybrid Journal   (Followers: 13, SJR: 1.048, CiteScore: 2)
Intl. Review of Social History     Full-text available via subscription   (Followers: 27, SJR: 0.315, CiteScore: 1)
Intl. Review of the Red Cross     Full-text available via subscription   (Followers: 13, SJR: 0.214, CiteScore: 0)
Intl. Theory: A J. of Intl. Politics, Law and Philosophy     Hybrid Journal   (Followers: 19, SJR: 2.293, CiteScore: 2)
Iraq     Full-text available via subscription   (Followers: 4)
Irish Historical Studies     Hybrid Journal   (Followers: 7, SJR: 0.103, CiteScore: 0)
Irish J. of Psychological Medicine     Hybrid Journal   (Followers: 2, SJR: 0.221, CiteScore: 0)
Israel Law Review     Hybrid Journal   (Followers: 2, SJR: 0.165, CiteScore: 0)
Italian Political Science Review / Rivista Italiana di Scienza Politica     Hybrid Journal  
Itinerario     Full-text available via subscription   (Followers: 11, SJR: 0.158, CiteScore: 0)
J. of African History     Hybrid Journal   (Followers: 22, SJR: 0.348, CiteScore: 1)
J. of African Law     Full-text available via subscription   (Followers: 3, SJR: 0.113, CiteScore: 0)
J. of Agricultural and Applied Economics     Open Access   (Followers: 2, SJR: 0.263, CiteScore: 1)
J. of Agricultural Science     Full-text available via subscription   (Followers: 8, SJR: 0.563, CiteScore: 1)
J. of American Studies     Hybrid Journal   (Followers: 20, SJR: 0.164, CiteScore: 0)
J. of Anglican Studies     Hybrid Journal   (Followers: 6, SJR: 0.101, CiteScore: 0)
J. of Applied Animal Nutrition     Hybrid Journal   (Followers: 4)
J. of Asian Studies     Full-text available via subscription   (Followers: 41, SJR: 0.591, CiteScore: 1)
J. of Benefit-Cost Analysis     Hybrid Journal   (Followers: 4)
J. of Biosocial Science     Hybrid Journal   (Followers: 5, SJR: 0.48, CiteScore: 1)
J. of British Studies     Full-text available via subscription   (Followers: 32, SJR: 0.246, CiteScore: 0)

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Similar Journals
Journal Cover
Global Mental Health
Number of Followers: 9  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2054-4251 - ISSN (Online) 2054-4251
Published by Cambridge University Press Homepage  [387 journals]
  • A pilot study of a stepped-care brief intervention to help
           psychologically-distressed women displaced by conflict in Bogotá,
           Colombia

    • Authors: J.M. Shultz; H. Verdeli, Á. Gómez Ceballos, L.J. Hernandez, Z. Espinel, L. Helpman, Y. Neria, R. Araya
      Abstract: BackgroundColombia's 6.5 million internally displaced persons (IDPs) have been exposed to trauma, loss, and hardships. Common mental disorders (CMDs) are prevalent in this group, yet there are few evidence-based psychosocial interventions for this population. We assessed the feasibility and acceptability of a stepped-care intervention for women IDPs in Bogota, Colombia.MethodsFeasibility to recruit participants for an intervention trial, to screen for CMDs and displacement-related traumas, to refer high-risk cases to professional consultation, to implement evidence-based interpersonal counseling (IPC) for women with diagnosed CMDs, to retain participants in the intervention, and to conduct follow-up assessments was assessed. Assessment instruments were validated. The intervention was delivered by trained outreach personnel. Intervention acceptability was assessed by monitoring session attendance, dropout rates, and satisfaction. Potential efficacy was evaluated with pre- and post-intervention measures of CMDs.ResultsWe recruited 279 women IDPs into the intervention. On screening, 177 (63.4%) had symptom levels suggesting a CMD. Participants endorsed a wide range of displacement-related exposures. Most participants receiving IPC decreased their symptom levels at follow-up. Many participants did not complete the recommended number of IPC sessions; loss to follow-up was 30%. The performance of the outreach personnel improved after the initial intervention team was replaced with community members trained to deliver the intervention. The Bogotá health system was unable to reliably accommodate emergency psychiatric referrals.ConclusionsThe IPC intervention shows promise, but significant challenges remain for improving reach, adherence, and participant retention. We identified strategies and partnerships to redress some of the main study limitations.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.26
      Issue No: Vol. 6 (2019)
       
  • Prevalence, correlates and help-seeking behaviour for depressive symptoms
           in rural Uganda: a population-based survey

    • Authors: J. Ssebunnya; G. Medhin, S. Kangere, F. Kigozi, J. Nakku, C. Lund
      Abstract: Background.Depression is a common disorder characterized by delayed help-seeking, often remaining undetected and untreated.Objectives.We sought to estimate the proportion of adults in Kamuli District with depressive symptoms and to assess their help-seeking behaviour.Methods.This was a population-based cross-sectional study conducted in a rural district in Uganda. Sampling of study participants was done using the probability proportional to size method. Screening for depression was done using Patient Health Questionnaire (PHQ-9). The participants who screened positive also reported on whether and where they had sought treatment. Data collected using PHQ-9 was used both as a symptom-based description of depression and algorithm diagnosis of major depression. All data analysis was done using STATA version 13.Results.With a cut-off score of ⩾10, 6.4% screened positive for current depressive symptoms and 23.6% reported experiencing depressive symptoms in the past 12 months. The majority of individuals who screened positive for current depression (75.6%) were females. In a crude analysis, people with lower education, middle age and low socio-economic status were more likely to have depressive symptoms. Help-seeking was low, with only 18.9% of the individuals who screened positive for current depression having sought treatment from a health worker.Conclusion.Depressive symptoms are common in the study district with low levels of help-seeking practices. People with lower levels of education, low socio-economic status and those in middle age are more likely to be affected by these symptoms. Most persons with current depression had past history of depressive symptoms.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.25
      Issue No: Vol. 6 (2019)
       
  • Vodou's role in Haitian mental health

    • Authors: E. Auguste; A. Rasmussen
      Abstract: This paper gives an overview of Vodou's history in Haiti and how Vodou informs Haitian mental health interventions.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.23
      Issue No: Vol. 6 (2019)
       
  • Nodding syndrome research, lessons learned from the NSETHIO project

    • Authors: D. Geelhand de Merxem; J. N. Siewe Fodjo, S. Menon, A. Hotterbeekx, R. Colebunders
      Abstract: Background.Until recently, nodding syndrome (NS) was considered as a mysterious disease of unknown etiology. A link between onchocerciasis and epilepsy was suspected for a long time. However, onchocerciasis was not considered as the cause of NS because NS was believed to occur only in onchocerciasis-endemic regions in Uganda, South Sudan, and Tanzania. In October 2015, with funding from the European Research Council, the NSETHIO group launched a trans-disciplinary, multi-country research project to identify the cause of NS and to study the link between onchocerciasis and epilepsy.Methods.We reviewed NSETHIO activities as well as all published papers, and compared project findings with results of previous research on NS.ResultsFindings from the NSETHIO project showed that NS is only one of the clinical manifestations in the wide spectrum of onchocerciasis-associated epilepsy (OAE) that could be prevented by strengthening onchocerciasis elimination programs. NSETHIO demonstrated that OAE is an important neglected public health problem in onchocerciasis-endemic areas with no or a sub-optimally functioning onchocerciasis control strategies.Conclusions.Today there is overwhelming evidence that NS together with the Nakalanga syndrome is clinical presentations of OAE, a condition that could be prevented by strengthening onchocerciasis elimination programs. While research needs to continue to elucidate the pathophysiological mechanisms causing NS, new strategies to accelerate onchocerciasis elimination coupled with community-based surveillance and treatment programs for epilepsy are urgently needed in areas of high Onchocerca volvulus transmission.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.24
      Issue No: Vol. 6 (2019)
       
  • Identifying research priorities for psychosocial support programs in
           humanitarian settings

    • Authors: C. Lee; A. J. Nguyen, E. Haroz, W. Tol, Y. Aules, P. Bolton
      Abstract: Background.Given the range and reach of psychosocial support (PSS) interventions in humanitarian settings, within the continuum of mental health and psychosocial support services, evaluation of their impact is critical. Understanding stakeholders' perspectives on which PSS interventions of unknown effectiveness warrant rigorous evaluation is essential to identify research priorities. This project aimed to facilitate a process with stakeholders to reach consensus on PSS interventions that are of high priority for further research based on existing evidence and stakeholders' opinions.Methods.Interviews with 109 stakeholders working on PSS programming in humanitarian settings served as the foundation for two in-person regional meetings and four webinars. Nominal Group Technique (NGT) was used to develop a priority PSS program list. The top five priorities from each meeting were combined for a final online survey distributed globally.Results.Seventy participants across six meetings contributed to the prioritization process. Eighty-seven individuals completed the final online survey. ‘Community based PSS’ was the top-ranked research priority, followed by PSS integrated into basic services, providing PSS to caregivers to improve child wellbeing, PSS-focused gender-based violence programming, and classroom-based PSS interventions.Conclusions.NGT and online surveys were effective methods to engage stakeholders in a priority setting exercise to development a research agenda. Information from this stage of the project will be combined with findings from a concurrent systematic review to form the base of a second phase of work, which will include the development and implementation of a research strategy to strengthen the evidence base for those prioritized interventions.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.19
      Issue No: Vol. 6 (2019)
       
  • The development of an ultra-short, maternal mental health screening tool
           in South Africa

    • Authors: T. van Heyningen; L. Myer, M. Tomlinson, S. Field, S. Honikman
      Abstract: Purpose.The burden of common perinatal mental disorders (CPMD) in low-and-middle-income countries is substantially higher than high-income countries, with low levels of detection, service provision and treatment in resource-constrained settings. We describe the development of an ultra-short screening tool to detect antenatal depression, anxiety disorders and maternal suicidal ideation.Methods.A sample of 376 women was recruited at a primary-level obstetric clinic. Five depression and anxiety symptom-screening questionnaires, demographics and psychosocial risk questionnaires were administered. All participants were assessed with the Mini-International Neuropsychiatric Interview (MINI), a structured, diagnostic interview. Screening tool items were analysed against diagnostic data using multiple logistic regression and receiver operating curve (ROC) analysis.Results.The prevalence of MINI-defined major depressive episode (MDE) and/or anxiety disorders was 33%. Overall, 18% of participants expressed suicidal ideation and behaviour, 54% of these had no depression or anxiety diagnosis. Multiple logistic regression identified four screening items that were independently predictive of MDE and anxiety disorders, investigating depressed mood, anhedonia, anxiety symptoms and suicidal ideation. ROC analysis of these combined items yielded an area under the curve of 0.83 (95% CI 0.78–0.88). A cut-off score of 2 or more offered a sensitivity of 78% and specificity of 82%.Conclusion.This novel screening tool is the first measure of CPMD developed in South Africa to include depressed mood, anxiety symptoms and suicidal ideation. While the tool requires further investigation, it may be useful for the early identification of mental health symptoms and morbidity in the perinatal period.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.21
      Issue No: Vol. 6 (2019)
       
  • How faithfully do HIV clinicians administer the PHQ-9 depression screening
           tool in high-volume, low-resource clinics' Results from a depression
           treatment integration project in Malawi

    • Authors: Brian W. Pence; Melissa A. Stockton, Steven M. Mphonda, Michael Udedi, Kazione Kulisewa, Bradley N. Gaynes, Mina C. Hosseinipour
      Abstract: Background.Integration of mental health services into nonspecialist settings is expanding in low and middle income countries (LMICs). Among many factors required for success, such programs require reliable administration of mental health screening tools. While several tools have been validated in carefully conducted research studies, few studies have assessed how reliably nonspecialist clinicians administer these tools to low-literacy LMIC populations in routine care.Methods.Ninety-seven patients accessing human immunodeficiency virus primary care in Malawi who completed Patient Health Questionnaire (PHQ)-9 depression screening with their clinician then completed a second PHQ-9 with a trained research assistant (RA) blinded to the first result.Results.Compared to clinicians, RAs identified more patients with any depressive symptoms (PHQ-9 score ⩾5: 38% v. 32%), moderate/severe symptoms (PHQ-9 ⩾ 10: 14% v. 6%), any suicidality (14% v. 4%), and active suicidality (3% v. 2%). Across these indicators, clinician and RA ratings had strong overall agreement (81–97%) but low corrected Kappa agreement (31–59%). Treating RA results as the reference standard of a carefully supervised research administration of the PHQ-9, clinician administration had high specificity (90–99%) but low sensitivity (23–68%) for these indicators.Conclusions.In routine care in LMICs, clinicians may administer validated mental health screening tools with varying quality. To ensure quality, integration programs must incorporate appropriate and ongoing training, support, supervision, and monitoring.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.22
      Issue No: Vol. 6 (2019)
       
  • Depressive symptoms among women in Raqqa Governorate, Syria: associations
           with intimate partner violence, food insecurity, and perceived needs

    • Authors: K. L. Falb; A. Blackwell, J. Stennes, M. Hussein, J. Annan
      Abstract: Background.Raqqa Governorate, Syria has recently been affected by overlapping conflicts related to the Syrian Civil war and occupation by ISIS, resulting in widespread displacement and disruption of economic livelihoods. However, little information is currently known about mental health needs and risk factors among women. Therefore, this study sought to examine potential risk factors for depressive symptoms among married women living in northern Syria.Methods.Data were collected between March and April 2018 as part of an evaluation of an International Rescue Committee cash transfer program targeted toward vulnerable households. Using cross-sectional data from 214 married women participating in the program, linear regression models were generated to explore the associations between depressive symptoms [nine-item Patient Health Questionnaire (PHQ-9)] and its potential risk factors, including food insecurity, perceived deprivation of basic needs [the Humanitarian Emergency Settings Perceived Needs Scale (HESPER) scale], and past-3-month intimate partner violence (IPV).Results.The average depressive symptom score was 10.5 (s.d.: 4.9; range: 2–27). In the final adjusted model, any form of recent IPV (β = 2.25; 95% CI 0.92–3.57; p = 0.001), severe food insecurity (β = 1.62; 95% CI 0.27–2.96; p = 0.02) and perceived needs (β = 0.38; 95% CI 0.18–0.57; p = 0.0002) were associated with an increase in depressive symptoms.Conclusion.Study findings point to the need to address the mental health needs of women in conflict-affected areas of Syria. Programming to address risk factors for depression, including IPV and other factors associated with daily stressors such as food insecurity and deprivation of basic needs, may be effective in reducing depression in this population.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.20
      Issue No: Vol. 6 (2019)
       
  • Is depression associated with pathways to care and diagnosis delay in
           people with tuberculosis in Ethiopia'

    • Authors: F. Ambaw; R. Mayston, C. Hanlon, A. Alem
      Abstract: Background.Co-morbid depression is common in people with tuberculosis (TB). Symptoms of depression (low energy, impaired concentration, decreased motivation and hopelessness) may affect help-seeking; however, this impact has not been studied so far. The objectives of this study were to assess the impact of co-morbid depression on diagnostic delay, pathways to care, and to identify if it mediates other factors associated with diagnostic delay.Methods.We analyzed cross-sectional data collected from 592 adults with newly diagnosed TB. We assessed probable depression using Patient Health Questionnaire, nine items (PHQ-9) at a cut-off 10. Data on diagnosis delay, pathways to TB care, socio-demographic variables, stigma, types of TB, substance use, co-morbid chronic illnesses, and perception about TB were assessed using a structured questionnaire. Generalized structural equation modelling was used to analyze the data.Results.A total of 313 (52.9%) participants had probable depression. Pathway to TB care was direct for 512 (86.5%) of the participants and indirect for 80 (13.5%) of them. The median diagnosis delay was 12.0 weeks. Depression did not have a statistically significant association with pathways to TB care (β = −0.45; 95% CI−1.85 to 0.96) or diagnostic delay [adjusted odds ratio (AOR) = 0.90; 0.77–1.06]. Indirect pathway to TB care was positively associated with diagnosis delay (AOR = 2.72; 95% CI 1.25–5.91).Conclusions.People with TB who had co-morbid probable depression visited the modern health care as directly as and as soon as those without co-morbid depression. How socio-demographic factors influence pathways to care and diagnosis delay require qualitative exploration.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.17
      Issue No: Vol. 6 (2019)
       
  • Effectiveness of non-medical health worker-led counselling on
           psychological distress: a randomized controlled trial in rural Nepal –
           ADDENDUM

    • Authors: N. Markkula; V. Lehti, P. Adhikari, S. Peña, J. Heliste, E. Mikkonen, M. Rautanen, E. Salama, B. Guragain
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.18
      Issue No: Vol. 6 (2019)
       
  • Priorities and preferences for school-based mental health services in
           India: a multi-stakeholder study with adolescents, parents, school staff,
           and mental health providers

    • Authors: R. Parikh; D. Michelson, M. Sapru, R. Sahu, A. Singh, P. Cuijpers, V. Patel
      Abstract: Background.Schools are important settings for increasing reach and uptake of adolescent mental health interventions. There is limited consensus on the focus and content of school-based mental health services (SBMHSs), particularly in low-resource settings. This study elicited the views of diverse stakeholders in two urban settings in India about their priorities and preferences for SBMHSs.Methods.We completed semi-structured interviews and focus group discussions with adolescents (n  =  191), parents (n  =  9), teachers (n  =  78), school counsellors (n  =  15), clinical psychologists/psychiatrists (n  =  7) in two urban sites in India (Delhi and Goa). Qualitative data were obtained on prioritized outcomes, preferred content and delivery methods, and indicated barriers.Results.All stakeholders indicated the need for and acceptability of SBMHSs. Adolescents prioritized resolution of life problems and exhibited a preference for practical guidance. Parents and teachers emphasized functional outcomes and preferred to be involved in interventions. In contrast, adolescents' favored limited involvement from parents and teachers, was related to widespread concerns about confidentiality. Face-to-face counselling was deemed to be the most acceptable delivery format; self-help was less frequently endorsed but was relatively more acceptable if blended with guidance or delivered using digital technology. Structured sensitization was recommended to promote adolescent's engagement. Providers endorsed a stepped care approach to address different levels of mental health need among adolescents.Conclusion.SBMHSs are desired by adolescents and adult stakeholders in this setting where few such services exist. Sensitization activities are required to support implementation. School counsellors have an important role in identifying and treating adolescents with different levels of mental health needs, and a suite of interventions is needed to target these needs effectively and efficiently.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.16
      Issue No: Vol. 6 (2019)
       
  • Recovering from the Ebola crisis: ‘Social Reconnection Groups’ in a
           rural Liberian community

    • Authors: M. Morelli; G. Cyrus, I. Weissbecker, J. Kpangbai, M. Mallow, A. Leichner, E. Ryan, R. Wener, J. Gao, J. Antigua, A. C. Levine, F. Feuchte
      Abstract: In 2014/2015, International Medical Corps (IMC) operated two Ebola Treatment Units (ETUs) in Liberia and three in Sierra Leone when the Ebola virus disease epidemic killed over 11,000 people across Liberia, Sierra Leone and Guinea. As Ebola cases declined in Liberia, IMC Psychosocial teams transitioned to working in communities highly affected by the epidemic. This article describes IMC's experience with developing and implementing a community-based mental health and psychosocial group intervention in a rural, severely affected Liberian town – Mawah – where 46 out of approximately 800 community members were infected, 39 of whom died. In this paper, we present how the group intervention, named ‘Social Reconnection Groups’, was developed and implemented. We then discuss intervention strengths, challenges, key lessons learnt and recommendations for how Social Reconnection Groups can be adapted for use in similar settings.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.13
      Issue No: Vol. 6 (2019)
       
  • Positioning for success: building capacity in academic competencies for
           early-career researchers in sub-Saharan Africa

    • Authors: C. Merritt; H. Jack, W. Mangezi, D. Chibanda, M. Abas
      Abstract: Background.Capacity building is essential in low- and middle-income countries (LMICs) to address the gap in skills to conduct and implement research. Capacity building must not only include scientific and technical knowledge, but also broader competencies, such as writing, disseminating research and achieving work–life balance. These skills are thought to promote long-term career success for researchers in high-income countries (HICs) but the availability of such training is limited in LMICs.Methods.This paper presents the contextualisation and implementation of the Academic Competencies Series (ACES). ACES is an early-career researcher development programme adapted from a UK university. Through consultation between HIC and LMIC partners, an innovative series of 10 workshops was designed covering themes of self-development, engagement and writing skills. ACES formed part of the African Mental Health Research Initiative (AMARI), a multi-national LMIC-led consortium to recruit, train, support and network early-career mental health researchers from four sub-Saharan African countries.Results.Of the 10 ACES modules, three were HIC-LMIC co-led, four led by HIC facilitators with LMIC training experience and three led by external consultants from HICs. Six workshops were delivered face to face and four by webinar. Course attendance was over 90% and the delivery cost was approximately US$4500 per researcher trained. Challenges of adaptation, attendance and technical issues are described for the first round of workshops.Conclusions.This paper indicates that a skills development series for early-career researchers can be contextualised and implemented in LMIC settings, and is feasible for co-delivery with local partners at relatively low cost.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.14
      Issue No: Vol. 6 (2019)
       
  • What should global mental health do about violent extremism'

    • Authors: S. Weine; S. Kansal
      Abstract: To prevent radicalization to violence and to rehabilitate returned foreign terrorist fighters, new programs which go by the name of ‘preventing and countering violent extremism’ are being implemented globally, including in low- and middle-income countries. In some of these countries, global mental health strategies are also being implemented so as to deliver mental health care or psychosocial support to individuals and populations in need. This commentary addresses what global mental health should considering doing about violent extremism. Global mental health should be open to addressing the challenges of violent extremism but should do so based upon existing mental health and public health values, practices, and evidence. Global mental health could help by critically appraising preventing and countering violent extremism practices and by working with multidisciplinary stakeholders to develop new evidence-based and best practice models that are rooted in civil society ownership, community collaboration, broader prevention programing, and non-securitized approaches.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.12
      Issue No: Vol. 6 (2019)
       
  • Effectiveness of non-medical health worker-led counselling on
           psychological distress: a randomized controlled trial in rural Nepal

    • Authors: N. Markkula; V. Lehti, P. Adhikari, S. Peña, J. Heliste, E. Mikkonen, M. Rautanen, E. Salama, B. Guragain
      Abstract: Background.An essential strategy to increase coverage of psychosocial treatments globally is task shifting to non-medical counsellors, but evidence on its effectiveness is still scarce. This study evaluates the effectiveness of lay psychosocial counselling among persons with psychological distress in a primary health care setting in rural Nepal.Methods.A parallel randomized controlled trial in Dang, rural Nepal (NCT03544450). Persons aged 16 and older attending primary care and with a General Health Questionnaire (GHQ-12) score of 6 or more were randomized (1:1) to receive either non-medical psychosocial counselling (PSY) or enhanced usual care (EUC). PSY was provided by lay persons with a 6-month training and consisted of 5-weekly counselling sessions of 35–60 min with a culturally adapted solution-focused approach. EUC was provided by trained primary health workers. Participants were followed up at 1 (T1) and 6 months (T2). The primary outcome, response to treatment, was the reduction of minimum 50% in the Beck Depression Inventory (BDI) score.Results.A total of 141 participants, predominantly socially disadvantaged women, were randomized to receive PSY and 146 to EUC. In the PSY, 123 participants and 134 in the EUC were analysed. In PSY, 101 participants (81.4%) had a response compared with 57 participants (42.5%) in EUC [percentage difference 39.4% (95% CI 28.4–50.4)]. The difference in BDI scores at T2 between PSY and EUC was −7.43 (95% CI −9.71 to −5.14).Conclusions.Non-medical (lay) psychosocial counselling appears effective in reducing depressive symptoms, and its inclusion in mental health care should be considered in low-resource settings.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.15
      Issue No: Vol. 6 (2019)
       
  • A systematic review of tools used to screen and assess for externalising
           behaviour symptoms in low and middle income settings

    • Authors: B. Nezafat Maldonado; J. Chandna, M. Gladstone
      Abstract: Background.Mental health issues, often manifested as behavioural difficulties, in children are estimated to be high in low and middle-income countries (LMIC) settings. There is a paucity of definitive data due to a lack of well-validated tools to use across settings. This review aims to provide evidence on what tools are used and which have been adapted and validated in LMIC settings.Methods.We performed a systematic review to identify tools used to assess or screen externalising behaviour problems in children and adolescents in LMIC and assess their cultural adaptations. We searched for studies measuring externalising behaviour in children from 0 to 19 years published up to September 2018. Articles were assessed to identify tools used and analysed using the Ecological Validity Framework.Results.We identified 82 articles from over 50 LMICs who had studied externalising behaviour in children. Twenty-seven tools were identified, with a predominance of studies using tools from the USA and Europe. Most studies did not describe an adaptation and evaluation process, with only one study following recommended criteria. New tools were identified which both screen and assess externalising behaviour which have not yet been utilised across settings.Conclusions.Although tools from the USA and Europe are often utilised to screen and assess for externalising behaviour problems in children in LMICs, the conceptual frameworks behind the use of these tools in other cultural contexts are not always carefully examined. In order to have valid data across cultures, we should aim to adapt and validate tools before use. Provision of processes to validate tools across LMIC settings would be beneficial.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.11
      Issue No: Vol. 6 (2019)
       
  • The myth of the 1-day training: the effectiveness of psychosocial support
           capacity-building during the Ebola outbreak in West Africa – ADDENDUM

    • Authors: Rebecca Horn; Fiona O'May, Rebecca Esliker, Wilfred Gwaikolo, Lise Woensdregt, Leontien Ruttenberg, Alastair Ager
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.10
      Issue No: Vol. 6 (2019)
       
  • Methodological approaches to situational analysis in global mental health:
           a scoping review

    • Authors: J. K. Murphy; E. E. Michalak, H. Colquhoun, C. Woo, C. H. Ng, S. V. Parikh, L. Culpepper, C. S. Dewa, A. J. Greenshaw, Y. He, S. H. Kennedy, X.-M. Li, T. Liu, C. N. Soares, Z. Wang, Y. Xu, J. Chen, R. W. Lam
      Abstract: Global inequity in access to and availability of essential mental health services is well recognized. The mental health treatment gap is approximately 50% in all countries, with up to 90% of people in the lowest-income countries lacking access to required mental health services. Increased investment in global mental health (GMH) has increased innovation in mental health service delivery in LMICs. Situational analyses in areas where mental health services and systems are poorly developed and resourced are essential when planning for research and implementation, however, little guidance is available to inform methodological approaches to conducting these types of studies. This scoping review provides an analysis of methodological approaches to situational analysis in GMH, including an assessment of the extent to which situational analyses include equity in study designs. It is intended as a resource that identifies current gaps and areas for future development in GMH. Formative research, including situational analysis, is an essential first step in conducting robust implementation research, an essential area of study in GMH that will help to promote improved availability of, access to and reach of mental health services for people living with mental illness in low- and middle-income countries (LMICs). While strong leadership in this field exists, there remain significant opportunities for enhanced research representing different LMICs and regions.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.9
      Issue No: Vol. 6 (2019)
       
  • Adapting culturally appropriate mental health screening tools for use
           among conflict-affected and other vulnerable adolescents in Nigeria

    • Authors: B. N. Kaiser; C. Ticao, C. Anoje, J. Minto, J. Boglosa, B. A. Kohrt
      Abstract: BackgroundThe Boko Haram insurgency has brought turmoil and instability to Nigeria, generating a large number of internally displaced people and adding to the country's 17.5 million orphans and vulnerable children. Recently, steps have been taken to improve the mental healthcare infrastructure in Nigeria, including revamping national policies and initiating training of primary care providers in mental healthcare. In order for these efforts to succeed, they require means for community-based detection and linkage to care. A major gap preventing such efforts is the shortage of culturally appropriate, valid screening tools for identifying emotional and behavioral disorders among adolescents. In particular, studies have not conducted simultaneous validation of screening tools in multiple languages, to support screening and detection efforts in linguistically diverse populations. We aim to culturally adapt screening tools for emotional and behavioral disorders for use among adolescents in Nigeria, in order to facilitate future validation studies.MethodsWe used a rigorous mixed-method process to culturally adapt the Depression Self Rating Scale, Child PTSD Symptom Scale, and Disruptive Behavior Disorders Rating Scale. We employed expert translations, focus group discussions (N = 24), and piloting with cognitive interviewing (N = 24) to achieve semantic, content, technical, and criterion equivalence of screening tool items.ResultsWe identified and adapted items that were conceptually difficult for adolescents to understand, conceptually non-equivalent across languages, considered unacceptable to discuss, or stigmatizing. Findings regarding problematic items largely align with existing literature regarding cross-cultural adaptation.ConclusionsCulturally adapting screening tools represents a vital first step toward improving community case detection.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.8
      Issue No: Vol. 6 (2019)
       
  • East African HIV care: depression and HIV outcomes

    • Authors: S. M. Meffert; T. C. Neylan, C. E. McCulloch, L. Maganga, Y. Adamu, F. Kiweewa, J. Maswai, J. Owuoth, C. S. Polyak, J. A. Ake, V. G. Valcour
      Abstract: Importance.Depression is a common co-morbidity for people living with HIV (PLWH) and is associated with elevated plasma HIV RNA levels. While depression correlates with deficits in antiretroviral (ARV) adherence, little data exist to inform the relationship between depression and HIV vial load more broadly.Objective.To examine the relationship between depression and viral load in the African Cohort Study (AFRICOS) independently of ARV adherence.Design.PLWH in Kenya, Uganda and Tanzania underwent screening for depression using the Center for Epidemiologic Studies Depression Scale (CESD) upon enrollment at AFRICOS HIV care sites.Setting.AFRICOS is an ongoing prospective longitudinal cohort study enrolling HIV-infected adults at HIV care centers including sites in Kenya, Tanzania and Uganda. These sites are administered by President's Emergency Plan For AIDS Relief programs.Participants.HIV+ individuals were eligible if they were at least 18 years old, receiving HIV care at the enrolling clinic and consented to data and specimen collection.Main outcome measure.CESD.Results.Among 2307 participants, 18–25% met the CESD threshold for depression. Depression was associated with decreased ARV adherence (OR 0.59, p =  0.01). Higher scores on three CESD items were significantly associated with 209–282% higher viral load, independently of ARV adherence among participants on ARVs ⩾6 months.Conclusions.PLWH had high prevalence of depression on the CESD. Diverse depression symptoms were independently associated with increases in viral load, underscoring the need for comprehensive treatment of depression.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.6
      Issue No: Vol. 6 (2019)
       
  • Mapping global Muslim mental health research: analysis of trends in the
           English literature from 2000 to 2015

    • Authors: H. H. Altalib; K. Elzamzamy, M. Fattah, S. S. Ali, R. Awaad
      Abstract: Background.By 2030, the global Muslim population is expected to reach 2.2 billion people. The representations of Islam and Muslims in the media and academic literature may unconsciously impact how clinicians perceive and approach their Muslim patients. Our study focuses on the emerging Muslim mental health (MMH) literature using bibliometric analysis, specifically social network analysis of word co-occurrence and co-authorship networks of academic publications, to describe how the content of MMH discourse is evolving.Methods.We conducted an Ovid search (including Medline and PsycInfo databases) to identify articles written in English from 2000 to 2015 that had the terms ‘Islam’ and/or ‘Muslim’ in the abstract as well as research conducted in Muslim-majority countries and among Muslim minorities in the rest of the world.Results.Of the 2652 articles on MMH, the majority (65.6%) focused on describing psychopathology; the minority (11.2%) focused on issues around stigma, religiosity, spirituality, identity, or acculturation. Among the top 15 most frequent terms in abstracts were ‘post-traumatic stress disorder’, ‘violence’, ‘fear’, ‘trauma’, and ‘war’. Social network analysis showed there was little collaborative work across regions.Conclusions.The challenges of producing MMH research are similar to the challenges faced across global mental health research. Much of the MMH research reflects regional challenges such as the impact of conflict and violence on mental health. Continued efforts to develop global mental health researchers through cross-cultural exchanges, academic journals' dedicated sections and programs for global mental health recruitment, and online training are needed to address the gap in research and collaborations.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.3
      Issue No: Vol. 6 (2019)
       
  • Using technology to scale-up training and supervision of community health
           workers in the psychosocial management of perinatal depression: a
           non-inferiority, randomized controlled trial

    • Authors: Atif Rahman; Parveen Akhtar, Syed Usman Hamdani, Najia Atif, Huma Nazir, Iftikhar Uddin, Anum Nisar, Zille Huma, Joanna Maselko, Siham Sikander, Shamsa Zafar
      Abstract: Background.The Thinking Healthy Programme (THP) is an evidence-based psychological intervention endorsed by the World Health Organization, tailored for non-specialist health workers in low- and middle-income countries. However, training and supervision of large numbers of health workers is a major challenge for the scale-up of THP. We developed a ‘Technology-Assisted Cascaded Training and Supervision system’ (TACTS) for THP consisting of a training application and cascaded supervision delivered from a distance.Methods.A single-blind, non-inferiority, randomized controlled trial was conducted in District Swat, a post-conflict area of North Pakistan. Eighty community health workers (called Lady Health Workers or LHWs) were randomly assigned to either TACTS or conventional face-to-face training and supervision by a specialist. Competence of LHWs in delivering THP post-training was assessed by independent observers rating a therapeutic session using a standardized measure, the ‘Enhancing Assessment of Common Therapeutic factors’ (ENACT), immediately post-training and after 3 months. ENACT uses a Likert scale to score an observed interaction on 18 dimensions, with a total score of 54, and a higher score indicating greater competence.Results.Results indicated no significant differences between health workers trained using TACTS and supervised from distance v. those trained and supervised by a specialist face-to-face (mean ENACT score M  =  24.97, s.d.  =  5.95 v. M =  27.27, s.d.  =  5.60, p  =  0.079, 95% CI 4.87–0.27) and at 3 months follow-up assessment (M  =  44.48, s.d.  =  3.97 v. M =  43.63, s.d.  =  6.34, p  =  0.53, CI −1.88 to 3.59).Conclusions.TACTS can provide a promising tool for training and supervision of front-line workers in areas where there is a shortage of specialist trainers and supervisors.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.7
      Issue No: Vol. 6 (2019)
       
  • The myth of the 1-day training: the effectiveness of psychosocial support
           capacity-building during the Ebola outbreak in West Africa

    • Authors: Rebecca Horn; Fiona O'May, Rebecca Esliker, Wilfred Gwaikolo, Lise Woensdregt, Leontien Ruttenberg, Alastair Ager
      Abstract: Background.In emergencies and resource-poor settings, non-specialists are increasingly being trained to provide psychosocial support to people in distress, with Psychological First Aid (PFA) one of the most widely-used approaches. This paper considers the effectiveness of short training programmes to equip volunteers to provide psychosocial support in emergencies, focusing particularly on whether the PFA training provided during the Ebola outbreak enabled non-specialists to incorporate the key principles into their practice.Methods.Semi-structured interviews were conducted in Sierra Leone and Liberia with 24 PFA trainers; 36 individuals who participated in PFA training; and 12 key informants involved in planning and implementing the PFA roll-out.Results.Findings indicate that many PFA training-of-trainers were short and rarely included content designed to develop training skills. As a result, the PFA training delivered was of variable quality. PFA providers had a good understanding of active listening, but responses to a person in distress were less consistent with the guidance in the PFA training or with the principles of effective interventions outlined by Hobfoll et al.Conclusions.There are advantages to training non-specialists to provide psychosocial support during emergencies, and PFA has all the elements of an effective approach. However, the very short training programmes which have been used to train non-specialists in PFA might be appropriate for participants who already bring a set of relevant skills to the training, but for others it is insufficient. Government/NGO standardisation of PFA training and integration in national emergency response structures and systems could strengthen in-country capacity.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.2
      Issue No: Vol. 6 (2019)
       
  • The integration of idioms of distress into mental health assessments and
           interventions: a systematic review

    • Authors: C. Cork; B. N. Kaiser, R. G. White
      Abstract: Background.Psychiatric diagnostic manuals recognise the importance of local expressions of distress in culturally diverse settings [i.e. idioms/cultural concepts of distress (CCDs)], yet there is a lack of consensus on how these should be incorporated into mental health related research.Aims.To perform a narrative synthesis and critical review of research exploring how idioms/CCDs have been integrated into assessment measures and interventions.Method.A systematic review was conducted in accordance with PRISMA guidelines. An adapted version of the COSMIN checklist was used to assess the quality of the linguistic translation of the idioms/CCDs.Results.Twenty-nine papers were included in the final review. Primary qualitative research was the most common method of gathering information about idioms/CCDs. The majority of studies described integrating idioms/CCDs into assessment measures as opposed to interventions. Some studies used information relating to idioms/CCDs to develop novel assessment measures, while others adapted pre-existing assessment measures. The measures generated moderate to high levels of validity. Information relating to the linguistic translation conducted in the completion of the studies tended to be inadequately reported.Conclusions.Integrating information about idioms/CCDs into assessment measures can enhance the validity of these assessments. Allocating greater research attention to idioms/CCDs can also promote more equitable exchanges of knowledge about mental health and wellbeing between the Global North and the Global South.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.5
      Issue No: Vol. 6 (2019)
       
  • Scaling-up psychological interventions in resource-poor settings: training
           and supervising peer volunteers to deliver the ‘Thinking Healthy
           Programme’ for perinatal depression in rural Pakistan

    • Authors: N. Atif; A. Nisar, A. Bibi, S. Khan, S. Zulfiqar, I. Ahmad, S. Sikander, A. Rahman
      Abstract: BackgroundThere is a scarcity of specialist trainers and supervisors for psychosocial interventions in low- and middle-income countries. A cascaded model of training and supervision was developed to sustain delivery of an evidence-based peer-delivered intervention for perinatal depression (the Thinking Healthy Programme) in rural Pakistan. The study aimed to evaluate the model.MethodsMixed methods were employed as part of a randomised controlled trial of the intervention. Quantitative data consisted of the peers' competencies assessed during field training and over the implementation phase of the intervention, using a specially developed checklist. Qualitative data were collected from peers and their trainers through 11 focus groups during the second and third year of intervention rollout.ResultsFollowing training, 43 peers out of 45 (95%) achieved at least a ‘satisfactory’ level of competency (scores of ⩾70% on the Quality and Competency Checklist). Of the cohort of 45 peers initially recruited 34 (75%) were retained over 3 years and showed sustained or improved competencies over time. Qualitatively, the key factors contributing to peers' competency were use of interactive training and supervision techniques, the trainer–peer relationship, and their cultural similarity. The partnership with community health workers and use of primary health care facilities for training and supervision gave credibility to the peers in the community.ConclusionThe study demonstrates that lay-workers such as peers can be trained and supervised to deliver a psychological intervention using a cascaded model, thus addressing the barrier of scarcity of specialist trainers and supervisors.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.4
      Issue No: Vol. 6 (2019)
       
  • Playing to live: outcome evaluation of a community-based psychosocial
           expressive arts program for children during the Liberian Ebola epidemic

    • Authors: C. A Decosimo; J. Hanson, M. Quinn, P. Badu, E. G. Smith
      Abstract: Background.This paper reviews the efficacy of a community psychosocial arts program focused on building mental health capacity within post-Ebola Liberia. The aim of this paper was to evaluate the outcome effects of two groups using pre- and post-treatment data. We hypothesized that there would be a difference in symptoms pre- and post-treatment, and the longer program would yield more significant results.Methods.There was a total of 870 child participants. Of 40 sites, 24 were selected for a 5-month treatment (TG1) while the remaining 16 sites received 3 months of treatment (TG2). Paired t tests and a mixed-model analysis of variance (ANOVA) were used to analyse pre- and post-psychological stress symptoms (PSS) for samples from both groups.Results.Separately, treatment group 1 (TG1) and treatment group 2's (TG2) paired t test yielded significant results (p < 0.001) for the decrease of PSS. The mixed-model ANOVA found that there were significant differences in total pre- and post-test PSS and a significant difference in PSS means over time.Conclusions.Results indicated that there was a statistically significant decrease in reported symptoms in both treatment groups pre- to post-intervention and a significant difference in total symptoms over time. However, the findings do not indicate that the longer programming was statistically different compared to the shorter programming. The study presented had gaps in data, largely due to limits in research during the crisis. However, this paper provides a unique case study for challenges that can be faced for project evaluation in emergency settings.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2019.1
      Issue No: Vol. 6 (2019)
       
  • Digital depression screening in HIV primary care in South Africa: mood in
           retroviral + application monitoring [MIR + IAM]

    • Authors: R. V Passchier; S. E Owens, M. N Wickremsinhe, N. Bismilla, I. D Ebuenyi
      Abstract: Background.Integrating mental health care into HIV services is critical to addressing the high unmet treatment needs for people living with HIV and comorbid major depressive disorder. Introducing routine mental health screening at the primary health care level is a much needed diagonal approach to enhancing HIV care. In low-resource settings with a shortage of mental health care providers, eMental Health may provide a novel opportunity to attenuate this treatment gap and strengthen the health system.Objective.To conduct formative health systems research on the implementation of routine depression screening using a digital tool – Mood in Retroviral Positive Individuals Application Monitoring (MIR  +  IAM) – in an HIV primary care setting in South Africa.Methods.A Theory of Change (ToC) approach was utilised through individual and group session interviews to design an intervention that is embedded in the local context. Ten experts and local stakeholders were selected from the UK and South Africa. Data were analysed thematically using Atlas.ti to identify interventions, assumptions, barriers and facilitators of implementation.Findings.The participants considered digital depression screening in HIV care services relevant for the improvement of mental health in this population. The six main themes identified from the ToC process were: (1) user experience including acceptability by patients, issues of patient privacy and digital literacy, and the need for a patient-centred tool; (2) benefits of the digital tool for data collection and health promotion; (3) availability of treatment after diagnosis; (4) human and physical resource capacity of primary health care; (5) training for lay health care workers; and (6) demonstration of the intervention's usefulness to generate interest from decision-makers.Conclusion.Digital depression screening coupled with routine mental health data collection and analysis in HIV care is an applicable service that could improve the mental and physical health outcomes of this population. Careful consideration of the local health system capacity, including both workers and patients, is required. Future research to refine this intervention should focus on service users, government stakeholders and funders.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2018.35
      Issue No: Vol. 6 (2019)
       
  • ‘Hiding their troubles’: a qualitative exploration of suicide in
           Bhutanese refugees in the USA

    • Authors: F. L. Brown; T. Mishra, R. L. Frounfelker, E. Bhargava, B. Gautam, A. Prasai, T. S. Betancourt
      Abstract: Background.Suicide is a major global health concern. Bhutanese refugees resettled in the USA are disproportionately affected by suicide, yet little research has been conducted to identify factors contributing to this vulnerability. This study aims to investigate the issue of suicide of Bhutanese refugee communities via an in-depth qualitative, social-ecological approach.Methods.Focus groups were conducted with 83 Bhutanese refugees (adults and children), to explore the perceived causes, and risk and protective factors for suicide, at individual, family, community, and societal levels. Audio recordings were translated and transcribed, and inductive thematic analysis conducted.Results.Themes identified can be situated across all levels of the social-ecological model. Individual thoughts, feelings, and behaviors are only fully understood when considering past experiences, and stressors at other levels of an individual's social ecology. Shifting dynamics and conflict within the family are pervasive and challenging. Within the community, there is a high prevalence of suicide, yet major barriers to communicating with others about distress and suicidality. At the societal level, difficulties relating to acculturation, citizenship, employment and finances, language, and literacy are influential. Two themes cut across several levels of the ecosystem: loss; and isolation, exclusion, and loneliness.Conclusions.This study extends on existing research and highlights the necessity for future intervention models of suicide to move beyond an individual focus, and consider factors at all levels of refugees’ social-ecology. Simply focusing treatment at the individual level is not sufficient. Researchers and practitioners should strive for community-driven, culturally relevant, socio-ecological approaches for prevention and treatment.
      PubDate: 2019-01-01T00:00:00.000Z
      DOI: 10.1017/gmh.2018.34
      Issue No: Vol. 6 (2019)
       
 
 
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