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Renwick L, Pedley R, Johnson I, Bell V, Lovell K, Bee P, Brooks H. Mental health literacy in children and adolescents in low- and middle-income countries: a mixed studies systematic review and narrative synthesis. Eur Child Adolesc Psychiatry 2024; 33:961-985. [PMID: 35570227 PMCID: PMC11032284 DOI: 10.1007/s00787-022-01997-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 04/23/2022] [Indexed: 12/12/2022]
Abstract
Mental illnesses are the leading cause of disease burden among children and young people (CYP) globally. Low- and middle-income countries (LMIC) are disproportionately affected. Enhancing mental health literacy (MHL) is one way to combat low levels of help-seeking and effective treatment receipt. We aimed to synthesis evidence about knowledge, beliefs and attitudes of CYP in LMICs about mental illnesses, their treatments and outcomes, evaluating factors that can enhance or impede help-seeking to inform context-specific and developmentally appropriate understandings of MHL. Eight bibliographic databases were searched from inception to July 2020: PsycInfo, EMBASE, Medline (OVID), Scopus, ASSIA (ProQuest), SSCI, SCI (Web of Science) CINAHL PLUS, Social Sciences full text (EBSCO). 58 papers (41 quantitative, 13 qualitative, 4 mixed methods) representing 52 separate studies comprising 36,429 participants with a mean age of 15.3 [10.4-17.4], were appraised and synthesized using narrative synthesis methods. Low levels of recognition and knowledge about mental health problems and illnesses, pervasive levels of stigma and low confidence in professional healthcare services, even when considered a valid treatment option were dominant themes. CYP cited the value of traditional healers and social networks for seeking help. Several important areas were under-researched including the link between specific stigma types and active help-seeking and research is needed to understand more fully the interplay between knowledge, beliefs and attitudes across varied cultural settings. Greater exploration of social networks and the value of collaboration with traditional healers is consistent with promising, yet understudied, areas of community-based MHL interventions combining education and social contact.
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Affiliation(s)
- Laoise Renwick
- Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, School of Health Sciences, University of Manchester, Room 6.304 Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
| | - Rebecca Pedley
- Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, School of Health Sciences, University of Manchester, Room 6.304 Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
| | - Isobel Johnson
- Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, School of Health Sciences, University of Manchester, Room 6.304 Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
| | - Vicky Bell
- Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, School of Health Sciences, University of Manchester, Room 6.304 Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
| | - Karina Lovell
- Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, School of Health Sciences, University of Manchester, Room 6.304 Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
| | - Penny Bee
- Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, School of Health Sciences, University of Manchester, Room 6.304 Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
| | - Helen Brooks
- Division of Nursing, Midwifery and Social Work, Faculty of Medicine, Biology and Health, School of Health Sciences, University of Manchester, Room 6.304 Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
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Koka BE, Deane FP, Lyons GC, Lambert G. General health workers' description of mental health problems and treatment approaches used in Papua New Guinea. Int J Soc Psychiatry 2014; 60:711-9. [PMID: 24351966 DOI: 10.1177/0020764013513441] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Papua New Guinea is a developing country with limited resources for specialist mental health services. Little is known about the mental health and treatment services of Papua New Guinea. AIM The aim of this study was to clarify the presenting mental health problems encountered by Papua New Guinean health workers and the common treatment approaches used. METHODS A total of 203 Papua New Guinean health workers completed a retrospective quantitative survey about their three most recent mental health patients. The survey asked about presenting symptomatology, diagnoses (including culture-bound diagnoses) and treatment approaches. RESULTS The major presenting mental health problems for males included schizophrenia, substance use disorder, sorcery and spirit possession. Depression was the most common diagnoses for women, followed by sorcery and somatisation. Over 65% of patients were prescribed psychotropic medication, over 50% received some form of psychological intervention and 28% were receiving traditional treatments. CONCLUSIONS Somatic symptoms are common among both male and female Papua New Guineans; however, males may be more likely to present with psychotic symptoms and females with mood-related problems. Schizophrenia and depression are commonly identified with substance use disorder more problematic among males. Culture-specific explanations and treatment are commonly used.
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Affiliation(s)
- Betty E Koka
- United Nations Population Fund, Port Moresby, Papua New Guinea
| | - Frank P Deane
- Illawarra Institute for Mental Health, University of Wollongong, Wollongong, NSW, Australia School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Geoffrey Cb Lyons
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Gordon Lambert
- Illawarra Institute for Mental Health, University of Wollongong, Wollongong, NSW, Australia School of Psychology, University of Wollongong, Wollongong, NSW, Australia
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