Mental Health: Global Challenges Journal
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The Mental Burden of COVID-19 in Pulmonary Patients: An Investigation of Fear, Anxiety, and Quality of Life
Get PDFIntroduction: The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted various aspects of life, particularly mental health and quality of life.
Purpose: This study aims to assess the levels of anxiety and fear experienced during the coronavirus disease 2019 (COVID-19) pandemic, examine how these factors vary according to sociodemographic and individual characteristics, and explore their impact on the quality of life of individuals attending private pulmonology clinics.
Methodology: A descriptive cross-sectional study was conducted with 112 patients who visited a private pulmonology clinic in Greece during the COVID-19 pandemic. Data were collected via a questionnaire that included six sections, covering demographics, stigma, fear, quality of life, coping strategies, and mental health. Statistical analysis was performed via SPSS 25.
Results: The survey revealed high rates of COVID-19-related stigma, especially for foreigners (50.9%) and health workers (29.5%), with half of the participants believing that people were ill due to irresponsible behaviour. Fear of COVID-19 appears to be significantly high (m = 15.7), with gender (women) being among the determinants of the highest levels of fear. Anxiety occurs at normal levels (m = 5.6), although higher levels of fear have been shown to lead to higher levels of anxiety. Finally, both fear (p = 0.000) and anxiety (p = 0.003) are negatively correlated with most dimensions of quality of life.
Conclusions: The present research highlights the stigma created by COVID-19, especially for specific groups of people. In addition, increased levels of fear and anxiety affect the quality of life of individuals
The Role of Pharmacists in Enhancing Mental Healthcare in South Africa: A Narrative Review
Get PDFIntroduction: Pharmacists have an obligation to comprehend the special requirements of people with mental disorders. Their role in mental healthcare is becoming more important as mental disorders are becoming more common and treatment plans get more complicated. Regretfully, pharmacists frequently fail to provide the best care possible to those with mental disorders.
Purpose: The purpose of this narrative review was to explore the role of pharmacists in enhancing mental healthcare services focusing on the current roles, challenges, and strategies for improvement.
Methodology: English language peer-reviewed articles from Google Scholar and PubMed, as well as guidelines and governmental data were screened and assessed for inclusion. The key terms "mental health," "mental health services," and "pharmacist role" and phrases related to the role of pharmacists in mental healthcare were used to extract the most pertinent literature from the databases. The Boolean operators "AND," "NOT," and "OR" were used alongside the keywords. The search covered literature published between 2010 and 2024.
Results: This review highlights the role that pharmacists play in providing mental healthcare services, emphasising their capacity to monitor and optimise therapy related to psychotropic medications, offer education and counselling, and manage substance use disorders. Although there are advantages to integrating pharmacists into mental healthcare, there are also obstacles, including systemic underutilisation of pharmacists, lack of training and specialisation, poor communication and collaboration, mental health stigma, lack of resources and time constraints.
Conclusion: The role of pharmacists in mental healthcare can be improved by employing strategies such as integrating mental health education into pharmacy curriculum, making use of technology, and implementing successful multidisciplinary approach. Given the increasing demand for mental healthcare services, integrating pharmacists into mental healthcare will be vital in providing comprehensive, patient-centred healthcare that improves the accessibility and quality of mental healthcare services, however, the realisation of this potential will require overcoming the mentioned obstacle
Harvard Medical School Global Mental Health: Trauma and Recovery Course: What is the Global Impact? Three Year’s Results
Get PDFPurpose: 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.
Methodology: Data was collected by self-reported anonymous evaluation by participants of three continuous years of the CME Global Mental Health: Trauma and Recovery certificate training course sponsored by Harvard Medical School. One hundred fifty-five participants (n= 39 in 2011; n = 57 in 2012; n=59 in 2013) underwent a pre- and post-course evaluation to determine sustained confidence in performing medical and psychiatric care to traumatized patients and communities, as well as to determine their learning of the Global Mental Health Action Plan (GMHAP).
Results: Over the course of three independent years, a total of 155 participants were evaluated. There was evidence for significant improvement in their confidence levels in all clinical areas (diagnosis; treatment of trauma; use of psychotropic medication) when comparing baseline to completion of the six-month course. All ten dimensions of the GMHAP and nine medical and psychiatric aspects of treatment revealed significant improvement in confidence levels. Regression analysis also indicated similar results after the adjustment of demographic covariates. Physicians and participants with mental health and social work background had significantly higher confidence. Participants who were MD’s or psychiatrists had higher confidence in most of the categories of confidence except for self-care, understanding culture, collaboration, and policy and financing. The model showed no difference in learning based upon gender and level of development of country of origin.
Conclusion: The evaluation of this blended learning CME program provides evidence of significant enhancement of clinical practice and planning skills in health care practitioners working with highly traumatized patients and communities worldwide. This successful training over the past 18 years has gone far to achieve the health and mental health capacity building as requested by the Ministers of Health from post-conflict societies in the historic Rome meeting in 2004
Well-being of mental health workers during the Russian-Ukrainian War
Get PDFIntroduction: While the detrimental impact of the Russian-Ukrainian War on mental health of Ukrainian population has been well-documented, less attention has been given to mental health workers (MHWs) providing mental health support services amid the war.
Purpose: To examine levels of domain-specific well-being in Ukrainian MHWs; identify and quantify the relative importance of factors associated with well-being; and examine interactions of risk and protective factors in relation to each well-being domain.
Methodology: A convenience sample of 178 MHWs completed a survey that assessed their well-being, and sociodemographic, war-related, mental health, and psychosocial characteristics.
Results: Lower levels of mental health difficulties such as anxiety and posttraumatic stress symptoms, and higher levels of psychosocial factors such as higher optimism, gratitude, and presence and search for meaning were associated with higher well-being. MHWs with high levels of protective psychosocial factors were more likely to report higher well-being even in the presence of mental health difficulties.
Conclusions: Results of this study provide insight into the levels and correlates of multiple well-being domains among Ukrainian MHWs amid the ongoing war. They further suggest that interventions to mitigate mental health difficulties and bolster protective psychosocial factors may help promote well-being in this populatio
From treatment to social reintegration: : principles of medical and psychological support of veterans (on example of the Russian-Ukrainian war)
Get PDFIntroduction: Analyzing numerical data from different countries around the world that have experience of participating in wars and resolving their consequences, it is important to consider the wide range of war effects on all spheres of society. This influence is discussed in the context of economic, political, state-building, demographic, and other spheres. Special attention is given to analyzing the consequences of this impact on individuals returning from war. These consequences are diverse and include physical and psychological problems, job loss, social exclusion, and other challenges that require an integrated approach to effectively address them.
Purpose: To analyze the main principles of medical and psychological rehabilitation of combat veterans, having conducted a comprehensive analysis of their links and constituent elements, and to consider possible ways of their implementation.
Methodology: We conducted a systematic search in the main electronic medical databases such as: PubMed, Scopus, Web of Science and Google Scholar until January 2024. We used theoretical methods such as systematic, bibliosemantic and retrospective, comparative analysis and generalization of the publication data of the conducted studies that considered links, components, principles and possible ways of their implementation in the field of medical and psychological rehabilitation of combat veterans. Relevant studies were identified by key words: war or combat veterans, rehabilitation, reintegration, psychoeducation, hub.
Results: The research revealed complex challenges in the system of medical and psychological rehabilitation of military veterans, including post-traumatic stress disorder, physical injuries, social isolation and limited resources. The analysis identified key principles important to the planning and implementation of rehabilitation programs, including individualization, comprehensiveness, accessibility, and integration. The results highlighted the importance of a systems approach and collaboration between various parties concerned for the effective implementation of the veterans’ rehabilitation system. The study suggests specific ways of the identified principles implementation. Understanding the modality of the medical and psychological rehabilitation system is a key aspect in improving the quality of rehabilitation and providing adequate support to veterans. In order to achieve these goals, a hierarchy of therapeutic goals was created determining the modalities of the medical and psychological rehabilitation system.
Conclusion: Effective medical and psychological rehabilitation for combat veterans should be based on the systematic organization of care, recognizing the importance of each component in ensuring coordination, efficiency and quality of services. Establishing clear therapeutic goals forms the basis for comprehensive psychological support, contributing to veterans’ self-esteem, mental health, and social integration, ultimately enhancing their overall well-being and quality of life
The Psychometric Properties of the Environmental Worry Index
Get PDFIntroduction: Environmental-related hazards are a global problem; consequently, an Environmental Worry Index (EWI) was developed; however, the psychometric properties of this scale in the Spanish population are unavailable. Purpose: The objective of this study was to adapt and examine the psychometric properties of an Environmental Worry Inventory (EWI) in a Spanish-speaking student population.Methodology: This study adopted a cross-sectional design. It used a snowball sampling technique to collect data using the compact questionnaire comprise of EWI, Climate Anxiety Scale (CAS), and Big Five Inventory (BFI-15) from 251 participants in 2023 among students of Autonomous University of Ciudad Juárez (UACJ), Juárez, Mexico.Results: Results of exploratory factor analysis (EFA), the Kaiser-Meyer-Olkin (KMO=0.891) and Bartlett's Test of Sphericity (p < 0.001) showed adequate data. Confirmatory factor analysis (CFA; ?2 (5) = 78,595, CFI = 0.94, and RMSEA=0.078) demonstrated adequate goodness of fit. EWI was associated with CAS, and neuroticism dimension of BFI-15. It has an acceptable overall Cronbach Alpha coefficient (? = 0.890); the two subscale factors’ reliability coefficients ranged from .80 to .89. Conclusion: The study concluded that EWI is reliable, valid and recommended for use among Mexicans especially the Spanish speaking students
Virtual Reality Exposure Therapy Protocol for Post-Traumatic Stress Disorder Treatment in Military Veterans: Cross-Cultural Adaptation of Virtual Exposure Therapy in Ukraine
Get PDFIntroduction. The integration of virtual reality technologies into PTSD treatment in Ukraine presents new opportunities for enhancing the mental health of military personnel, veterans, and individuals affected by war-related trauma. During military operations, soldiers often experience intense stress, anxiety, and intrusive memories, which can lead to PTSD. VR therapy uses fully and partially immersive technologies to create a safe virtual environment where patients can explore and process traumatic experiences under the guidance of a qualified specialist.
The use of VR technologies for PTSD treatment during the ongoing conflict in Ukraine may become a crucial tool for addressing and healing trauma in both military personnel and civilians. This method provides a structured setting that fosters emotional processing and therapeutic engagement, aiming to alleviate psychological burdens and improve mental health outcomes.
Purpose: To conduct a cross-cultural adaptation of the physiologically facilitated Virtual Reality Exposure Therapy (VRET) protocol with gradually increasing exposure, develop a Ukrainian version of the protocol tailored to the specific needs of Ukrainian PTSD patients, create VR technology and content that reflect the unique aspects of the Ukrainian war experience, and pilot test this protocol with a focus group of Ukrainian war veterans diagnosed with PTSD and carrying war-related traumatic memories.
Methodology: For the cross-cultural adaptation of the Virtual Reality Exposure Therapy (VRET) protocol, a physiologically facilitated version with gradually increasing exposure was selected. This protocol was translated by two independent translators, followed by synthesis into a single version, back-translation, analysis, and final approval by a working group. The finalized Ukrainian version was prepared for field studies with a focus group of Ukrainian war veterans (n=50). All veterans underwent diagnostic assessments both before and after the VRET intervention, using the following standardized scales: the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) for PTSD evaluation, the Generalized Anxiety Disorder 7-item (GAD-7) scale for anxiety disorders, the Patient Health Questionnaire-9 (PHQ-9) for depression, the Columbia-Suicide Severity Rating Scale (C-SSRS) for suicidal intentions, the Short Form Survey (SF-36) for quality of life, and the Alcohol Use Disorders Identification Test (AUDIT) for alcohol dependence.
A series of VR scenarios were developed specifically to address the needs of Ukrainian war PTSD patients, designed to trigger common PTSD responses. A unique administrative panel was also created for therapists to adjust the presence and intensity of various triggers in real time, allowing for personalized tuning of the VR experience throughout the session.
Results: Over a 6-month period, 50 Ukrainian war veterans participated in the study to assess the effectiveness of the adapted Ukrainian version of the VRET protocol for PTSD treatment. Comparison of baseline and post-intervention assessments showed significant improvements in clinical outcomes, including reductions in PTSD symptoms, anxiety, depression, and an overall improvement in quality of life.
Conclusions: The cross-cultural adaptation and testing of the Virtual Reality Exposure Therapy protocol with a focus group of Ukrainian veterans with PTSD demonstrated reductions in PTSD symptoms, anxiety, and depression, alongside improvements in quality of life. Virtual reality allowed veterans to safely re-experience traumatic events under professional supervision, with gradually increased realism, enhancing the therapy's effectiveness. This method also reduces stigma by offering a confidential setting for therapist interaction, showing substantial promise in helping veterans manage their mental health more effectivel
Will Including Health at COP28 Mean Transformation of Global Mental Health Action? And will Mental Health Professionals transform to help achieve it? Research Note
Get PDFIntroduction: For the first time COP28 have included Public Health in their climate change discussions. Given progress on climate change has many hurdles, from domestic, economic and corporate pressures, it is pertinent to explore what impact this inclusion might have and what specific challenges there might be in relation to global mental health.Purpose: This positioning paper considers whether the implication of the inclusion of Health at COP28 might bring about transformation in the way Global Mental Health is addressed. It also considers how it might transform how mental health professionals, but also all others involved in working with people with mental health issues, transform mental health. The paper considers challenges to be faced going forward and potential solutions. The author acknowledges they are sharing their position on this subject, but in doing so, hopes to generate wider discussion.Methodology: As this is a positioning paper, data has been derived from the argument and counter argument within the paper. Therefore, there is a possibility of the risk of bias. Results: Plans to improve mental health globally have focused on replicating a Western, Global North model. Despite over 10 years of the WHO Mental Health Action Plan, there continues to be a growing mental health pandemic, worsened by Covid-19. Mental ill- health is caused by multiple factors, many are national, regional and even localized. The Western Global North model does not factor this in sufficiently to bring about improvement.Conclusion: This paper evaluated whether by including ‘Health’ at the recent COP28, it would help transform Global Mental Health. What became clear, after reviewing previous policies and action plans, was that significant change and improvement had not occurred. Policy makers and professionals approach needs to focus on preventing mental ill-health rather than treating after the event. Additionally, decolonisation of policies and professionals education is required to co-create sustainable resilience with people/communities and reduce mental ill-health
“Best Before”: On Women, Ageism, and Mental Health
Get PDFIntroduction: Our world has changed over the last decades, and one of the dramatic changes has been the increase in human life expectancy. Due to important life-saving breakthroughs, the current life expectancy for the world in 2024 is 73.33 years; and female global life expectancy is 76.0 years. This trend manifests one of the greatest achievements of human society, which, however, reveals issues that humanity has yet to address. One of them is the place and role of women over 40 in modern society.
Purpose: This paper aims to unveil gendered ageism and to identify its negative impact on women’s mental health.
Methodology: We conducted a systematic search in the main electronic databases, such as PubMed, Scopus, Web of Science, and Google Scholar. Relevant studies were identified using search terms: women over 40, aging, gendered ageism, mental health, wellbeing, beauty standards, youthfulness, age stereotypes, multiple discrimination, inequity, identity, sexuality, social exclusion, intersectionality. The authors used phenomenological philosophical, hermeneutic, and inductive approaches, as well as the interpretive research paradigm.
Review and Discussion: Constant anxiety about aging, attempts to turn back time, desperate cosmetic battles that women are involved in are far from just a tribute to fashion or female vanity, but also an attempt to come out of the shadows, to overcome the boundaries of female limited space, and to make a woman visible. However, women’s grand entrance onto the big stage faces gendered ageism that forces women over 40 feel excluded in society and life by making them invisible. Despite certain changes in public consciousness over the role of women in society, we still live in a men’s world. The centuries-old subordination of women to men, cultural ideas about the “perfect” female face, body, age, weight, compliance with which is a “pass” to the world of success, or, according to evolutionary psychologists, a “mechanism” that promotes survival, crystallize in various disorders, thereby undermining women’s mental health, downplaying the value of wisdom, knowledge and life experience, and eroding women’s self-esteem.
Conclusion: Aging is a natural and inevitable process, and old age is a significant part of life, which can be filled with joy, achievements of small and big goals, dissemination of accumulated experience and wisdom. Unfortunately, these wonderful aspirations are hindered by ageism – one of the last socially acceptable prejudices. Inducing age stereotypes and perpetuating internalized ageism, our social environment maintains discrimination of women over 40 in workplace, social settings, and private sphere that has detrimental consequences for women’s mental and physical health. Therefore, combating ageism and sexism and eliminating age discrimination is essential to support older women’s health and wellbeing. Both women and men share the responsibility to progress towards true equity that will help women around the world achieve success on their own terms and reach their full potential. Life journey of every woman is a way of self-discovery and self-development, in which the various aspects of a woman’s personality come together to create unique integrity of body, mind, and spirit. To fully realize the potential of half of humanity, it is necessary to dismantle the systems that maintain inequities, as well as to raise up and empower women of all ages, colors, abilities to assert themselves and be respected in both public and private spheres, to accept reality and move on, to feel comfortable and confident in their own skin, to do wonders for everyone on our planet, and to know that every woman matters
Measuring Medication Adherence in Chronic Diseases: The Psychometric Properties of Simplified Medication Adherence Questionnaire in Patients with Chronic Diseases in Rural Greece
Get PDFIntroduction: Medication adherence is one of the most important factors in the effectiveness of treatment, especially for patients with chronic diseases. This study aims to assess the adherence of patients with chronic diseases and investigate the parameters that influence it. It will also examine the psychometric properties of the SMAQ scale, a tool used to assess adherence.
Purpose: The study's main purpose was to assess the psychometric properties of the SMAQ scale, including its reliability and validity, to evaluate the adherence of patients with medication and to analyse the factors that shape it, focusing on the influence of gender, diagnosis, level of education, marital status, and living conditions.
Methodology: The study was based on a sample of patients with chronic diseases, such as cardiovascular diseases, rheumatoid arthritis, and systemic lupus erythematosus. The patient's compliance with medication was assessed using the SMAQ scale. Statistical analysis included chi-square analysis to examine the association between participant characteristics and compliance, while logistic regression analysis was also performed to assess the parameters that predict non-compliance.
Results: The chi-square analysis revealed significant associations between compliance and parameters such as gender, type of disease, level of education, and marital status. Men and patients with cardiovascular diseases showed better compliance. Logistic regression indicates that diagnosis is the most important factor in predicting non-compliance. Regarding the psychometric properties of the SMAQ, the scale showed satisfactory reliability with Cronbach’s Alpha = 0.717 and stability (Intraclass Correlation Coefficient = 0.525). Confirmatory factor analysis (CFA) confirmed the unidimensional structure of the scale, with good fit values ??(CFI, TLI, GFI > 0.9).
Conclusions: The results of the study provide valuable data on the factors that influence the compliance of patients with chronic diseases. The diagnosis appears to be the most important predictor of non-compliance, while the evaluation of the SMAQ scale indicates that it is a reliable and valid tool for measuring compliance. The study highlights the need for strategies that will improve compliance, especially for patients with chronic diseases who may face psychological and social challenges. Limitations of the study include the sample size and the absence of data on other psychological parameters, such as mental health, which should be addressed in future researc