Research Outputs

Now showing 1 - 3 of 3

Metadata only
Health system responsiveness to the mental health needs of Syrian refugees: mixed-methods rapid appraisals in eight host countries in Europe and the Middle East
(F1000 Research Ltd, 2024) Woodward, Aniek; Fuhr, Daniela C.; Barry, Alexandra S.; Balabanova, Dina; Sondorp, Egbert; Dieleman, Marjolein A.; Pratley, Pierre; Schoenberger, Samantha F.; McKee, Martin; Burchert, Sebastian; Knaevelsrud, Christine; Brown, Felicity L.; Steen, Frederik; Spaaij, Julia; Morina, Naser; de Graaff, Anne M.; Sijbrandij, Marit; Cuijpers, Pim; Bryant, Richard; Akhtar, Aemal; Roberts, Bayard; Department of Psychology; İlkkurşun, Zeynep; Acartürk, Ceren; Department of Psychology; ; Graduate School of Social Sciences and Humanities; College of Social Sciences and Humanities;
Background: Syrian refugees have a high burden of mental health symptoms and face challenges in accessing mental health and psychosocial support (MHPSS). This study assesses health system responsiveness (HSR) to the MHPSS needs of Syrian refugees, comparing countries in Europe and the Middle East to inform recommendations for strengthening MHPSS systems Methods: A mixed-methods rapid appraisal methodology guided by an adapted WHO Health System Framework was used to assess HSR in eight countries (Egypt, Germany, Jordan, Lebanon, Netherlands, Sweden, Switzerland, and Türkiye). Quantitative and qualitative analysis of primary and secondary data was used. Data collection and analysis were performed iteratively by multiple researchers. Country reports were used for comparative analysis and synthesis. Results: We found numerous constraints in HSR: i) Too few appropriate mental health providers and services; ii) Travel-related barriers impeding access to services, widening rural-urban inequalities in the distribution of mental health workers; iii) Cultural, language, and knowledge-related barriers to timely care likely caused by insufficient numbers of culturally sensitive providers, costs of professional interpreters, somatic presentations of distress by Syrian refugees, limited mental health awareness, and stigma associated to mental illness; iv) High out-of-pocket costs for psychological treatment and transportation to services reducing affordability, particularly in middle-income countries; v) Long waiting times for specialist mental health services; vi) Information gaps on the mental health needs of refugees and responsiveness of MHPSS systems in all countries. Six recommendations are provided to address these issues. Conclusions: All eight host countries struggle to provide responsive MHPSS to Syrian refugees. Strengthening the mental health workforce (in terms of quantity, quality, diversity, and distribution) is urgently needed to enable Syrian refugees to receive culturally appropriate and timely care and improve mental health outcomes. Increased financial investment in mental health and improved health information systems are crucial. Copyright: © 2024 Woodward A et al.
Metadata only
Intimate partner violence and HIV treatment adherence in urban South Africa: mediating role of perinatal common mental disorders
(Elsevier, 2022) Hatcher, Abigail M.; Stöckl, Heidi; Woollett, Nataly; García-Moreno, Claudía M.; Christofides, Nicola Joan; N/A; Turan, Janet Molzan; Other; School of Medicine; N/A
Background: Antiretroviral therapy (ART) has potential to eliminate perinatal HIV infections, but adherence to ART in late pregnancy and postpartum is often suboptimal. Intimate partner violence (IPV) may influence non-adherence among perinatal women living with HIV (WWH), but few quantitative studies have examined this over time or explored mechanisms for this association. Methods: We used secondary data from a parent trial in Johannesburg comprising WWH from the control arm (n=63) and WWH ineligible for the trial (n=133). Trained nurse researchers administered questionnaires at first antenatal visit on past-year psychological, physical, and/or sexual IPV (WHO instrument), socio-demographics (age, food security, education), and perinatal common mental symptoms of depression (Hospital Anxiety and Depression Screener-d); anxiety (HADS-a); post-traumatic stress disorder (PTSD; Harvard Trauma Questionnaire). At endline visit 2-4 months postpartum, nurse researchers assessed self-reported ART adherence using a visual analog scale (with ≥95% considered “good”). We fitted structural equation models (SEM) in MPlus to explore direct and indirect effects of IPV on ART adherence. Results: Of 196 perinatal WWH, 53.1% reported IPV exposure at baseline. The majority of participants (85.7%) had good perinatal ART adherence. In adjusted models, IPV at baseline was associated with halved odds of good adherence (aOR=0.51, 95%CI=0.20-0.96). IPV was associated with higher adjusted odds of probable depression (aOR=4.64), anxiety (aOR=2.85), and PTSD (aOR=3.42). In SEM, IPV had a direct (standardized coef=-0.22) and indirect effect (coef=-0.05) on ART via common mental disorders. The total effect of IPV on perinatal adherence was of moderate size (coef= -0.27) and the model had good fit (CFI=0.972; TLI=0.969; RMSEA=0.045; SRMR=0.076). Conclusion: IPV was longitudinally associated with perinatal ART non-adherence in part due to its relationship with mental health symptomology. Addressing IPV within clinical care has potential to improve perinatal mental health, maternal HIV outcomes, and HIV-free infant survival.
Metadata only
Mental health in the mediterranean area
(Bentham Science Publishers, 2020) Carta, Mauro Giovanni; Moussaouiand, Driss; Karam, Elie; Department of Psychology; Eskin, Mehmet; Faculty Member; Department of Psychology; College of Social Sciences and Humanities; 2210
N/A

Research Outputs

Browse

Filters

Advanced Search

Filter by

Settings

Sort By

Results per page

Search Results