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EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-312814


Background: Bangladesh, like other low-resource countries, faces a shortage of a trained mental health workforce to meet its population's mental health needs adequately. The ongoing COVID-19 pandemic has further aggravated this. Mental health first aid (MHFA) is an internationally recognized training program that has been operating in Bangladesh since 2015. It offers a potential way to reduce the mental health treatment gap and skills shortage by training laypeople to help support individuals with mental health issues. The present study evaluated the effectiveness of MHFA training in Bangladesh. MethodsAn online modified Delphi study was conducted consisting of two rounds of a self-administered survey and a consensus workshop. A five-step logic framework was used to develop questionnaire statements (n=111) that consisted of 'general,' 'I,' and 'social impact' statements around the seven MHFA aims. The statements were constructed in English and adapted in Bangla. The expert panel consisted of 20 participants trained in the MHFA program. Participants anonymously stated their opinion on 111 round-1 statements and then on 27 low agreement statements in round-2. The consensus workshop facilitated a group discussion where participants explained their views on the low consensus items. ResultsThe consensus ranged from 61.5% (Aim 3: Promote recovery of good mental health) to 100% (Aim 7: To improve own health and well-being) with an overall consensus of 83.8%. 'Social impact' items produced the most (50%) disagreements. Participants' comments reflected 12 themes of MHFA's effectiveness in fostering and promoting mental health individually and socially. There were nine themes of disagreement reflecting individual, sociocultural, and political barriers to the implementation of MHFA in Bangladesh. Participants made recommendations for the MHFA and mental health initiatives in Bangladesh to increase mental health awareness, acceptance, and support in society.ConclusionMHFA training offers Bangladesh and other low-and-middle-income countries a potential solution to tackle mental health burden at individual and societal levels and the additional challenges that the COVID-19 pandemic poses to mental health.

BMJ Open ; 11(7): e045615, 2021 07 02.
Article in English | MEDLINE | ID: covidwho-1455713


INTRODUCTION: The mental health burden and treatment gap in South and Southeast Asia is high and significant. Capacity building of healthcare workers is essential to support programmes related to the detection and management of patients with mental health conditions. We aim to conduct a systematic review to summarise the research on educational, training and capacity-building interventions aimed at the healthcare workforce in detection and management of mental health conditions in South and Southeast Asia. OBJECTIVE: To synthesise evidence on (1) the types of educational and training interventions that have been used to improve the knowledge, skills and attitudes of healthcare workers in South and Southeast Asian countries in the detection and management of mental health conditions; (2) the effectiveness, including cost-effectiveness of the interventions; and (3) the enabling factors and barriers that influence the effectiveness of these interventions. METHODS AND ANALYSIS: This review will be conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. We will search six electronic databases: MEDLINE, EMBASE, PsycINFO, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, and Global Health for empirical studies published from 1 January 2000 to 31 August 2020. Search results from each database will be combined and uploaded in Covidence library. Title, abstract and full-text screening, and data extraction of each included study will be performed by two independent reviewers. Disagreements between reviewers will be resolved by a third reviewer and study team. Quality of included studies will be assessed by the modified Cochrane Collaboration tool and ROBINS-I tool. Data will be synthesised and if a meta-analysis is not appropriate, a stepwise thematic analysis will be performed. ETHICS AND DISSEMINATION: Ethics approval is not required for this study. Findings will be disseminated through peer-reviewed publications, fact sheets, multimedia press briefings, conferences, seminars and symposia. PROSPERO REGISTRATION NUMBER: CRD42020203955.

Mental Disorders , Mental Health , Health Personnel , Humans , Mental Disorders/diagnosis , Mental Disorders/therapy , Meta-Analysis as Topic , Research Design , Systematic Reviews as Topic
J Epidemiol Community Health ; 2021 Apr 30.
Article in English | MEDLINE | ID: covidwho-1209000


BACKGROUND: The COVID-19 pandemic has created a period of global economic uncertainty. Financial strain, personal debt, recent job loss and housing insecurity are important risk factors for the mental health of working-age adults. Community interventions have the potential to attenuate the mental health impact of these stressors. We examined the effectiveness of community interventions for protecting and promoting the mental health of working-age adults in high-income countries during periods of financial insecurity. METHODS: Eight electronic databases were systematically screened for experimental and observational studies published since 2000 measuring the effectiveness of community interventions on mental health outcomes. We included any non-clinical intervention that aimed to address the financial, employment, food or housing insecurity of participants. A review protocol was registered on the PROSPERO database (CRD42019156364) and results are reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: From 2326 studies screened, 15 met our inclusion criteria. Five categories of community intervention were identified: advice services colocated in healthcare settings; link worker social prescribing; telephone debt advice; food insecurity interventions; and active labour market programmes. In general, the evidence for effective and cost-effective community interventions delivered to individuals experiencing financial insecurity was lacking. From the small number of studies without a high risk of bias, there was some evidence that financial insecurity and associated mental health problems were amenable to change and differences by subpopulations were observed. CONCLUSION: There is a need for well-controlled studies and trials to better understand effective ingredients and to identify those interventions warranting wider implementation.