A inclusão de ações de saúde mental junto às equipes de Atenção Primária tem importante relevância se considerada a magnitude epidemiológica dos transtornos mentais e a necessidade de ampliação do acesso aos cuidados em saúde mental na rede SUS. Esta tem sido uma prioridade da Política Nacional de Saúde Mental para Atenção Primária do Ministério da Saúde e muitos municípios brasileiros têm experiências consolidadas neste campo. Entretanto, constata-se que a avaliação das ações de saúde mental na atenção primária no SUS ainda estão voltadas para experiências locais e não há estudos sobre estratégias de avaliação de alcance nacional, de forma a apontar as diretrizes das políticas que orientam este campo e as evidências quantitativas e qualitativas que devem orientar as equipes da rede básica. Este estudo visou construir subsídios para uma política de avaliação e monitoramento das ações de saúde mental na atenção primária, em diálogo com a Reforma Sanitária, Reforma Psiquiátrica e da Atenção Primária. A pesquisa se caracteriza como qualitativa avaliativa, com a utilização de diferentes técnicas para coleta de dados: análise documental, revisão narrativa da literatura e a realização de Painel de Especialistas para construção de consensos sobre indicadores e parâmetros de saúde mental para a atenção primária. A partir da análise de documentos da Política Nacional de Saúde Mental e da Política Nacional de Atenção Primária...

Objectives. We examined correlates and rates of past-year mental health service use in a national sample of Latinos residing in the United States.

Objectives. We examined rates of mental health–related service use (i.e., any, general medical, and specialty mental health services) as well as subjective satisfaction with and perceived helpfulness of care in a national sample of Asian Americans, with a particular focus on immigration-related factors.

Objective. We examined trends in delivery of mental health and substance abuse services at the nation’s community health centers.

Objectives. We examined the extent to which the stress paradigm linking psychosocial stressors to mental health status has focused disproportionate attention on microlevel social stressors to the detriment of macrolevel stressors. Also, we assessed the effects of the terrorist attacks of September 11, 2001, on subsequent mental health among participants in a Midwestern cohort study.

Objectives. We assessed whether an intervention based on acceptance and commitment therapy (ACT) and mindfulness was successful in promoting positive mental health by enhancing psychological flexibility.

Objectives. We sought to describe the prevalence of mental health and illness, the stability of both diagnoses over time, and whether changes in mental health level predicted mental illness in a cohort group.

The social and economic consequences of poor mental health in the developing world are presumed to be significant, yet are largely under-researched. The authors argue that mental health modules can be meaningfully added to multi-purpose household surveys in developing countries, and used to investigate this relationship. Data from nationally representative surveys in Bosnia and Herzegovina, Indonesia, and Mexico, along with special surveys from India and Tonga, show similar patterns of association between mental health and socioeconomic characteristics across countries. Individuals who are older, female, widowed, and report poor physical health are more likely to report worse mental health outcomes. Individuals living with others with poor mental health are also significantly more likely to report worse mental health themselves. In contrast, there is little observed relationship between mental health and poverty or education, common measures of socio-economic status. The results instead suggest that economic and multi-dimensional shocks such as illness or crisis can have a greater impact on mental health than overall levels of poverty. This may have important implications for social protection policy. The authors also find significant associations between poor mental health and lowered labor force participation (especially for women) and higher frequency visits to health centers...

Afghanistan has been in internal and external strife for more than thirty years. Prolonged conflict and civil war have left millions dead, thousands with disabilities and massive internal and external population displacement. The situation has contributed negatively to every aspect of the country and society as the majority of the population has been traumatized by constant conflict, natural disasters, and the difficult Taliban years. There is ample evidence that these calamities have contributed to an increase in mental health problems and has been further complicated by growing level of drug abuse. As Afghanistan rebuilds itself, it is critical to understand the challenges and develop workable solutions. The paucity of high quality data on mental health problems and the lack of qualified human resources have hampered the development of cost-effective strategies and interventions to address the growing challenge of mental health in the country. There are few mental health facilities, and these facilities are scattered across the country with limited capacity and low levels of coverage. In addition, the population continues to face the main stressors with ongoing conflict in various parts of the country. To address mental health issues on a larger scale...

The history and some of the consequences of the growth of the sex industry in Nigeria have been identified and discussed by previous researchers (Little 1973; Caldwell, Caldwell and Orubuloye 1992; Orubuloye, Caldwell and Caldwell 1991, 1994). These authors have contributed immensely to providing fundamental information that may be useful in preventing or at least minimizing the hazardous effects of the sex industry. They stress the vital roles played by the sex workers in transmitting STDs and HIV/AIDS and suggested how the situation can be controlled. There are however, some issues of psychological importance that are yet to be examined. For instance, we are interested in knowing what prompted the interest of the women in the business, the occupational hazards in the sex industry, the coping mechanisms adopted, what is keeping the sex workers on the job in spite of the occupational hazards, their level of satisfaction with the business, and most importantly, the mental health implications of the growth of the sex industry in Nigeria. The present study was an attempt to give a psychological analysis of commercial sex in Nigeria and to appraise the prevalence and level of psychopathological symptoms among sex workers. Findings from this study not only will suggest how to arrest the growth of the sex industry in Nigeria but also may alert the Federal Ministry of Health and other health organizations to the mental health implications of commercial sex.; no

OBJECTIVE: To determine, by the use of a telephone survey, the mental health status of SA adults (18+ years) using the GHQ-28, SF-12 and self-report as indicators of mental health, and to examine risk factors for mental health morbidity. SAMPLE: A random representative sample of South Australian adults selected from the Electronic White Pages. Overall, 2,501 interviews were conducted (74.0% response rate). RESULTS: Overall, 19.5% of respondents had a mental health problem as determined by the GHQ-28, 11.8% as determined by the mental health component summary score of the SF-12 and 11.9% self-reported a mental health condition. The percentage of people with a mental health problem who had used a psychologist or a psychiatrist in the previous 12 months was 9.6% for people diagnosed by the GHQ-28, 16.2% by SF-12 and 23.7% for self-report. The logistic regression analyses undertaken to describe people with a mental health problem as determined by the GHQ-28 and to describe people who visited a psychologist or psychiatrist produced different age categories, demographic and co-morbidity indicators. Variables found in both analyses included living in the metropolitan area, being economically inactive and being a high user of health services. CONCLUSIONS: One in five South Australian adults has a mental problem. Although the prevalence is higher for younger age groups...

Objectives: To determine whether the prevalence of mental health problems among adolescents on court ordered remand in South Australia has changed since 1989. To compare the prevalence of mental health problems reported among adolescents on remand in 1989 and 2008/09 with the prevalence among adolescents in the general community. Method: Mental health problems were identified using the Youth Self-Report (YSR), which was completed by 11-17 year olds on remand in South Australia in 1989 (n=100) and in 2008/09 (n=197), and 13-17 year olds (n=1,283) in the national survey of mental health problems among Australian adolescents conducted in 1998. Results: Although adolescents on remand reported somewhat fewer mental health problems in 2008/09 than were reported in 1989, the prevalence of problems in both groups of adolescents on remand was significantly higher than that reported for adolescents in the general community. Conclusion: Adolescents on remand have a much higher prevalence of mental health problems than other adolescents in the community, with little change evident over the past 20 years. Implications: To reduce the high levels of mental health problems experienced by adolescents on remand, interventions need to provide effective management and treatment both during the time adolescents are on remand and after they return to the general community.; Michael G. Sawyer...

While these data seem to 'paint' a rather bleak picture, it is the view of the authors that this time can be actually be an opportunity for mental health nurses, as periods of economic downturn can be times of innovation for service delivery and dynamic changes in roles and skill mix. Mental health nurses may not realize this, but they are in a primary or pole position to give voice to the quality principle and lead the development of new models of care. Mental health nurses could develop innovative new models of care delivery, and nurses are ideally placed to co-ordinate the delivery of care closer to patients' homes and along care pathways (RCN, 2009). Community care, skill-mix, psychotherapies, e-health-therapy and further research need to be reconsidered to improve the mental health of the population, and perhaps we, as Mental Health Nurses, are in a unique position to contribute to and achieve that.

Objective: This study explored the impact of separation from family members on the mental health and wellbeing of Sudanese refugees in Australia, and the coping strategies used. Methods: In-depth interviews were conducted with Sudanese community representatives and health workers, primary and mental health care practitioners, health service managers and policy makers. Interviews were analysed using thematic analysis. Results: Separation was perceived as having a negative impact on the mental health of Sudanese refugees in Australia, and manifested in concern about the safety of relatives abroad and in changing roles. The pressure to send money home emerged as a high priority for Sudanese refugees, often superseding local concerns. Several strategies were used to bridge the separation gap, including maintaining contact through the use of information communication technologies, and family-reunification. Conclusions: Separation from family can be an ongoing source of stress and sadness among refugees in countries such as Australia. While resettling refugees are actively taking steps to cope with the impact of separation, awareness of the issue in mainstream services appears to be low. Implications: Separation from family continues to affect refugees' lives in countries of resettlement. While it may be difficult to alter the course of the monumental circumstances that cause forced migration...

Objective: The effects of using different approaches to scoring the SF-12 summary scales of physical and mental health were examined with a view to informing the design and interpretation of community-based survey research. Method: Data from a population-

O objetivo do presente estudo foi estimar a prevalência de problemas de saúde mental em estudantes do primeiro ciclo do ensino fundamental e dos seus responsáveis e investigarpossíveis relações existentes entre a saúde mental das crianças e a saúde mental de seus responsáveis. Foram participantes, 321 responsáveis por estudantes da rede municipal de ensino do município de São Carlos. Os instrumentos de medida utilizados foram: Questionário de Capacidades e Dificuldades, para a avaliação da saúde mental das crianças e Mini International Neuropsychiatric Interview, para avaliar a presença de problemas de saúde mental nos responsáveis. Para a análise, aplicou-se o teste não paramétrico de Mann-Whitney. Verifi cou-se que 43% das crianças apresentaram escores clínicos no SDQ e 63% dosresponsáveis apresentaram pelo menos um transtorno mental. Os resultados também indicaram que a pontuação da criança no SDQ foi signifi cativamente maior quando o responsável apresentava algum transtorno mental Aponta-se que a vivência de problemas de saúde mental pelos responsáveis é um fator de risco para a saúde mental infantil e indica-se a necessidade de políticas públicas que considerem essa realidade e implementem ações de prevenção e promoção da saúde mental de crianças e adultos.; The purpose of this study was to measure the prevalence of mental health problems in students in the fi rst cycle of elementary school and in their parents or guardians. Moreover...

INTRODUCTION: Mental health workers who listen to stories of fear, pain and distress of traumatised clients may develop deleterious emotional, cognitive and physical consequences (Cairns, 2007). This phenomenon has been called secondary traumatic stress (STS) (Perez, Jones, Englert, & Sachau, 2010). Rwanda is well-known for the 1994 genocide, with the death of hundreds of thousands of people in a planned campaign of violence. Numerous mental health workers operating in Rwanda were also victims of the violence and it has been suggested that there is a high level of STS in mental health workers in Rwanda (Iyamuremye & Brysiewicz, 2008). AIM: To develop a comprehensive model to manage the effects of STS in mental health workers operating in Rwanda METHOD: An action research project was initiated to develop this model and data for the model was collected through individual interviews with mental health workers (nurses, doctors, psychologists, trauma counsellors and social workers) as well as a quantitative tool measuring secondary traumatic stress (Trauma Attachment Belief Scale) in these health workers. RESULTS: The Intervention Model to Manage Secondary Traumatic Stress (IMMSTS) was synthesised from these findings and includes preventive...

Mental health issues are usually given very low priority in health service policies. Although this is changing, African countries are still confronted with so many problems caused by communicable diseases and malnutrition that they have not woken up to the impact of mental disorders. Every country must formulate a mental health policy based on its own social and cultural realities. Such policies must take into account the scope of mental health problems, provide proven and affordable interventions, safeguard patients’ rights, and ensure equity.

New assessment guidelines for measuring the overall impact of mental health problems in Latin America have served as a catalyst for countries to review their mental health policies. Latin American countries have taken various steps to address long-standing problems such as structural difficulties, scarce financial and human resources, and social, political, and cultural obstacles in the implementation of mental health policies and legislation. These policy developments, however, have had uneven results. Policies must reflect the desire, determination, and commitment of policy-makers to take mental health seriously and look after people’s mental health needs. This paper describes the development of mental health policies in Latin American countries, focusing on published data in peer-reviewed journals, and legislative change and its implementation. It presents a brief history of mental health policy developments, and analyzes the basis and practicalities of current practice.