The lifetime prevalence of psychiatric diagnoses in an academic gender reassignment service

PURPOSE OF THE REVIEW : To review the literature regarding the prevalence of mental health concerns, including psychiatric diagnoses in the TGNC community. RECENT FINDINGS : Gender dysphoria is not the only mental health concern experienced by some members of TGNC people. Stigma and discrimination play a role in the development of mental health concerns. Even after reassignment surgery some members of the TGNC community is almost 5 times more likely to attempt suicide. Using a structured clinical psychiatric interview improves the likelihood of recognizing the presence of psychiatric diagnoses. Non-affirming attitudes and behavior seem to predispose to psychiatric symptoms in some members of the TGNC community and impacts on family and peer relationships. Psychiatric symptoms are often hidden for fear of further discrimination. SUMMARY : A significant proportion of the TGNC community present with mental health concerns. Clinicians should screen appropriately for these concerns. Gender affirming interventions generally have an efficacious effect.The Department of Psychiatry at the University of Pretoriahttp://journals.lww.com/co-psychiatry2018-11-01hj2017Psychiatr

Case study : a patient with severe delusions who self-mutilates

Although some overlapping features exist between self-injury and intention to die, there is growing recognition that non-suicidal self-injury (NSSI), including major self-mutilation (MSM), and suicidal behaviour are distinct entities as evidenced by their significance in terms of aetiology, psychiatric impairment, psychological function, method of self-harm and course or outcome between the two phenomena.1 We present a case of self-harm in a mental healthcare user diagnosed with schizophrenia to highlight the distinction made above.http://www.sajpsychiatry.orgam2021Psychiatr

How can a 6-week training course shape mental healthcare professionals’ understanding of mindfulness? Experiences at Weskoppies Psychiatric Hospital

BACKGROUND: Mindfulness-based practice has gained increasing attention in the mental health community over the last four decades, and many studies have explored the evidence of its various benefits among healthcare users and providers alike. However, there remains limited research regarding the understanding of mindfulness among mental healthcare professionals. This poses the question: how much do mental healthcare professionals really know about mindfulness, and can self-practice increase the understanding of these providers? AIM: This descriptive or exploratory case study aimed to explore the understanding of mindfulness amongst 15 mental healthcare professionals. SETTING: The study took place at Weskoppies Psychiatric Hospital. METHOD: The study was conducted following a 6-week training course in which the participants were taught, and carried out mindfulness-based practices and techniques. The study also explored the following: (1) the healthcare workers’ experiences, benefits and challenges regarding the consistent practice of mindfulness and (2) their confidence when explaining the concept of mindfulness, and the practices learned, to other colleagues and patients. Data were collected in the form of semi-structured interviews with the participants, 4–6 weeks after completion of the training course. RESULTS: Three main themes were identified: (1) understanding of mindfulness expanded with practice; (2) unexpected experiences during the mindfulness course; and (3) experience caused partial gains in confidence and skills. Overall, 15 subthemes were derived from the data collected. CONCLUSION: Self-practice of mindfulness can increase one’s understanding of the concept and the confidence to teach informal techniques. More research is needed to determine how the design and duration of such training could impact this understanding and confidence.Research Committee of the University of Pretoria for the payment of the transcription services of Lynton Lurie.http://www.sajpsychiatry.orgPsychiatr

Mental health literacy among primary healthcare workers in South Africa and Zambia

BACKGROUND : In developing countries, mental health literacy (MHL) still needs to be improved due to the high prevalence of mental disorders. It is widely recognized that MHL can improve health outcomes for both individuals and populations. Healthcare professionals’ development in MHL is crucial to the prevention of mental disorders. The aim of this study was to assess MHL of primary healthcare (PHC) workers in South Africa (SA) and Zambia and determinants thereof. Limited evidence is available on the levels of MHL among PHC workers in the sub-Saharan Africa region, which faces a large burden of mental disorders. METHODS : The study population for this cross-sectional survey comprised PHC workers (n = 250) in five provinces of SA and Zambia. MHL was measured with the Mental Health Literacy Scale (MHLS). We conducted a multivariate analysis to explore determinants of MHL. RESULTS : Results showed moderate MHL among PHC professionals, but with a wide range from low to high MHL. Knowledge-related items had a greater dispersion than other attributes of MHL. PHC workers with more education showed a greater ability to recognize mental health-related disorders. Those who had experience in the use of mental health-related assessment scales or screening tools reported a higher total MHL. The results confirmed strong internal consistency for the MHLS. CONCLUSION : The results highlighted varying mental health perceptions and knowledge in PHC. Implementation of specifically developed formal training programs and interventions to improve MHL in PHC workers to strengthen their competence may help bridge the treatment gap.Erasmus+ Capacity Building and European Commission.https://wileyonlinelibrary.com/journal/brb3am2023Psychiatr

Design and development process of a youth depression screening m-health application for primary health care workers in South Africa and Zambia : an overview of the MEGA project

Literature indicates a high prevalence and burden of mental illness in youths world-wide, which may be even higher in low- and middle-income countries (LMIC), such as South Africa and Zambia. Additionally, there is a lack of knowledge regarding youth depression amongst many primary health care (PHC) practitioners. The principal goal of the MEGA project is to provide youth with better access to mental health services and appropriate care, by developing a mental health screening mobile application tool to be used in PHC settings in South Africa and Zambia. In this study, we will use a mixed methods multi-center study design. In phase one, we will investigate the mental health literacy of PHC practitioners to identify areas in need of development. Based on the needs identified, we will develop and test a mobile health application to screen for common youth mental health problems in phase two. In phase three, we will implement and evaluate a tiered education and training program in the use of the m-health application. In the final phase, we will evaluate the acceptability and feasibility of the m-health application in PHC centres across South Africa and Zambia. Evidence suggests that PHC practitioners should routinely consider mental illness when assessing youth. However, common psychiatric disorders remain largely undetected and untreated in PHC settings. By identifying limitations in PHC workers knowledge with regard to youth mental health, we aspire to improve the depression care provided to youth in Southern Africa and Zambia by developing and implementing a locally relevant m-health application.http://www.tandfonline.com/loi/imhn20hj2020Psychiatr

Content validation of Mental Health Literacy Scale (MHLS) for primary health care workers in South Africa and Zambia ─ a heterogeneous expert panel method

BACKGROUND : The lack of public knowledge and the burden caused by mental-health issues’ effect on developing and implementing adequate mental-health care for young and adolescent in low- and middle-income countries (LMIC). Primary health care could be the key in facing the challenge, but it suffers from insufficient resources and poor mental health literacy. This study’s aim was to adapt the content validity of the Mental Health Literacy Scale (MHLS) developed by O’Connor & Casey (2015) with researchers and primary health-care workers in low- and middle-income contexts in South Africa (SA) and in Zambia. OBJECTIVES : The study population comprised two expert panels (N = 21); Clinical Experts (CE) (n = 10) from Lusaka, Zambia and Professional Research Experts (PE) (n = 11) from the MEGA project management team were recruited to the study. METHODS : MHLS was validated in a South African and a Zambian context using a heterogeneous expert-panel method. Participants were asked to rate the 35 MHLS items on a 4-point scale with 1 as not relevant and 4 as very relevant After the rating, all 35 MHLS items were carefully discussed by the expert panel and evaluated according their relevance. The data were analyzed using an item-level content validity index (I-CVI) and narrative and thematic analyses. RESULTS : All 35 items ranked by the PREs met the cutoff criteria (≥0.8), and ten (n = 10) items were seen as relevant by CE when calculating I-CVIs. Based on the results of ratings and discussion, a group of sixteen (n = 16) of all items (n = 35) were retained as original without reviewing. A total of nineteen (n = 19) items were reviewed. CONCLUSION : This study found the MHLS to have sufficient validity in LMICs’ context but also recognized a gap between professional researchers’ and clinical workers’ knowledge and attitudes related to mental health.Erasmus+ Capacity Buildinghttps://www.tandfonline.com/loi/zgha20am2020Psychiatr