МОТИВАЦІЙНI ДИСКУРСИ СУЧАСНОСТІ: ВІД МЕТАФОРИ «ВІДПОВІДНОСТІ» ДО МЕТАФОРИ «СТАНОВЛЕННЯ»

Сучасна психологія мотивації стикається із новими проблемами, зокрема домінуванням постнекласичної наукової парадигми, у рамках якої на зміну кла­сичній «об’єкт-суб’єктній» та некласичній «суб’єкт-суб’єктній» діадам прихо­дить «суб’єкт-суб’єкт-контекстна» тріада. Відтак, психологія мотивації, з одно­го боку, стикається з необхідністю стати соціальною психологією мотивації, з другого – набути динамічності, яка б відповідала динамічності змін людини в сучасному світі, з третього – не втратити при цьому науковості й практичності. Проаналізувавши сучасні наукові тексти з психології мотивації, виділяємо домі­нування чотирьох дискурсів – автентичності, оцінювання, експансії та констру­ювання – вивчення яких, у свою чергу, відкриває їхній перехідний статус від ме­тафори «відповідності», яка закладена в дискурсах оцінювання, автентичності й експансії, до метафори «становлення» (дискурс конструюван­ня). Зроблено висновок, що в рамках дискурсу конструювання психологія моти­вації відпо­відає на всі виклики постмодерну й інтегрується з сучасною постнекласичною науковою парадигмою

Mental health care system and reform efforts in Ukraine

The abstract purpose is identifying the key goals of the Ukrainian MH transformation efforts according to the national legislation and the WHO trend

The Commission on mental health in Ukraine: areas for development

peer reviewe

Depression, anxiety, suicidal ideation and social determinants of mental health of Romani in Ukraine

Research pape

Assessing performance of the Healthcare Access and Quality Index, overall and by select age groups, for 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019

Background: Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019), we measured the Healthcare Access and Quality (HAQ) Index overall and for select age groups in 204 locations from 1990 to 2019. Methods: We distinguished the overall HAQ Index (ages 0–74 years) from scores for select age groups: the young (ages 0–14 years), working (ages 15–64 years), and post-working (ages 65–74 years) groups. For GBD 2019, HAQ Index construction methods were updated to use the arithmetic mean of scaled mortality-to-incidence ratios (MIRs) and risk-standardised death rates (RSDRs) for 32 causes of death that should not occur in the presence of timely, quality health care. Across locations and years, MIRs and RSDRs were scaled from 0 (worst) to 100 (best) separately, putting the HAQ Index on a different relative scale for each age group. We estimated absolute convergence for each group on the basis of whether the HAQ Index grew faster in absolute terms between 1990 and 2019 in countries with lower 1990 HAQ Index scores than countries with higher 1990 HAQ Index scores and by Socio-demographic Index (SDI) quintile. SDI is a summary metric of overall development. Findings: Between 1990 and 2019, the HAQ Index increased overall (by 19·6 points, 95% uncertainty interval 17·9–21·3), as well as among the young (22·5, 19·9–24·7), working (17·2, 15·2–19·1), and post-working (15·1, 13·2–17·0) age groups. Large differences in HAQ Index scores were present across SDI levels in 2019, with the overall index ranging from 30·7 (28·6–33·0) on average in low-SDI countries to 83·4 (82·4–84·3) on average in high-SDI countries. Similarly large ranges between low-SDI and high-SDI countries, respectively, were estimated in the HAQ Index for the young (40·4–89·0), working (33·8–82·8), and post-working (30·4–79·1) groups. Absolute convergence in HAQ Index was estimated in the young group only. In contrast, divergence was estimated among the working and post-working groups, driven by slow progress in low-SDI countries. Interpretation: Although major gaps remain across levels of social and economic development, convergence in the young group is an encouraging sign of reduced disparities in health-care access and quality. However, divergence in the working and post-working groups indicates that health-care access and quality is lagging at lower levels of social and economic development. To meet the needs of ageing populations, health systems need to improve health-care access and quality for working-age adults and older populations while continuing to realise gains among the young. Funding: Bill & Melinda Gates Foundation

Decentralisation and community engagement for better mental health services development in the conflict-affected regions of Ukraine

Purpose: The purpose of this paper is to explore how conflict-affected communities in Ukraine (the Lugansk region) can develop sustainable mental health services in decentralised settings. The main interest focuses on communities' perception of their problems and solutions that communities can create to achieve better mental health coverage. Design: /methodology/approach Series of roundtables (4 roundtables, 62 participants overall), accompanied by interactive brainstorming techniques, were conducted with communities' representatives from the East of Ukraine (Lugansk region, government-controlled area). Participants were provided with the opportunity to discuss mental health services development challenges and create affordable solutions for their communities. Results of discussions were submitted to qualitative analysis and offered to review by participants. Findings: Decentralisation in Ukraine led to allocating funds alongside responsibilities for developing the services to communities. Most of the communities appear not to be ready to acknowledge the role of mental health services, entirely relying on the existing weak psychiatric hospital-based system. Rising-awareness interactive capacity-building activities for the community leaders and decision-makers effectively promote community-based mental health services development. Five clusters of challenges were identified: leadership, coordination, and collaboration problems; infrastructure, physical accessibility, and financial problems; mental health and primary healthcare workforce shortage and lack of competencies; low awareness in mental health, available services, and high stigma; war, crises, and pandemic-related problems. Communities foresaw seven domains of actions: increasing the role of communities and service users in the initiatives of governmental bodies; establishing in the communities local coordination/working groups dedicated to mental health service development; developing the community-based spaces (hubs) for integrated services provision; embedding the mental health services in the existing services (social, administrative, healthcare); mental health advocacy and lobby lead by local leaders and service users; increasing capacity of communities in financial management, fundraising; developing of services by combining efforts and budgets of neighbouring communities. Originality The paper is original in terms of its topic (connecting decentralisation and community engagement for understanding the challenges of mental health services development) and research strategy (engagement of Ukrainian communities, qualitative analysis of the discussion results and applying the best practices and international recommendations to the local context)