PrimAry prevention takes a leading role in world mental health action

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Primary Mental Health Prevention Themes in Published Research and Academic Programs in Israel

Background: The World Health Organization Comprehensive Mental Health Action Plan (CMHAP) 2013-2020 proposes the implementation of primary prevention strategies to reduce the mental health burden of disease. The extent to which Israeli academic programs and published research adhere to the principles spelled out by the CMHAP is unknown. Objective: To investigate the presence of mental health primary prevention themes in published research and academic programs in Israel. Methods: We searched for mental health primary prevention themes in: (1) three major journals of psychiatry and social sciences during the years 2001-2012; (2) university graduate programs in psychology, social work and medicine in leading universities for the academic year of 2011-2012; and (3) doctoral and master\u27s theses approved in psychology and social work departments in five universities between the years 2007-2012. Results: Of the 934 articles published in the three journals, 7.2%, n=67, addressed primary prevention. Of the 899 courses in the 19 graduate programs 5.2%, n=47, elective courses addressed primary prevention. Of the 1960 approved doctoral and master\u27s theses 6.2%, n=123, addressed primary prevention. Only 11 (4.7%) articles, 5 (0.6%) courses, and 5 (0.3%) doctoral and master\u27s theses addressed primary prevention directly. Conclusions: The psychiatric reform currently implemented in Israel and WHO CMHAP call for novel policies and course of action in all levels of prevention, including primary prevention. Yet, the latter is rarely a component of mental health education and research activities. The baseline we drew could serve to evaluate future progress in the field

Primary Mental Health Prevention Themes in Published Research and Academic Programs in Israel

Background: The World Health Organization Comprehensive Mental Health Action Plan (CMHAP) 2013-2020 proposes the implementation of primary prevention strategies to reduce the mental health burden of disease. The extent to which Israeli academic programs and published research adhere to the principles spelled out by the CMHAP is unknown. Objective: To investigate the presence of mental health primary prevention themes in published research and academic programs in Israel. Methods: We searched for mental health primary prevention themes in: (1) three major journals of psychiatry and social sciences during the years 2001-2012; (2) university graduate programs in psychology, social work and medicine in leading universities for the academic year of 2011-2012; and (3) doctoral and master\u27s theses approved in psychology and social work departments in five universities between the years 2007-2012. Results: Of the 934 articles published in the three journals, 7.2%, n=67, addressed primary prevention. Of the 899 courses in the 19 graduate programs 5.2%, n=47, elective courses addressed primary prevention. Of the 1960 approved doctoral and master\u27s theses 6.2%, n=123, addressed primary prevention. Only 11 (4.7%) articles, 5 (0.6%) courses, and 5 (0.3%) doctoral and master\u27s theses addressed primary prevention directly. Conclusions: The psychiatric reform currently implemented in Israel and WHO CMHAP call for novel policies and course of action in all levels of prevention, including primary prevention. Yet, the latter is rarely a component of mental health education and research activities. The baseline we drew could serve to evaluate future progress in the field

Presenting Problems and Treatment Expectations Among Service Users Accessing Psychiatric Outpatient Care: Are There Gender Differences?

Background: Community-based studies have documented gender differences in mental health problems and service utilization. This mixed methods study explored gender differences in severity of emotional distress, referral paths, presenting problems and care expectations among service users upon accessing outpatient psychiatric care. Methods: Consecutive service users (N=284, 64% women) who presented for a new or repeated episode of care in adult outpatient clinics completed questionnaires on a measure of emotional distress, treatment history and referral path. These variables were quantitatively analyzed. Also, users completed two open-ended questionnaires on reasons for seeking care and expectations from the services. These variables were qualitatively analyzed using thematic analyses. Results: No significant gender differences emerged on any of the variables examined among new and repeated users. The main reasons for seeking care were psychiatric symptoms as well as non-specific psychopathology. The most frequent expectations from the services were receiving psychotherapy and specific tools to better manage life problems. Limitations: The sample of new male service users was relatively small. Conclusions: Once care is initiated, men and women showed similar clinical presentation and care expectations

Cancer and Common Mental Disorders in the Community: Results of the Israel-World Mental Health Survey

Background and Objectives: To study common mental disorders (CMD) and other mental health-related variables among community residents with active cancer, cancer survivors and cancer-free respondents. Methods: Data were extracted from the Israeli component of the 28-country World Mental Health Survey. The sample included 165 respondents who reported ever having cancer and 2,282 cancer-free respondents, all aged 39 years and older. The WHO/Composite International Diagnostic Interview (CIDI) was used to determine the prevalence rate of CMD. Emotional distress (ED) was ascertained with the GHQ-12. Also, respondents were asked about sleep disturbances and mental health service utilization. Results: Respondents with active cancer were more likely to endorse CMD in the past year than cancer-free respondents, 22.1% SE = 6.1 and 7.2% SE = 2.5, respectively (adjusted odds ratio = 2.6, 95% CI 1.2-5.6); to have higher ED scores, M = 27.1 SE = 1.3 and M = 19.8 SE = 0.3, respectively (Wald F = 16.7, p \u3c 0.001); and higher prevalence rates of sleep disturbances, 64.7% SE = 6.5% and 31.5% SE = 4.6%, respectively (adjusted odds ratio = 2.1, 95% CI 1.1-3.9). Cancer survivors did not significantly differ from cancer-free respondents on the study variables. Despite the emotional toll, there were no differences in mental health service utilization among the three cancer groups. Conclusions: Respondents with active cancer residing in the community show enhanced psychopathology. Study findings highlight a double need: to adequately assess mental health problems in persons with cancer and to bridge the treatment gap

The Effect of Cancer on Suicide In Ethnic Groups with a Differential Suicide Risk

This study examined the suicide risk among persons with cancer in ethnic groups with differential suicide mortality in the general population. We calculated the suicide standardized incidence ratios (SIRs) among Europe-America and Asia-North Africa-born Israelis with cancer, relative to the respective rates in the general population. The SIRs were higher in the European-American group [men: 1.96, 95% confidence interval (CI) 1.62-2.30; women: 2.03, 95% CI 1.51-2.56], but not significantly different in the Asian-North African group (men: 0.86, 95% CI 0.52-1.20; women: 0.80, 95% CI 0.10-1.50). Assessment of suicide risk must consider the \u27suicide culture\u27 of the person with cancer

Psychological Factors Associated with Emotional Distress Among Palestinian Arabs from East Jerusalem Accessing Psychiatric Care in Israel

Background: The Palestinian population residing in East Jerusalem is characterized by high rates of poverty and unemployment and is subject to discrimination in various forms, including infrastructure of mental health services. Little is known about the help seeking needs and practices of East Jerusalem residents. Method: We examined socio-demographic and clinical characteristics of a consecutive sample Palestinian residents from East Jerusalem (N=50) who accessed a specially assigned psychiatric clinic in Israel. In addition, we examined the psychological factors associated with emotional distress among these service-users upon entry to care. Participants completed a survey in Arabic that included a socio-demographic questionnaire and measures assessing emotional distress, perceived exposure to discrimination and social support, and mental health stigma. Results: Participants reported high levels of emotional distress. Female gender, low socioeconomic status, higher perceived exposure to discrimination and higher perceived social support were associated with increased emotional distress. Conclusions: Findings add to the scarce body of knowledge on specific mental health characteristics of East Jerusalem Palestinian residents

Jornada sobre modelos y estrategias en salud mental.

En la inauguración, Alberto Fernández Liria, Presidente de la AEN, destacó la existencia actual de un consenso entre las CC.AA., plasmado en la Estrategia en Salud Mental del Sistema Nacional de Salud, acerca de la necesidad de un modelo comunitario para el que existe un conocido soporte empírico. Y exponía la situación de Madrid, donde en este momento de consenso, los poderes políticos y las circunstancias económicas promueven estrategias y modelos que llevan a la incertidumbre, por no saber si este sistema de recursos en red va a poder seguir funcionando. A continuación, Antonio Burgueño, Director General de Hospitales de Madrid, se refirió a la Jornada como un foro altamente oportuno ya que en este momento se ha propuesto hacer una revisión de nuestro sistema de Salud Mental, enmarcado en un Plan que toca revisar. Animó a los presentes a que se le hicieran llegar las conclusiones y comentó su intención de desarrollar una herramienta útil a la CAM. Pablo Rivero, Director General de Calidad y Cohesión del Sistema Nacional de Salud, expuso la necesidad de defender los avances logrados en el estado de bienestar, el SNS, y seguir avanzando sin caer en la autocomplacencia, en unos momentos de incertidumbre internacional. Destacó la importancia de haber desarrollado de manera cooperativa la Estrategia en Salud Mental del Sistema Nacional de Salud y la necesidad de que este consenso llegue a dar herramientas a los profesionales y ciudadanos