A suicide research agenda for people from immigrant and refugee backgrounds

The aim of this study was to establish mental health and suicide research priorities for people from immigrant and refugee background in Australia. This article focuses on the data relevant to the development of the suicide research agenda. This study was conducted using Delphi consensus method with two rounds of online questionnaires. A total of 138 and 86 participants, respectively, completed the first and second rounds of survey. Participants were policy makers, service providers, academics, service users, and carer advocates in Australia with expertise in mental health and/or suicide among people from immigrant and refugee backgrounds. Of the total 268 research questions included in the questionnaires, 70 questions about suicide were ranked as essential by over 50% respondents (i.e., the set level of consensus). In particular, research questions regarded as the greatest priority related to access and engagement with suicide prevention services, suicide protective and risk factors compared to populations not from immigrant and refugee backgrounds, and culturally appropriate assessment of suicide risk

Global mental health and psychiatric institutions in the 21st century.

In the 19th century, psychiatric institutions were the focus of thousands of articles in the leading English-language medical and psychiatric journals. This area of concern remained important through the first half of the 20th century, with some decline in the number of published articles in the second half of the 20th century as de-institutionalisation gathered pace. The number of articles about this topic has declined sharply in the past 25 years, and psychiatric institutions are not the focus of any of the Grand Challenges in Global Mental Health even though psychiatric institutions of all kinds are widely acknowledged to be the among the main sites of human rights abuses. In this commentary we present examples of impressive transformations of institutions in Sri Lanka and Vietnam, and suggest that the field of global mental health should devote more of its efforts to improving the lives of persons with mental disorders who have been incarcerated in a variety of settings, often under the care of mental health specialists

An analysis of the production-regeneration system in the coastal upwelling area off N.W. Africa based on oxygen, nitrate and ammonium distributions

Using the hydrographic and nutrient data from the R/V Jean Charcot CINECA-V cruise and Broenkow\u27s (1965) mixing model, we have calculated the biologically induced changes in the oxygen, nitrate and ammonium distribution patterns of the upwelling system off Cape Blanc, N .W. Africa...

Suicide first aid guidelines for assisting persons from immigrant or refugee background: a Delphi study

Objective: Suicide rates vary across different cultural groups and some immigrant or refugee populations display higher risk for suicide. This study aimed to produce guidelines to help members of the public provide assistance to a person from an immigrant or refugee background who is having suicidal thoughts or displaying suicidal behaviour. Method: The Delphi expert consensus method was used to identify warning signs and first aid actions to include in guidelines. Forty- four professionals and/or advocates with lived experience were asked to rate whether each statement contained in an online questionnaire should be included in the guidelines and to suggest additional statements considered by the respondent to be particularly relevant to a person from an immigrant or refugee background. The Delphi process started with 473 statements and 80 new items were written based on suggestions from panel members. Results: Out of the total 553 statements, 345 were endorsed as appropriate warning signs or helping actions. These statements were used to develop the guidelines. Discussion: The guidelines specific to people from immigrant or refugee backgrounds contain additional items to those included in similar guidelines for English-speaking countries. The guidelines may be used for gatekeeper training for suicide prevention in culturally diverse societies

Human rights of persons with mental illness in Indonesia: more than legislation is needed

<p>Abstract</p> <p>Background</p> <p>Although attention to human rights in Indonesia has been improving over the past decade, the human rights situation of persons with mental disorders is still far from satisfactory. The purpose of this paper is to examine the legal framework for protection of human rights of persons with mental disorder and the extent to which Indonesia's international obligations concerning the right to health are being met.</p> <p>Methods</p> <p>We examined the Indonesian constitution, Indonesian laws relevant to the right to health, the structure and operation of the National Human Rights Commission, and what is known about violations of the human rights of persons with mental illness from research and the media.</p> <p>Results</p> <p>The focus of the Indonesian Constitution on rights pre-dated the Universal Declaration, Indonesia has ratified relevant international covenants and domestic law provides an adequate legal framework for human rights protections. However, human rights abuses persist, are widespread, and go essentially unremarked and unchallenged. The National Human Rights Commission has only recently become engaged in the issue of protection of the rights of persons with mental illness.</p> <p>Conclusion</p> <p>More than legislation is needed to protect the human rights of persons with mental illness. Improving the human rights situation for persons with mental illness in Indonesia will require action by governments at national, provincial and district levels, substantial increases in the level of investment in mental health services, coordinated action by mental health professionals and consumer and carer organisations, and a central role for the National Human Rights Commission in protecting the rights of persons with mental illness.</p

Lab-on-a-chip for biological fluids analysis by spetrophotometry

The healthcare sector is nowadays one of the most dynamic and where the novelty is a strategic and operational imperative. The possibility of increase the quantity and quality of clinical analysis, performed with instantaneous results and outside the clinical laboratories, contributes to a better quality in the health care services and also a better efficiency in the clinical and administrative processes [1]. This possibility can be achieved with the presented lab-on-a-chip for spectrophotometric analysis of biological fluids. It allows the selective measurement of the concentration of several biomolecules in biological fluids, with instantaneous results, at any location, with small quantities of reagents and samples and with low-cost. That measurement is based on colorimetric detection by the optical absorption in a part of the visible spectrum defined by the reaction of the specific biomolecule with a specific reagent. The device comprises a highly efficient and selective optical filtering and colorimetric detection system. This system allows the measurement with a regular white light illumination, thus avoiding the use of complex and expensive analysis systems like the ones that comprise spectrophotometers, for example. This feature highly facilitates portability and ensures analysis within consultation time, at a patient house (allowing a first trial) and in clinical laboratories or hospitals.Fundação para a Ciência e a Tecnologia (FCT) SFRH/BD/1281/2000 Escola de Engenharia da Universidade do Minho - Projecto IN2TEC. Centro Algoritmi da Universidade do Minh

In or out? Barriers and facilitators to refugee-background young people accessing mental health services

Refugee young people have been identified as a group with high risk for mental health problems, due to their experience of trauma, forced migration, and stressors associated with settlement. A high prevalence of mental health problems is reported in this group, however some research suggests refugee young people have low rates of mental health service access. There is little information available on barriers and facilitators to mental service delivery for this group. Using data from 15 focus groups and five key informant interviews with a total of 115 service providers from 12 agencies in Melbourne, Australia, this paper explores barriers and facilitators to engaging young people from refugee backgrounds with mental health services. Eight key themes emerged: cultural concepts of mental health, illness, and treatment; service accessibility; trust; working with interpreters; engaging family and community; the style and approach of mental health providers; advocacy; and continuity of care

Improving access to and engagement with mental health services among young people from refugee backgrounds: service user and provider perspectives

Limited research has been conducted worldwide on the experiences that children and young people from refugee backgrounds have with mental health services, despite evidence that they have significant vulnerability to the development of mental health problems and to suicidal behaviour and that those with mental ill-health typically underutilise services. The authors were particularly interested in barriers and facilitators to service access and engagement, and conducted two qualitative research projects to improve understanding of the issues – the first with service providers experienced in the refugee area and the second with young refugee service users. The aim of this project was to compare the perspectives of professionals and service users and to identify similarities and differences. The perspectives of the service users and providers were strikingly similar. The analysis identified 21 implications for policy makers, agencies and practitioners, which ranged from issues concerning cultural sensitivity, background matching and mental health literacy to accessibility, setting boundaries and expectations and implementing a holistic and outreach approach. There is a range of specific, practical measures that policy makers and service providers can introduce to enhance access to and engagement with mental health services for young people from refugee backgrounds

Suicide first aid guidelines for Sri Lanka: a Delphi consensus study

Background: Sri Lanka has one of the highest suicide rates in the world. Gatekeeper programs aimed at specific target groups could be a promising suicide prevention strategy in the country. The aim of this study was to develop guidelines that help members of the public to provide first aid to persons in Sri Lanka who are at risk of suicide. Methods: The Delphi method was used to elicit consensus on potential helping statements to include in the guidelines. These statements describe information members of the public should have and actions they can take to help a person who is experiencing suicidal thoughts. An expert panel, comprised of mental health and suicide experts in Sri Lanka, rated each statement. The panellists were encouraged to suggest any additional action that was not included in the original questionnaire and, in particular, to include items that were culturally appropriate or gender specific. Responses to open-ended questions were used to generate new items. These items were included in the subsequent Delphi rounds. Three Delphi rounds were carried out. Statements were accepted for inclusion in the guidelines if they were endorsed (rated as essential or important) by at least 80 % of the panel. Statements endorsed by 70–79 % of the panel were re-rated in the following round. Statements with less than 70 % endorsement, or re-rated items that did not receive 80 % or higher endorsement were rejected. Results: The output from the Delphi process was a set of endorsed statements. In the first round questionnaire 473 statements were presented to the panel and 58 new items were generated from responses to the open-ended questions. Of the total 531 statements presented, 304 were endorsed. These statements were used to develop the suicide first aid guidelines for Sri Lanka. Conclusion: By engaging Sri Lankans who are experts in the field of mental health or suicide this research developed culturally appropriate guidelines for providing mental health first aid to a person at risk of suicide in Sri Lanka. The guidelines may serve as a basis for developing training for members of the public to provide mental health first aid to persons at risk of suicide as part of Sri Lanka’s suicide prevention strategy