A Cross-Cultural Perspective on Selected Mental Health Systems

The information provided from authors around the world on their respective mental health systems is analyzed and compared. Several key dimensions are utilized, including the relationship of mental health services to other services, institutional care, community care, staffing, prevention and mental health promotion services, and accessibility. Resources and governmental priorities are identified as being essential to the provision of effective services. It is clear that the general trends identified by the experts for mental health in both developing and developed countries are by no means universal in applicability

The Development of Mental Health Services in Sub-Saharan Africa: The Case of Rwanda

This paper considers several aspects of the evolution, organization and current status of the mental health system of Rwanda. The centerpiece of the Rwandan mental health system is the neuropsychiatric hospital in Ndera. Resource constraints preclude development of an extensive system of specialty mental health care. The World Health Organization has proposed that mental health services can best be delivered in developing countries through decentralization and integration with primary health care services. The accomplishments and problems encountered in implementing this model in Rwanda are described and, based on this experience, some recommendations are offered for other developing countries

The mediating sex-specific effect of psychological distress on the relationship between adverse childhood experiences and current smoking among adults

<p><b>Abstract</b></p> <p><b>Background</b></p> <p>Research suggests that ACEs have a long-term impact on the behavioral, emotional, and cognitive development of children. These disruptions can lead to adoption of unhealthy coping behaviors throughout the lifespan. The present study sought to examine psychological distress as a potential mediator of sex-specific associations between adverse childhood experiences (ACEs) and adult smoking.</p> <p><b>Method</b></p> <p>Data from 7,210 Kaiser-Permanente members in San Diego California collected between April and October 1997 were used.</p> <p><b>Results</b></p> <p>Among women, psychological distress mediated a significant portion of the association between ACEs and smoking (21% for emotional abuse, 16% for physical abuse, 15% for physical neglect, 10% for parental separation or divorce). Among men, the associations between ACEs and smoking were not significant.</p> <p><b>Conclusions</b></p> <p>These findings suggest that for women, current smoking cessation strategies may benefit from understanding the potential role of childhood trauma.</p