Making space for embedded knowledge in global mental health: a role for social work

The ‘Global Mental Health’ (GMH) movement, an influential driver of transnational knowledge transfer in the field of mental health, advocates evidence-based strategies to ‘scale up’ services in low- and middle-income countries. As with debates on global and local frameworks for social work, there are concerns about marginalisation of knowledge that does not neatly fit the GMH discourse. This article analyses the professional and disciplinary structures that shape knowledge transfer in GMH and the implications for social work's engagement with the movement. Analysis of key documents and secondary literature identifies three key issues for GMH: its potentially negative impact on ‘local’ knowledge production; the challenges of accounting for culture and context; and the selective forms of evidence that are ‘allowed’ to contribute to GMH. Finding ways to encompass more ‘situated’ perspectives could reshape GMH in accord with its aspirations for participation by a wider range of stakeholders. Social work's values-based commitment to rights and empowerment, emphasis on embedded knowledge emerging from close links with practice, and theoretical engagement with social, cultural and political context, enable the profession to contribute significantly to this task. Such engagement would bring improvements in care for those suffering from mental health disorders, their families and communities

Elimination of All Forms of Forced or Compulsory Labor

A compilation of reports submitted by various countries to the ILO by the year 2000, describing labor conditions and relevant laws, specifically relating to forced or compulsory labor

Mental Health in the Workplace: Situation Analyses, Finland

[From Introduction] Mental health problems are among the most important contributors to the global burden of disease and disability. Of the ten leading causes of disability worldwide, five are psychiatric conditions: unipolar depression, alcohol use, bipolar affective disorder (manic depression), schizophrenia and obsessive-compulsive disorder. The burden of mental disorders on health and productivity throughout the world has long been profoundly underestimated.2 The impact of mental health problems in the workplace has serious consequences not only for the individuals whose lives are influenced either directly or indirectly, but also for enterprise productivity. Mental health problems strongly influence employee performance, rates of illnesses, absenteeism, accidents, and staff turnover. The workplace is an appropriate environment in which to educate and raise individuals\u27 awareness about mental health problems. For example, encouragement to promote good mental health practices, provide tools for recognition and early identification of the symptoms of problems, and establish links with local mental health services for referral and treatment can be offered. The need to demystify the topic and lift the taboos about the presence of mental health problems in the workplace while educating the working population regarding early recognition and treatment will benefit employers in terms of higher productivity and reduction in direct and in-direct costs. However, it must be recognised that some mental health problems need specific clinical care and monitoring, as well as special considerations for the integration or reintegration of the individual into the workforce

Mental Health in the Workplace: Situation Analyses, Germany

[From Introduction] The ILO’s primary goals regarding disability are to prepare and empower people with disabilities to pursue their employment goals and facilitate access to work and job opportunities in open labour markets, while sensitising policy makers, trade unions and employers to these issues. The ILO’s mandate on disability issues is specified in the ILO Convention 159 (1983) on vocational rehabilitation and employment. No. 159 defines a disabled person as an individual whose prospects of securing, retaining, and advancing in suitable employment are substantially reduced as a result of a duly recognised physical or mental impairment. The Convention established the principle of equal treatment and employment for workers with disabilities

Keeping our mob healthy in and out of prison

The prison health system presents an opportunity to improve Aboriginal prisoners’ health and wellbeing, diagnose and treat health and mental health problems, and mitigate the effects of harmful behaviours. Executive summary The prison health system presents an opportunity to improve Aboriginal prisoners’ health and wellbeing, diagnose and treat health and mental health problems, and mitigate the effects of harmful behaviours. Improving prison health systems for Aboriginal people can also reduce high rates of postrelease hospitalisation and mortality experienced by Aboriginal prisoners and improve quality of life. Aboriginal prisoners experience higher rates of health and mental health problems than non-Aboriginal prisoners. The impact on prison health care is foreshadowed by consistent increases in the number of Aboriginal people imprisoned in Victoria each year. One in 33 Aboriginal males is imprisoned in Victoria at any one time, and the rate of overrepresentation is increasing for both Aboriginal men and women. More than 50% of Aboriginal people released from Victorian prisons return within two years, which places increasing importance on continuity of care. With large numbers of Aboriginal people moving in and out of the prison system, a strong relationship should exist between prison health services and prisoners’ community health and mental health provider. The 28 Aboriginal Community Controlled health Organisations (ACCHOs) and their auspiced organisations across Victoria are located within 55km of all Victorian prisons. ACCHOs are a critical extension of prison health care given Aboriginal prisoners access ACCHOs more frequently than mainstream services in the community. ACCHOs’ comprehensive support and engagement of Aboriginal people plays a big part in improving quality of life and improving poor health and mental health outcomes by providing a holistic, healing health service. The Victorian Aboriginal Community Controlled Health Organisation (VACCHO), with support from the Victorian Government Department of Justice, explored ways to improve continuity of care for Aboriginal people in Victorian prisons and identify ways to improve relationships and partnerships between ACCHOs and prison health services. ACCHOs, prison health services, and Koori support staff members from the Department of Justice were interviewed and their responses analysed for common themes. We found no relationship or partnership between ACCHOs and prison health services interviewed despite policy references requiring it within the Justice Health Policy and Quality Framework (attached to the prison health services contracts). Responses also indicated that prison health service systems were not meeting cultural safety policy standards. ACCHOs identified several areas in need of improvement to assist Aboriginal prisoner health including prisoner release planning and the transfer of health information. Given the low level of contact between ACCHOs and prison health services there were few working examples that could be shared. A list of recommendations based on interview responses, a literature review and exploration of non-Victorian models is presented as a first step in improving health and mental health outcomes for Aboriginal prisoners

The Elimination of All Forms of Forced or Compulsory Labor (2003)

A compilation of reports submitted by various countries to the ILO by the year 2002, describing labor conditions and relevant laws, specifically relating to forced or compulsory labor

Short-Term Labour Market Outlook and Key Challenges in G20 Countries

[Excerpt] The latest available forecasts from the IMF and the OECD point to a weak uptick in economic activity in 2013 and 2014. This will continue to hold back short-term employment growth and hinder progress towards the medium-term objective of restoring the employment to working-age population ratio prevailing before the crisis. Persistently high and mainly cyclical unemployment in several G20 countries is heightening the risks of labour market exclusion and structural unemployment. In over half of countries, the share of longterm unemployment in total unemployment remains above its pre-crisis level. Overall slower economic growth in emerging economies in the last 12 months is weighing on the growth of rewarding and productive formal employment and on the pace of decline in working poverty and underemployment. The situation calls for strong and well-designed employment, labour and social protection policies applied in conjunction with supportive macroeconomic policy mixes to address the underlying demand and supply conditions of each economy. Only a few emerging and advanced countries, applying different policy mixes, have sustained or raised employment levels and seen a decline in unemployment and underemployment. In a majority of G20 countries labour market conditions have either improved only marginally or not improved and deteriorated, at times significantly so. This bears heavily on the underlying strength of the recovery

Efficacy and effectiveness of the combination of sulfadoxine/pyrimethamine and a 3-day course of artesunate for the treatment of uncomplicated falciparum malaria in a refugee settlement in Zambia.

In the Maheba Refugee Settlement, in the clinics supported by Medecins Sans Frontieres, all children aged up to 5 years with a confirmed diagnosis of uncomplicated falciparum malaria are treated with the combination of sulfadoxine/pyrimethamine (SP) and artesunate (AS). We compared the treatment's efficacy and effectiveness. Patients were randomized in order to receive the treatment supervised (efficacy) or unsupervised (effectiveness). Therapeutic response was determined after 28 days of follow up. The difference between recrudescence and re-infection was ascertained by polymerase chain reaction (PCR). We also assessed genetic markers associated to SP resistance (dhfr and dhps). Eighty-five patients received treatment under supervision and 84 received it unsupervised. On day 28, and after PCR adjustment, efficacy was found to be 83.5% (95% CI: 74.1-90.5), and effectiveness 63.4% (95% CI: 52.6-73.3) (P < 0.01). Point mutations on dhfr (108) and dhps (437) were found for 92.0% and 44.2% respectively of the PCR samples analysed. The significant difference in therapeutic response after supervised and unsupervised treatment intake can only be explained by insufficient patient adherence. When implementing new malaria treatment policies, serious investment in ensuring patient adherence is essential to ascertain the effectiveness of the new treatment schedules

Water incident related hospital activity across England between 1997/8 and 2003/4: a retrospective descriptive study

Every year in the United Kingdom, 10,000 people will die from accidental injury and the treatment of these injuries will cost the NHS £2 billion and the consequences of injuries received at home cost society a further £25 billion [1]. Non-fatal injuries result in 720,000 people being admitted to hospital a year and more than six million visits to accident and emergency departments each year [2]. Drowning is the second leading cause of unintentional injury mortality globally behind road traffic injuries. It is estimated that a total of 409, 272 people drown each year [3]. This equates to a global incident rate of 7.4 deaths per 100, 000 people worldwide and relates to a further 1.3 million Disability Adjusted Life Years (DALYs) which are lost as a result of premature death or disability [4]. 'Death' represents only the tip of the injury "iceberg" [5]. For every life lost from an injury, many more people are admitted to hospital, attend accident and emergency departments or general practitioners, are rescued by search and rescue organisations or resolve the situation themselves. It is estimated that 1.3 million people are injured as a result of near drowning episodes globally and that many more hundreds of thousands of people are affected through incidents and near misses but there are no accurate data [4]. The United Kingdom has reported a variable drowning fatality rate, the injury chart book reports a rate of 1.0 – 1.5 per 100,000 [6] and other studies suggest a rate as low as 0.5 per 100, 000 population [7] for accidental drowning and submersion, based on the International Classification of Disease 10 code W65 – 74, however, the problem is even greater and these Global Burden of Disease (GDB) figures are an underestimate of all drowning deaths, since they exclude drownings due to cataclysms (floods), water related transport accidents, assaults and suicide [3]. A recent study in Scotland highlighted this underestimation in drowning fatality data and found that the overall death rate due to drownings in Scotland 3.26 per 100,000 [8]. Even though drowning fatality rates in the United Kingdom vary, little is known about the people who are admitted to hospital after an incident either in or on water. This paper seeks to address this gap in our knowledge through the investigation of the data available on those admitted to NHS hospitals in England

Epidemiological dynamics of Ebola outbreaks

Ebola is a deadly virus that causes frequent disease outbreaks in the human population. Here, we analyse its rate of new introductions, case fatality ratio, and potential to spread from person to person. The analysis is performed for all completed outbreaks, and for a scenario where these are augmented by a more severe outbreak of several thousand cases. The results show a fast rate of new outbreaks, a high case fatality ratio, and an effective reproductive ratio of just less than 1