Mental health status of adults under institutional quarantine: a cross-sectional survey in Tunisia

Introduction: restrictive measures imposed during the COVID-19 pandemic, such as quarantine, may induce psychiatric outcomes among concerned individuals. The present study aimed to describe the mental health status of Tunisian adults under mandatory institutional quarantine imposed during the COVID-19 pandemic, and to determine factors influencing the occurrence of psychiatric symptoms. Methods: a cross-sectional phone survey was conducted from April to November 2020 using convenience sampling of persons who had experienced mandatory institutional quarantine. A standardized questionnaire was administered to participants including questions about socio-demographic characteristics and quarantine related information. Generalized anxiety disorder, depression symptoms, and sleep quality during quarantine were assessed using, respectively, the generalized anxiety disorder-7 (GAD-7), the centre for epidemiological studies depression (CES-D-10) and the insomnia severity index (ISI) scales. Bivariate and multivariate analyses were performed to determine factors associated with anxiety and/or depression and with clinical insomnia. Results: among 506 participants, 38.3% experienced anxiety and/or depression symptoms (anxiety:15.4%; depression:37.4%) and 19.2% had clinical insomnia. The prevalence of anxiety and/or depression symptoms and insomnia were higher among women those who spent three hours or above on COVID-19 news, those who had economic difficulties due to COVID-19 pandemic, those who were not satisfied by the accommodation conditions of quarantine facilities, and those who had experienced stigma. Conclusion: high prevalence of psychiatric symptoms among quarantined individuals was found in this study. Psychological interventions should thus be an integral part of the COVID-19 control strategy in order to provide adequate psychological support to persons quarantined due to COVID-19

Advocacy training for young family doctors in primary mental health care: A report and global call to action

Background The World Health Organization (WHO) recognises the essential role of mental health in achieving health for all; its mental health action plan calls for more effective leadership for mental health and the provision of community-based, integrated care. 1 However, integrating mental health care into primary care is a challenging, transformational change that requires more than clinical knowledge. 2 It depends on strong advocacy, leadership, and change management: skills that can be learnt. 3,4 Project The Farley Health Policy Centre (FHPC) partnered with the World Organization of Family Doctors (WONCA) to develop and pilot a global curriculum to enable learners to lead practice transformation and be empowered with policy-influencing skills to advocate for their patients, to promote and enhance primary care mental health. We recruited 12 young family doctors, of whom seven were women and ten were from low- and middle-income countries (LMICs), as shown in Figure 1. The programme began with a survey of learners' needs and aspirations, and an expectation that each would self-identify a practice transformation goal. Faculty and learners took part in a two-phase learning evaluation. Funding from WONCA was provided for logistics and evaluation. A small stipend was offered to each learner on successful course completion. Faculty gave their time pro bono. The programme was conducted between March and October 2020. The evaluation process was approved by the University of Liverpool Health and Life Sciences Research Ethics Committee. The learners were divided into two learning cohorts. Sessions were facilitated by two leaders and supported by four mentors. The educational content was delivered twice (to accommodate differing time zones) in six 90-minute monthly virtual sessions. The topics were: • Introduction to mental health integratio