Telepsychiatry - From a Dream to Reality in Bangladesh

The governments of Low and Middle Income Countries are struggling with poverty, political instability, social inequality and inadequate health care facilities. Mental health services never get adequate attention to overcome all of these priority issues. These countries are stressed with a wide mental health treatment gap and there is no sign of adequate initiatives to minimise this gap. However, Information Communication Technologies (ICT) sectors show explosive growth. The landscape of ICT in the health sector is expanding every day. Most developing countries have no national mental health data base or electronic health record. With the help of ICT countries can collect real time data, and record the data from mobile devices in a cost effective manner. The problem of lack of trained mental health professionals, wide geographic area coverage and the large number of patients can be overcome by using telepsychiatry services. People can contact a psychiatrist or psychologist from their mobile phone whenever they need help. It removes the cost of travelling, the need to wait for an appointment and avoids the fear of being stigmatised as being mentally ill. Electronic algorithm based diagnostic systems provide professional expertise and can assist poorly trained personnel in primary care settings. Millions of people can be contacted at a time using Short Message Service (SMS), Interactive voice response (IVR) and video clips. This can be used to reduce the stigma and improve treatment adherence, two important obstacles in mental health service in low income counties. Social Networking Sites like Facebook have opened new horizons for understanding mental health conditions and providing interventions. Friendsourcing is interesting area to for mental health. All these aspect can transform mental health in Low and Middle Income Countries with their available resources

Telepsychiatry for Transforming Mental Health Scenario

Low and Middle Income Countries are struggling with poverty, political instability and inadequate healthcare facilities. Mental health hardly gets adequate attention and is relegated by other priority issues. The countries are stressed with a wide mental health treatment gap without any sign of adequate initiatives to minimise this gap. However, Information Communication Technologies (ICT) have shown promise in this regard. With the help ICT the problem of lack of trained mental health professionals, wide geographic area coverage and huge number of patients can be overcome. People can contact a psychiatrist or psychologist from their mobile phone whenever they need help. It removes the cost of travelling, overcomes the need to wait for an appointment and by-passes the fear of being identified as mentally ill during a visit to the psychiatrist. Millions of people can be addressed at a time using Short Message Service (SMS), Interactive voice response (IVR) and video clips. All these can  reduce the stigma of mental health and can improve treatment adherence, two important obstacles in mental health service in low income counties. Social Networking Sites like Facebook have opened new horizons for understanding mental health conditions and providing interventions. All these initiatives indicate the potential of telepsychiatry to transform the tragic mental health scenario in Low and Middle Income Countries

An mCARE Study on Patterns of Risk and Resilience for Children with ASD in Bangladesh

Community-wide lockdowns in response to COVID-19 influenced many families, but the developmental cascade for children with autism spectrum disorder (ASD) may be especially detrimental. Our objective was to evaluate behavioral patterns of risk and resilience for children with ASD across parent-report assessments before (from November 2019 to February 2020), during (March 2020 to May 2020), and after (June 2020 to November 2020) an extended COVID-19 lockdown. In 2020, our study Mobile-based care for children with ASD using remote experience sampling method (mCARE) was inactive data collection before COVID-19 emerged as a health crisis in Bangladesh. Here we deployed “Cohort Studies”, where we had in total 300 children with ASD (150 test group and 150 control group) to collect behavioral data. Our data collection continued through an extended COVID-19 lockdown and captured parent reports of 30 different behavioral parameters (e.g., self-injurious behaviors, aggression, sleep problems, daily living skills, and communication) across 150 children with ASD (test group). Based on the children’s condition, 4–6 behavioral parameters were assessed through the study. A total of 56,290 behavioral data points was collected (an average of 152.19 per week) from parent cell phones using the mCARE platform. Children and their families were exposed to an extended COVID-19 lockdown. The main outcomes used for this study were generated from parent reports child behaviors within the mCARE platform. Behaviors included of child social skills, communication use, problematic behaviors, sensory sensitivities, daily living, and play. COVID-19 lockdowns for children with autism and their families are not universally negative but supports in the areas of “Problematic Behavior” could serve to mitigate future risk

Applying behavioural theory to the challenge of sustainable development: using hairdressers as diffusers of more sustainable hair-care practices

The challenges presented by sustainable development are broadly accepted, yet resource use increases unabated. It is increasingly acknowledged that while technical solutions may play a part, a key issue is behaviour change. In response to this there has been a plethora of studies into how behaviour change can be enabled, predominantly from psychological and sociological perspectives. This has resulted in a substantial body of knowledge into the factors that drive behaviour change and how they can be manipulated to achieve desired social goals. In this paper we describe a study that draws on this body of knowledge to design an intervention to drive behaviour change across the hairdressing sector, and by the process of diffusion, across the vast social networks of this occupational group to influence domestic hair-care practices. The intervention was successful: hairdressers indicated positive intentions to adopt more sustainable practices within their salons and pass them onto their customers. The customer survey (N=776) confirms this: customers surveyed after their hairdresser attended the Green-Salon-Makeover intervention were significantly more likely to report that environmental issues had been considered in their salon visit and that they themselves would consider such issues in their hair-care practices at home than customers who were surveyed before the intervention

The sun is no fun without rain : Physical environments affect how we feel about yellow across 55 countries

Across cultures, people associate colours with emotions. Here, we test the hypothesis that one driver of this cross-modal correspondence is the physical environment we live in. We focus on a prime example – the association of yellow with joy, – which conceivably arises because yellow is reminiscent of life-sustaining sunshine and pleasant weather. If so, this association should be especially strong in countries where sunny weather is a rare occurrence. We analysed yellow-joy associations of 6625 participants from 55 countries to investigate how yellow-joy associations varied geographically, climatologically, and seasonally. We assessed the distance to the equator, sunshine, precipitation, and daytime hours. Consistent with our hypotheses, participants who live further away from the equator and in rainier countries are more likely to associate yellow with joy. We did not find associations with seasonal variations. Our findings support a role for the physical environment in shaping the affective meaning of colour.Peer reviewe

Transforming access to care for serious mental disorders in slums (the TRANSFORM Project) : rationale, design and protocol

This paper introduces the TRANSFORM project, which aims to improve access to mental health services for people with serious and enduring mental disorders (SMDs – psychotic disorders and severe mood disorders, often with co-occurring substance misuse) living in urban slums in Dhaka (Bangladesh) and Ibadan (Nigeria). People living in slum communities have high rates of SMDs, limited access to mental health services and conditions of chronic hardship. Help is commonly sought from faith-based and traditional healers, but people with SMDs require medical treatment, support and follow-up. This multicentre, international mental health mixed-methods research project will (a) conduct community-based ethnographic assessment using participatory methods to explore community understandings of SMDs and help-seeking; (b) explore the role of traditional and faith-based healing for SMDs, from the perspectives of people with SMDs, caregivers, community members, healers, community health workers (CHWs) and health professionals; (c) co-design, with CHWs and healers, training packages for screening, early detection and referral to mental health services; and (d) implement and evaluate the training packages for clinical and cost-effectiveness in improving access to treatment for those with SMDs. TRANSFORM will develop and test a sustainable intervention that can be integrated into existing clinical care and inform priorities for healthcare providers and policy makers