Working globally, thinking locally: providing psychosocial intervention training in Sierra Leone

This article reflects on the work of a project that brings Clinical Psychologists from Europe and the United States to Sierra Leone to train local workers in psychosocial interventions. Strengths, weaknesses, and opportunities associated with this work are highlighted

Reciprocity in global mental health policy

In an attempt to address inequalities and inequities in mental health provision in low and middle-income countries the WHO commenced the Mental Health Gap Action Programme (mhGAP) in 2008. Four years on from the commencement of this programme of work, the WHO has recently adopted the Comprehensive Mental Health Action Plan 2013-2020. This article will critically appraise the strategic direction that the WHO has adopted to address mental health difficulties across the globe. This will include a consideration of the role that the biomedical model of mental health difficulties has had on global strategy. Concerns will be raised that an over-reliance on scaling up medical resources has led to a strengthening of psychiatric hospital-based care, and insufficient emphasis being placed on social and cultural determinants of human distress. We also argue that consensus scientific opinion garnered from consortia of psychiatric ‘experts’ drawn mainly from Europe and North America may not have universal relevance or applicability, and may have served to silence and subjugate local experience and expertise across the globe. In light of the criticisms that have been made of the research that has been conducted into understanding mental health problems in the global south, the article also explores ways in which the evidence-base can be made more relevant and more valid. An important issue that will be highlighted is the apparent lack of reciprocity that exists in the impetus for change in how mental health problems are understood and addressed in low and middle-income countries compared to high-income countries. Whereas there is much focus on the need for change in low and middle-income countries, there is comparatively little critical reflection on practices in high-income countries in the global mental health discourse. We advocate for the development of mental health services that are sensitive to the socio-cultural context in which the services are applied. Despite the appeal of global strategies to promote mental health, it may be that very local solutions are required. The article concludes with some reflections on the strategic objectives identified in the Comprehensive Mental Health Action Plan 2013-2020 and how this work can be progressed in the future

Construction and performance of a novel capture-mark-release moth trap

Mark-recapture studies can provide important information about moth movement as well as habitat preference across a landscape, but to date, such studies tend to be species-specific or require labor-intensive methodologies. To address this challenge, we designed a capture-mark-release-trap (CMRT) featuring a cooling unit attached to a black light trap. The CMRT captures and incapacitates moths throughout the night until the morning, when they can be marked on-site and released. Moths captured with the CMRT during summer of 2016 had a recapture rate of 1.6%, similar to those of previous studies. Importantly, because moths are immobilized by the CMRT, they can be handled and marked with ease, reducing the opportunities to damage specimens prior to release. The CMRT trap can capture a wide array of moth species and may facilitate an increase in the monitoring of moth movement across landscapes

The capabilities approach: fostering contexts for enhancing mental health and wellbeing across the globe

Concerted efforts have been made in recent years to achieve equity and equality in mental health for all people across the globe. This has led to the emergence of Global Mental Health as an area of study and practice. The momentum that this has created has contributed to the development, implementation and evaluation of services for priority mental disorders in many low- and middle-income countries. This paper discusses two related issues that may be serving to limit the success of mental health initiatives across the globe, and proposes potential solutions to these issues. First, there has been a lack of sophistication in determining what constitutes a ‘good outcome’ for people experiencing mental health difficulties. Even though health is defined and understood as a state of ‘wellbeing’ and not merely an absence of illness, mental health interventions tend to narrowly focus on reducing symptoms of mental illness. The need to also focus more broadly on enhancing subjective wellbeing is highlighted. The second limitation relates to the lack of an overarching theoretical framework guiding efforts to reduce inequalities and inequities in mental health across the globe. This paper discusses the potential impact that the Capabilities Approach (CA) could have for addressing both of these issues. As a framework for human development, the CA places emphasis on promoting wellbeing through enabling people to realise their capabilities and engage in behaviours that they subjectively value. The utilization of the CA to guide the development and implementation of mental health interventions can help Global Mental Health initiatives to identify sources of social inequality and structural violence that may impede freedom and individuals’ opportunities to realise their capabilities

A cross-sectional examination of candidate psychological factors associated with Post-Psychotic PTSD & Research Portfolio

Introduction: Experiencing schizophrenia can be sufficiently distressing to precipitate Post-psychotic PTSD (PP-PTSD). Understanding about PP-PTSD has developed without reference to contemporary trauma theory. A conceptual framework informed by Ehlers & Clark (2000) is used to determine if PP-PTSD was associated with a sense of serious current threat and negative appraisals of psychosis. Methods: This study recruited 27 individuals with schizophrenia. Associations that PP-PTSD caseness had with fear of recurrence, intolerance of uncertainty, beliefs about paranoia and interpretations about hallucinatory voices were investigated. Links with psychiatric symptoms were also assessed. Results: The prevalence rate of PP-PTSD was 37%. PP-PTSD caseness was associated with being fearful about psychosis recurring, being intolerant of uncertainty, and making negative appraisals about paranoia. Fear of recurrence was the only significant predictor of PP-PTSD caseness. Conclusions: PP-PTSD appears to be largely consistent with a conceptual framework for persistent PTSD. Fear of recurrence was identified as a candidate psychological factor for PP-PTSD

Oblique shock interactions with gas cylinder interfaces

This thesis presents an experimental study of fluid instabilities formed due to an oblique interatction of a shock wave with a cylindrical gas column seeded with glycol droplets. Two gases are injected into quiescent air to form the column. The first is sulfur hexafluoride (SF6) which generates the well-known Richtmyer-Meshkov Instability (RMI) when impulsively accelerated by a shock wave. This instability is formed due to the misalignment of the pressure and density gradients during the acceleration phase. The second is air. In this case, there is no macroscopic density gradient between the gas column and the surrounding air. Nonetheless, an instability similar to RMI develops due to the presence of the glycol droplets. Experimental studies are performed at an oblique angle of 15 degrees and a Mach number of 1.67. Experiments of this nature typically make an assumption that the cylindrical gas column is nominally two-dimensional to simplify the problem. The validity of this assumption is explored by investigating the morphology of the instabilities in multiple horizontal planes and a vertical plane. Major variations of the morphology only occur near the bounding walls, with less variation far from these walls. An investigation of the rotation of the gas column is also presented

Redshift Weights for Baryon Acoustic Oscillations : Application to Mock Galaxy Catalogs

Large redshift surveys capable of measuring the Baryon Acoustic Oscillation (BAO) signal have proven to be an effective way of measuring the distance-redshift relation in cosmology. Building off the work in Zhu et al. (2015), we develop a technique to directly constrain the distance-redshift relation from BAO measurements without splitting the sample into redshift bins. We parametrize the distance-redshift relation, relative to a fiducial model, as a quadratic expansion. We measure its coefficients and reconstruct the distance-redshift relation from the expansion. We apply the redshift weighting technique in Zhu et al. (2015) to the clustering of galaxies from 1000 QuickPM (QPM) mock simulations after reconstruction and achieve a 0.75% measurement of the angular diameter distance $D_A$ at $z=0.64$ and the same precision for Hubble parameter H at $z=0.29$. These QPM mock catalogs are designed to mimic the clustering and noise level of the Baryon Oscillation Spectroscopic Survey (BOSS) Data Release 12 (DR12). We compress the correlation functions in the redshift direction onto a set of weighted correlation functions. These estimators give unbiased $D_A$ and $H$ measurements at all redshifts within the range of the combined sample. We demonstrate the effectiveness of redshift weighting in improving the distance and Hubble parameter estimates. Instead of measuring at a single 'effective' redshift as in traditional analyses, we report our $D_A$ and $H$ measurements at all redshifts. The measured fractional error of $D_A$ ranges from 1.53% at $z=0.2$ to 0.75% at $z=0.64$. The fractional error of $H$ ranges from 0.75% at $z=0.29$ to 2.45% at $z = 0.7$. Our measurements are consistent with a Fisher forecast to within 10% to 20% depending on the pivot redshift. We further show the results are robust against the choice of fiducial cosmologies, galaxy bias models, and RSD streaming parameters.Comment: 13 pages, 8 figures, submitted to MNRA

Reciprocity in global mental health policy

In an attempt to address inequalities and inequities in mental health provision in low and middle-income countries the WHO commenced the Mental Health Gap Action Programme (mhGAP) in 2008. Four years on from the commencement of this programme of work, the WHO has recently adopted the Comprehensive Mental Health Action Plan 2013-2020. This article will critically appraise the strategic direction that the WHO has adopted to address mental health difficulties across the globe. This will include a consideration of the role that the biomedical model of mental health difficulties has had on global strategy. Concerns will be raised that an over-reliance on scaling up medical resources has led to a strengthening of psychiatric hospital-based care, and insufficient emphasis being placed on social and cultural determinants of human distress. We also argue that consensus scientific opinion garnered from consortia of psychiatric ‘experts’ drawn mainly from Europe and North America may not have universal relevance or applicability, and may have served to silence and subjugate local experience and expertise across the globe. In light of the criticisms that have been made of the research that has been conducted into understanding mental health problems in the global south, the article also explores ways in which the evidence-base can be made more relevant and more valid. An important issue that will be highlighted is the apparent lack of reciprocity that exists in the impetus for change in how mental health problems are understood and addressed in low and middle-income countries compared to high-income countries. Whereas there is much focus on the need for change in low and middle-income countries, there is comparatively little critical reflection on practices in high-income countries in the global mental health discourse. We advocate for the development of mental health services that are sensitive to the socio-cultural context in which the services are applied. Despite the appeal of global strategies to promote mental health, it may be that very local solutions are required. The article concludes with some reflections on the strategic objectives identified in the Comprehensive Mental Health Action Plan 2013-2020 and how this work can be progressed in the future