Category Archives: Early Childhood Development

We need sustainable solutions to deal with mental health treatment gap

On World Mental Health Day many have thought about mental health status in their countries and the treatment gaps all over the world.

Our blog focuses on articles and statistics around mental health care and in particular around maternal mental health care globally and in low- and middle-income countries.

“Mental health matters because it affects everyone”

“Around 30% of women in low-income countries and 10-15% in high-income countries have a significant mental health problem during pregnancy and after childbirth. And yet most of these women never get diagnosed or receive any treatment” Maternal Mental Health-Global Challenge

“South Africa needs sustainable solutions to deal with its mental health treatment gap, delegates heard at a roundtable discussion ahead of World Mental Health Day (WMHD) – “Economy, Equality and Access to Mental Health Services” Close the mental health treatment gap

“The mental health of pregnant women can be affected by a range of factors, including partner violence and unemployment. But one of the key drivers that adversely affect a pregnant woman’s mental health is food insecurity. Being food insecure is when someone doesn’t have food or has the wrong kinds of food.” How hunger affects the mental health of pregnant mothers


Image: Robin Hammond

“Lack of food security is driving depression, anxiety and suicidal behaviour in poor communities” How hunger erodes mental health

“From OCD to suicide and depression, these numbers will alarm you.” (South Africa focus) 10 Mental Health stats South Africa

“South African children may be affected by a myriad of traumas. According to the South African Journal of Psychiatry, children and adolescents can suffer from post-traumatic stress disorder (PTSD) after being exposed to a range of traumatic events.” Here’s how the Sesame Street’s Muppets help kids

“Crisis issue needs to be priority among developing nations” Mental health treatment a human right

“World Mental Health Day: the need for conversations on the subject in India is as strong as ever, because despite a start, not enough of them are taking place.” A poignant series of films relates the stories of people who fought and won

Sick link between hunger and mental health – linking food insecurity and mental health.

“Future actions should focus on better identification of people in vulnerable situations who may require specific support including people experiencing mental distress, early intervention and culturally appropriate mental health training for all frontline staff.” Mental health is not the problem, it’s the solution

“Children whose mothers are depressed during pregnancy have a small increased risk of depression in adulthood, according to a UK study.” Depression risk ‘starts in the womb’

“What more needs to be done to make mental health care a reality for people worldwide.” Making mental health a cultural priority

“Mental health needs a new narrative. citiesRISE is a global platform committed to transforming the state of mental health policy and practice in cities and beyond to meet the mental health needs of populations across the world.” citiesRISE new website

 

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Breaking the negative cycle of mental ill-health and poverty during the perinatal period

The negative cycle of mental ill-health and poverty is particularly relevant for women and their infants during the perinatal period. During this time, major life transitions render women more vulnerable to mental illness from social, economic and gender-based perspectives.

Those with the most need for mental health support, have the least access. Overburdened maternal and mental health services have not been able to address adequately this significant unmet need. There have been limited attempts at a programmatic level, to integrate mental health care within maternal care services.

The perinatal period, where women are accessing health services for their obstetric care, presents a unique opportunity to intervene in the event of mental distress. Preventive work involving screening and counselling may have far-reaching impact for women, their offspring and future generations.

Mental health care is a notoriously neglected area – even more so in “healthy” pregnant and postnatal women. The focus on the physical to the detriment of the emotional is particularly felt now against the backdrop of HIV and AIDS. The public health service has been unable to address the mental health needs of women from poorer communities – neither within maternity services nor within mental health services. This is despite a wide body of evidence showing that distress in the mother may have long-lasting physical, cognitive and emotional effects on her children.

Integrating mental health into maternal care in South Africa

The PMHP aims to integrate mental health service routinely, within the primary maternal care environment.
Based at selected government MoU facilities in Cape Town, we offer counselling and support services focused on the emotional wellbeing of pregnant women with a strong focus on postnatal and clinical depression.

New Study examines effects of Maternal Depression on young children

We know a mom who is clinically depressed has a lot of negative outcomes. Those negative outcomes are not just for the mom, they can also have long-term implications for children.

Researchers and clinicians alike have been particularly concerned about the effects of maternal depression during and after pregnancy on children.

Picture: scope stanford medicine

But a new study suggests that a mother’s depression during the preschool years may be more harmful to children than either her prenatal or immediately postnatal depression. It is the first study to track the effects of maternal depression on children from pregnancy until the children turn 5.

Source: New Study Examines Effects Of Maternal Depression On Young Children | Scope Blog

Domestic violence during pregnancy

Domestic violence is any physical, sexual, psychological or economic abuse that takes place between people who are sharing, or have recently shared a home.

In Africa, there is more violence against women than on any other continent. Three women are killed by their partners in South Africa every day, thats twice as many women than in the United States of America. Violence during pregnancy has negative effects for both the mother and the child. Abused women are more likely to delay getting pregnancy care and to attend fewer antenatal visits.

Our recent research study looked at pregnant women who experience domestic violence in Hanover Park, Cape Town. We looked at the profile of women who reported domestic violence and what factors in their lives were associated with this abuse.

domestic_violence_during_pregnancy

We found that women who were experiencing domestic violence were more likely than those without domestic violence to:

– have a current mental health problem like depression, anxiety, suicidal thoughts or behaviours, alcohol or drug abuse

– have had past mental health problems
– have experienced past abuse
– not feel supported by their partner
– not likely feel pleased about being pregnant
– more likely experience food insecurity and not have a job

Out of this study with developed a learning brief which targets any service providers who interact with vulnerable women and children, especially those service providers who work with pregnant women. Such services providers can arise from nongovernmental organisations (NGOs) or civil society organisations and may be healthcare providers or social service providers.
Find this and more on our resources for professionals pages.

How can we screen for perinatal depression – globally!

Source: https://womensmentalhealth.org/posts/can-screen-perinatal-depression-developing-world/

While perinatal mood and anxiety disorders (PMAD) have a global footprint, the majority of research related to this group of illnesses has come largely from more affluent, Westernized countries.  Similarly, the tools used to detect and screen for PMADs were developed and tested in these Westernized countries.

The instrument most commonly used to detect PMADs is the Edinburgh Postnatal Depression Scale (EPDS), which was originally developed in Great Britain.  While it has been translated into many different languages and used in many different countries, it is unclear if these translated versions of the EPDS accurately identify PMAD in disparate, non-English speaking countries.  Specifically there has been concern that simply translating the EPDS may not fully capture the cultural determinants of mood and anxiety disorders.

Asian mother holds her newborn baby

Asian mother holds her newborn baby

Particularly vulnerable to mental health problems are the women who are pregnant or have recently given birth living in resource-constrained, low- and lower-middle-income countries (LALMICs) as defined by the World Bank.  A  recent systematic review appraised formally validated local language versions of the EPDS used in resource-constrained settings (Shrestha et al., 2016).

 

Integrating mental health care into maternal and infant care can help low-income families

Integrating therapy, other services, or information into routine visits can make getting help easier and chip away at the stigma regarding postpartum depression.

Photo: Shuttershock Image: Shuttershock

Unlike the “baby blues,” which are commonly associated with mild feelings of worry and fatigue after having a baby, postpartum depression is a mood disorder characterized by a broad range of symptoms including anxiety, extreme sadness, and exhaustion.

Source: How Folding Mental Health Services Into Maternal and Infant Care Can Help Low-Income Families – Rewire

Impact of maternal depression and anxiety on child development

A number of new studies have found that stress, depression or anxiety during and after pregnancy can have long lasting effects on the development of your child.

We have translated some of those findings into an Issue Brief and added some of our recommendations for evidence based interventions for parents.

maternal mental health care

This Issue Brief outlines not only the risk factors for parents, but also encourages the building of resilience to prevent or lessen the negative impacts for children.

caring for the future

“Caring for mothers and fathers – is caring for the future”

Maternal depression and mental health in early childhood

Depression during and after pregnancy is affecting up to one in five women globally.

Previous studies from around the world suggest that depression during and after pregnancy affects the bonding between mother and child and can have direct implications for infant survival and early childhood development.

In this new review, the authors focused mainly on low and middle income countries and are calling for urgent interventions for mothers and children.

There is a substantial lack of research specific to women in poorer countries, where interventions such as cognitive behavioural therapy may not be available

– Prof Vivette Glover, Imperial College London

MMH_screening

Previously, research into perinatal depression has focused on high income countries. But current studies suggest that the problem is more common in low- and middle-income countries, some even suggest that up to 50% of women living in adversity are experiencing depression during or after pregnancy.

Therefor more resources are needed to support expectant and new mothers. Urgent investment is needed in research and the development of appropriate low cost interventions that are specific to these areas.

The Lancet review full text: Maternal depression and mental health in early childhood: an examination of underlying mechanisms in low-income and middle-income countries

Depression after Childbirth – a silent killer in India

Our partner – organisation, PRIME, was recently featured on NDTV’s programme Every Life Counts in a news clip zooming in on perinatal depression in India. A full feature will be aired in September.

Perinatal depression continues to be a stigmatised and poorly addressed problem in many low- and middle-income countries. In India it’s no different and the burden of this disease increases every year. Watch the clip below and keep an eye out for the full feature in September.

depression after childbirth

Source: PRIME

Thinking Healthy manual by @WHO #maternalmentalhealth

‘Thinking Healthy’
A manual for psychosocial management of perinatal depression

This new publication is the first of a new World Health Organization (WHO)​ series on low-intensity psychological interventions.

The manual outlines an evidence-based approach describing how community health workers can reduce prenatal depression through evidence-based cognitive-behavioural techniques recommended by the mhGAP programme.

Find the manual here:
http://apps.who.int/iris/bitstream/10665/152936/1/WHO_MSD_MER_15.1_eng.pdf?ua=1&ua=1

maternalmentalhealth

Find out more about the Mental Health Gap Action Programme (mhGAP) here:
http://www.who.int/mental_health/mhgap/en/

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