- Human Rights, Multiculturalism, Mental Health, China, Medical Anthropology, Indonesia, and 9 moreTranscultural Psychiatry, Global Mental Health, Culture and Mental Health, Mental Health Policy, Physical Restraint, Mental Health Policy and Systems, International Relations, International Law, and Public Policyedit
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We, the editors, have encouraged contributors to provide historical, cultural, social, economic and political perspectives on the development of mental health in the diverse nations of the Asia-Pacific region. Such a multi-pronged... more
We, the editors, have encouraged contributors to provide historical, cultural, social, economic and political perspectives on the development of mental health in the diverse nations of the Asia-Pacific region. Such a multi-pronged approach is required to understand this complex phenomenon. Most nations in the region were or became colonies of European powers. Just when psychiatry itself was being formed as a branch of medicine in Europe, it encountered non-Western cultures with deeply rooted, different approaches to mental disorders. Despite the subsequent growth of Western-derived psychiatry in such countries, cross-cultural issues remain significant for the current and future development of policy and services. Indeed, as those involved in the new effort to reduce the burden of untreated mental illness in low- and middle-income countries (LAMIC) realise, cultural appropriateness is central to success. In the last decade or so a debate has developed between epistemic and policy communities as to how best to do this. We believe it will advance understanding if we put the current situation in LAMIC, where globalisation is producing rapid, often disruptive, cultural, economic and social change, in a comparative historical context: the health effects, physical and mental, of this current transformation may be compared with the health impact of the ‘modernisation’ of the West in the nineteenth century. The rise of asylum psychiatry itself in Europe may be seen as an organised, expert response to the growth of mental disorders produced by the speedy, initially unregulated, impact of industrialisation and urbanisation on traditional ways of life, just as the rise of public health in the same era may be viewed as an organised, expert response to the growth of threats to physical health from ‘fevers’ and other communicable diseases. We need to apply what some health analysts have called the ‘re-socializing’ disciplines—history, anthropology, sociology and political economy—to understand more fully mental health in the Asia-Pacific region, and so, hopefully, to contribute more effectively to its promotion.
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Background Primary care doctors in Shenzhen, China are increasingly expected to identify and prevent depressive disorder; however, they have received limited mental health training and community healthcare centres (CHC) do not provide... more
Background Primary care doctors in Shenzhen, China are increasingly expected to identify and prevent depressive disorder; however, they have received limited mental health training and community healthcare centres (CHC) do not provide standardised protocols for the diagnosis and care of depressive disorder. The World Health Organization’s mental health gap intervention guide, version 2 (mhGAP-IG.v2) is a decision support tool for non-specialists for the assessment, management and follow-up of mental, neurological and substance use disorders (including depressive disorder). Given that mhGAP-IG.v2 is a generic tool, it requires adaptation to take account of cultural differences in depression presentation and unique characteristics of China’s emergent mental health system. Methods A two-round, web-based, Delphi survey was conducted. A panel of primary care doctors from Shenzhen, were invited to score their level of agreement with 199 statements (arranged across 10 domains) proposing ch...
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Background A range of services within Australia and internationally have been developed that are focused on the engagement of individuals who are of refugee background to work as a liaison between their communities and mental health... more
Background A range of services within Australia and internationally have been developed that are focused on the engagement of individuals who are of refugee background to work as a liaison between their communities and mental health services. The Community Liaison Worker (CLW) role at the Victorian Foundation for Survivors of Torture (VFST) was developed in 2008 in order to engage in such capacity-building initiatives. Aims To review and document the establishment, evolution and current status of the VFST CLW role, and examine the perspectives of CLWs on their role in trauma-informed community capacity-building. Methods The study comprised of two stages: a historical case study of the development of the CLW role, and a qualitative research study based on interviews with CLWs in order to identify key themes regarding various aspects of their role and understand the facilitators and barriers to their work of trauma-informed capacity-building with their respective communities. Results ...
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OBJECTIVES This study aimed to identify the prevalence and correlates of depressive symptomatology among Vietnamese older people. METHOD We used baseline survey data collected in 2018 from the Longitudinal Study of Ageing and Health in... more
OBJECTIVES This study aimed to identify the prevalence and correlates of depressive symptomatology among Vietnamese older people. METHOD We used baseline survey data collected in 2018 from the Longitudinal Study of Ageing and Health in Vietnam (LSAHV) conducted across seven regions and comprising 6,050 people aged 60 years and over of whom 4962 completed the brief 11-item Center for Epidemiological Studies-Depression (CES-D) scale. Clinically significant depressive symptomatology was a CES-D score of 8.8 or higher. The association between demographic, physical, and mental factors with depressive symptomatology was examined using univariate and multivariable logistic regression. RESULTS The prevalence of depressive symptomatology was 31.3% (95% CI 29.8% - 32.9%). Depressive symptomatology was highest among people living in the Central Coast region (46.8%, 95% CI 44.5% - 49.2%). Factors associated with depressive symptomatology from the multivariable model included female sex (OR 1.3, 95% CI: 1.1-1.6), rural residence (OR 1.4, 95%CI: 1.1-1.7), not having a partner (OR 1.6, 95% CI: 1.3-1.9), low income (OR 1.8, 95% CI: 1.5-2.1), and health-limitations on activities (OR 1.3, 95% CI: 1.1-1.6). Poorer self-rated mental health (OR 2.1, 95% CI:1.8-2.5) or general health status (OR 1.5, 95% CI: 1.3-1.9) was associated with a higher prevalence of depressive symptomatology, as was poorer function with respect to different activities of daily living, and dissatisfaction with current life (OR 6.1, 95% CI: 4.4-8.4). CONCLUSIONS Depressive symptomatology was frequent among older Vietnamese. Efforts to improve mental health in older persons in Vietnam, including prevention, early intervention and better medical care, appear warranted.
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Background While depression is a leading contributor to burden of disease in Vietnam, there is a critical gap in depression care due to the shortage of mental health specialists and extremely limited mental health services in general... more
Background While depression is a leading contributor to burden of disease in Vietnam, there is a critical gap in depression care due to the shortage of mental health specialists and extremely limited mental health services in general health care settings. We have previously reported the effectiveness of a supported self-management (SSM) task-sharing intervention for depression, delivered by social collaborators (lay social workers). The purpose of this study was to identify factors influencing the effectiveness of delivery of SSM by social collaborators and delineate areas for further attention that are relevant for scale-up. Methods A hundred and ten (110) key informant interviews were conducted with three stakeholder groups (patients, social collaborators, experts) from eight provinces in Vietnam. Participants were identified through records from a recently completed randomized trial that showed the effectiveness of SSM in community-based settings in Vietnam. Qualitative descripti...
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Background: The COVID-19 pandemic is expected to have profound mental health impact, including in the Asia Pacific Economic Cooperation (APEC) region. Some populations might be at higher risk of experiencing negative mental health impacts... more
Background: The COVID-19 pandemic is expected to have profound mental health impact, including in the Asia Pacific Economic Cooperation (APEC) region. Some populations might be at higher risk of experiencing negative mental health impacts and may encounter increased barriers to accessing mental health care. The pandemic and related restrictions have led to changes in care delivery, including a rapid shift to the use of e-mental health and digital technologies. It is therefore essential to consider needs and opportunities for equitable mental health care delivery to the most at-risk populations. This rapid scoping review: 1) identifies populations in the APEC region that are at higher risk of the negative mental health impacts of COVID-19, 2) identifies needs and gaps in access to standard and e-mental health care among these populations, and 3) explores the potential of e-mental health to address these needs.Methods: We conducted a rapid scoping review following the PRISMA Extension...
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Background: Integrated antenatal care in Indonesia has the potential to extend the role of community health workers (CHWs) to include the identification of perinatal depression in the community and referral to primary health care (PHC)... more
Background: Integrated antenatal care in Indonesia has the potential to extend the role of community health workers (CHWs) to include the identification of perinatal depression in the community and referral to primary health care (PHC) centres, which is an example of task-sharing. This study aimed to examine the acceptability of this type of task-sharing in perinatal depression in Surabaya.Methods: Semi-structured interviews were conducted with participants from four PHC stakeholder groups. 62 participants were recruited from PHC centres, villages and integrated health service posts, the district health office, and one hospital. Data were analysed using framework analysis.Results: More than ninety percent of participants accepted or conditionally accepted task-sharing in perinatal depression. Acceptability was influenced by the perceived benefits of task-sharing, the convenience of the service delivery, the existence of cases of perinatal depression perceived by stakeholders, person...
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ObjectivesThe present study investigated the reliability and validity of a newly developed Vietnamese version of the 9‐item Utrecht Work Engagement Scale (UWES‐9‐V) in a sample of hospital nurses in Hanoi, Vietnam.MethodsThe UWES‐9 was... more
ObjectivesThe present study investigated the reliability and validity of a newly developed Vietnamese version of the 9‐item Utrecht Work Engagement Scale (UWES‐9‐V) in a sample of hospital nurses in Hanoi, Vietnam.MethodsThe UWES‐9 was translated into Vietnamese following a standard procedure. A survey was conducted of 949 registered nurses in a large tertiary general hospital in Hanoi, Vietnam, in 2018, using a self‐administered questionnaire including the Vietnamese UWES‐9, other scales measuring health status, work performance, job demand, job control, and workplace social support, and questions pertaining to demographic variables. Cronbach’s alpha and interclass correlation coefficients (ICC) were calculated to assess reliability. Explanatory and confirmatory factor analyses were conducted to assess factorial validity. Convergent validity was tested based on associations between the UWES‐9‐V and subscales and other scales.ResultsThe Cronbach’s alpha coefficients of the UWES‐9‐V ...
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ObjectivesThe aim of this study was to examine the reliability and validity of the Job Content Questionnaire (JCQ) in Vietnamese among hospital nursing staff.MethodsThe 22‐items version of the JCQ was used. This includes four scales: (a)... more
ObjectivesThe aim of this study was to examine the reliability and validity of the Job Content Questionnaire (JCQ) in Vietnamese among hospital nursing staff.MethodsThe 22‐items version of the JCQ was used. This includes four scales: (a) psychological demands (5 items); (b) job control (9 items); (c) supervisor support (4 items); and (d) coworker support (4 items). All 1258 nurses in a general hospital in Vietnam, excluding 11 who were due to retire, were invited to complete the cross‐sectional survey. The internal consistency reliability was estimated using Cronbach's α. Construct validity was examined using exploratory factor analysis (EFA). Convergent validity was evaluated by calculating correlations between the JCQ scores and DASS 21 and overtime work.ResultsIn total, 949 (75%) of the 1258 eligible nurses completed the survey. Cronbach's α values demonstrated acceptable internal consistency in two scales (supervisor support α = .87; coworker support α = .86), while Cron...
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Research Interests: Management, Assessment, Mental Health, Depression, Health Care, and 15 moreChina, Health Administration, Medicine, Mental Illness, Clinical Practice, Diagnosis, Barriers, Depressive Disorder, Follow Up, Common Mental Disorders, Mental, Health system reform, Mental health systems, Enablers, and Medical and Health Sciences
IntroductionDue to an increasing demand for healthcare in low-income and middle-income countries in Asia, it is important to develop a strategy to manage work-related stress in healthcare settings, particularly among nurses in these... more
IntroductionDue to an increasing demand for healthcare in low-income and middle-income countries in Asia, it is important to develop a strategy to manage work-related stress in healthcare settings, particularly among nurses in these countries. The purpose of this three-arm randomised controlled trial (RCT) is to examine the effects of a newly developed smartphone-based multimodule stress management programme on reducing severity of depressive and anxiety symptoms as primary outcomes at 3-month and 7-month follow-ups among hospital nurses in Vietnam.Methods and analysisThe target study population will be registered nurses working in a large general hospital (which employs approximately about 2000 nurses) in Vietnam. They will be invited to participate in this study. Participants who fulfil the eligibility criteria will be randomly allocated to the free-choice, multimodule stress management (intervention group A, n=360), the internet cognitive behavioural therapy (iCBT), that is, fixe...
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In Shenzhen, despite recent primary and mental healthcare reform, Primary healthcare doctors (PHC) have limited access to diagnostic tools and a significant mental health treatment gap presides. The World Health Organization’s (WHO)... more
In Shenzhen, despite recent primary and mental healthcare reform, Primary healthcare doctors (PHC) have limited access to diagnostic tools and a significant mental health treatment gap presides. The World Health Organization’s (WHO) mental health gap intervention guide (mhGAP-IG.v2) offers a non-specialist and evidence-based guide for the assessment of depression however requires adaptation to the context of use. Bilingual (Mandarin and English) qualitative research was undertaken with 30 PHC leaders from Shenzhen to compare their assessment approach for depression against the mhGAP-IG.v2 in order to identify context-specific modifications for a local guide. Local assessment differentiators included: a need for culturally sensitive translation of depression symptoms; a preference for a broad, non-hierarchical symptom presentation (including somatic, behavioural and anxiety items); national prioritisation of suicide patients; the integration of family into the cycle of care; limited ...
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Background Universities are increasingly recognised as institutions where health and wellbeing can be promoted to maximise academic outcomes, career transitions, and lifelong positive health behaviours. There is concern about the mental... more
Background Universities are increasingly recognised as institutions where health and wellbeing can be promoted to maximise academic outcomes, career transitions, and lifelong positive health behaviours. There is concern about the mental health of university students and other factors which affect academic outcomes particularly for subgroups such as international students. There are few cohort studies of the breadth of issues that can impact on mental health and academic outcomes for both local and international students. We conducted a baseline prevalence survey of students at a large Australian university covering health, academic, and social determinants of wellbeing. The purpose was to inform the university’s new student health and wellbeing framework with a view to follow-up to determine predictors of mental ill-health and academic outcomes in the subsequent year. In this paper we present the baseline prevalence data and report on selected mental health and health care access is...
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Research Interests: Evolutionary Biology, Dentistry, Applied Ethics, Education, Biomedical Engineering, and 15 moreImmunology, Complementary and Alternative Medicine, Chinese Medicine, Globalization And Health, Ecology, Biological Sciences, Human Resources for Health, Biomedical science, Acknowledgement, Geomatic Engineering, Clinical Sciences, Eye, Conflict and Health, Environmental Health Engineering science, and Clinical Bioinformatics
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We need to apply what some health analysts have called the 're-socializing' disciplines—history, anthropology, sociology and political economy—to understand more fully mental health in the Asia-Pacific region, and so,... more
We need to apply what some health analysts have called the 're-socializing' disciplines—history, anthropology, sociology and political economy—to understand more fully mental health in the Asia-Pacific region, and so, hopefully, to contribute ..
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Domestic/family violence is a widespread major public health and human rights violation issue that runs across ethno-cultural affiliations and economic status. Relative to the actual incidence of family violence, use of services is low,... more
Domestic/family violence is a widespread major public health and human rights violation issue that runs across ethno-cultural affiliations and economic status. Relative to the actual incidence of family violence, use of services is low, and delayed for years after onset, within the broader Victorian and Australian community. Utilization is even lower for women from immigrant and refugee communities. It has been noted that family violence service utilization by Indian women immigrants in particular was especially low, relative to the size of the Indian population in Victoria. With the Indian culture understood to be traditionally a strongly male-dominated culture, it was deemed important to explore the nature of family violence experience of Indian women living in Australia, and culturally determined barriers to use of services. A partnership was formed to explore this issue through a participatory community theatre approach. Forum Theatre is a powerful tool that uses theatre for gen...
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BACKGROUND Work engagement is important for employee’s well-being and work performance. However, no intervention study has investigated the effect of eMental Health intervention on work engagement among workers in low- and middle-income... more
BACKGROUND Work engagement is important for employee’s well-being and work performance. However, no intervention study has investigated the effect of eMental Health intervention on work engagement among workers in low- and middle-income countries (LMICs). OBJECTIVE The aim of the study was to examine the effects of the newly developed smartphone-based stress management program (“ABC stress management”) on improving work engagement among hospital nurses in Vietnam, a LMIC. METHODS Full-time nurses (N= 949) were randomly assigned to two types of intervention groups and a control group. A 6-week, 6-lesson program offering basic cognitive behavioral therapy (CBT-based stress management skills); provided in free-choice (Program A) and fixed order (Program B). Work engagement was assessed at baseline, 3- and 7-month follow-ups in each of the three groups. RESULTS Program B showed a significant intervention effect on improving work engagement at 3-month follow-up (p = 0.049) with a small e...
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Background This study tested the effectiveness of a supported self-management (SSM) intervention to reduce symptoms of depression among adults compared with enhanced treatment as usual in community-based and primary care settings in... more
Background This study tested the effectiveness of a supported self-management (SSM) intervention to reduce symptoms of depression among adults compared with enhanced treatment as usual in community-based and primary care settings in Vietnam. Methods The cluster randomized trial included 376 adults in 32 communes in eight provinces. Eligible participants scored > 7 on the SRQ-20 depression scale. Patients with severe symptoms were excluded and referred to tertiary care. Randomization took place at the commune level. The immediate intervention group included 16 communes with 190 participants and the delayed group included 16 communes with 186 participants. Participants in communes randomized to the immediate intervention group received a two-month course of SSM, consisting of a workbook and supportive coaching. Those in communes randomized to the delayed group received enhanced treatment as usual and, for ethical purposes, received the SSM intervention after 4 months. The primary o...
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Objective: There has been increased attention in recent years to mental health, quality of life, stress and academic performance among university students, and the possible influence of learning styles. Brief reliable questionnaires are... more
Objective: There has been increased attention in recent years to mental health, quality of life, stress and academic performance among university students, and the possible influence of learning styles. Brief reliable questionnaires are useful in large-scale multivariate research designs, such as the largely survey-based research on well-being and academic performance of university students. The objective of this study was to examine the psychometric properties of a briefer version of the 39-item Adelaide Diagnostic Learning Inventory. Results: In two survey samples - medical and physiotherapy students - a 21-item version Adelaide Diagnostic Learning Inventory - Brief (ADLIB) was shown to have the same factor structure as the parent instrument, and the factor structure of the brief instrument was found to generalise across students of medicine and physiotherapy. Sub-scale reliability estimations were in the order of magnitude of the parent instrument. Sub-scale inter-correlations, i...
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Non-professional community health workers have been widely reported as possibly having a role in mental health. In Indonesia, their role is currently being introduced in the national health system for perinatal depression. Prior... more
Non-professional community health workers have been widely reported as possibly having a role in mental health. In Indonesia, their role is currently being introduced in the national health system for perinatal depression. Prior publications have shown that it is generally considered feasible and acceptable by key stakeholders for community health workers to identify and refer women experiencing mental health issues during their perinatal phase to primary care. However, characteristics and competencies required for these workers have not yet been identified. 62 participants from four groups of stakeholders in primary health care in Surabaya were interviewed, including program managers, health workers, community health workers (CHWs), mental health specialists, and pregnant and postpartum women. Semi-structured questions were used to explore participants' views about characteristics and competencies required by CHWs to identify and refer perinatal depression. Literacy and social ...
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Indonesian maternal health policies state that community health workers (CHWs) are responsible for detection and referral of pregnant women and postpartum mothers who might suffer from mental health problems (task-sharing). The documents... more
Indonesian maternal health policies state that community health workers (CHWs) are responsible for detection and referral of pregnant women and postpartum mothers who might suffer from mental health problems (task-sharing). The documents have been published for a while, however reports on the implementation are hardly found which possibly resulted from feasibility issue within the health system. To examine the feasibility of task-sharing in integrated mental health care to identify perinatal depression in Surabaya, Indonesia. Semi-structured interviews were conducted with 62 participants representing four stakeholder groups in primary health care: program managers from the health office and the community, health workers and CHWs, mental health specialists, and service users. Questions on the feasibility were supported by vignettes about perinatal depression. WHO's health systems framework was applied to analyse the data using framework analysis. Findings indicated the policy ini...
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The core of Australia's response to asylum seekers who arrive in an unauthorised manner has been to detain them in immigration detention centres until they are judged to engage Australia's protection obligations or, if... more
The core of Australia's response to asylum seekers who arrive in an unauthorised manner has been to detain them in immigration detention centres until they are judged to engage Australia's protection obligations or, if they do not, until they are returned to their country of origin. For a number of asylum seekers this has resulted in very prolonged detention. This policy has aroused a storm of controversy with very polarised positions being taken by participants in the debate. In particular, the claim has frequently been made (including by this author) that the circumstances and duration of immigration detention cause substantial harm to the mental health of a significant number of detained asylum seekers. A rational debate on the effects of detention has been hampered by the fact that the Australian government has not allowed researchers access to the detention centres in spite of persistent requests for access by professional bodies. This paper is written in response to the following questions posed by the Journal: Is there a case to be made for individuals agreeing to participate in research studies and for the wider population of current and future detainees to be involved in research without informing either the detention provider or the host nation? Is is legitimate for a researcher to engage in potentially deceptive actions in order to obtain access to such detention facilities to undertake research? What ethical framework should underpin such research? Although there is very little guidance in the literature on the ethical conduct of research in settings such as immigration detention centres, a consideration of the ethical implications of carrying out research in the manner raised by these questions leads this author to conclude that such research cannot be ethically justified. Governments must be persuaded to allow, and to provide substantial support for, ethically conducted research on all aspects of detention. There is also a need for the development of an explicit ethical framework for the conduct of research in settings characterised by a very problematic human rights context.
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Research Interests: Psychology, Death Studies, Immigration, Australia, Suicide, and 9 moreImmigrants and Emigrants, Refugees, Humans, Refugee, Female, Male, Middle Aged, Adult, and Routledge
The 60-item General Health Questionnaire (GHQ) was translated into Turkish and administered to a community sample of 437 Turkish-speaking immigrants resident in Melbourne, Australia. The factor structures of the 60-item and 28-item... more
The 60-item General Health Questionnaire (GHQ) was translated into Turkish and administered to a community sample of 437 Turkish-speaking immigrants resident in Melbourne, Australia. The factor structures of the 60-item and 28-item versions of the GHQ were examined to determine the cross-cultural validity of the four subscales of the 28-item GHQ "anxiety/insomnia", "social dysfunction", "severe depression" and "somatic complaints". Four-factor principal components analyses yielded factors which corresponded to similar underlying traits, but the pattern of symptom loadings differed in several ways. Insomnia was less closely associated with anxiety, and general illness ratings such as "not feeling perfectly well" were not uniquely associated with somatic symptoms. The "anxiety/insomnia" and "severe depression" factors overlapped, with many symptoms partially correlated with both factors. These factors appeared to be...