- Vilnius, Vilniaus Apskritis, Lithuania
Dainius Puras
Vilnius University, Faculty of Medicine, Faculty Member
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The 12 narratives included in this symposium on living with mental health challenges reflect the broad spectrum of experiences and interpretations of individuals who have mental health conditions. They also reflect the range of views... more
The 12 narratives included in this symposium on living with mental health challenges reflect the broad spectrum of experiences and interpretations of individuals who have mental health conditions. They also reflect the range of views within global mental health discourse about effective ways to improve the mental health of individuals and populations. Some important issues are common in these narratives, notably how experiencing trauma, particularly in childhood, can impact mental health. The narratives present a broad spectrum of views regarding the interpretation of mental health conditions and the ways mental healthcare systems have addressed them. These narratives demonstrate an urgent need globally to liberate the field of mental health from the overuse of the biomedical model and allow other models to compete and receive support.
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Introduction The epidemiology of Asperger syndrome (AS) has been speciffically investigated only in one total population study by S. Ehlers, C. Gillberg (1993) in Goteborg (Sweden). Because of AS was included as a separate diagnostic... more
Introduction The epidemiology of Asperger syndrome (AS) has been speciffically investigated only in one total population study by S. Ehlers, C. Gillberg (1993) in Goteborg (Sweden). Because of AS was included as a separate diagnostic category in the ICD-10 and DSMIV there was perceived need to obtain reliable prevalence estimates of AS in other countries. The purpose of the study was to estimate the prevalence rate of AS in Vilnius (Lithuania).
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Future of psychiatry is discussed in the context of modern human rights principles, evidence-based policies and sustainable development goals.After international community agreed on sustainable development goals to be reached by 2030,... more
Future of psychiatry is discussed in the context of modern human rights principles, evidence-based policies and sustainable development goals.After international community agreed on sustainable development goals to be reached by 2030, there is a good opportunity to address mental health as a priority and to substantially invest in promotion of mental health and emotional well-being.Psychiatry, as an influential specialty, needs to reconsider its strategy in this context, and to rethink strengths and weaknesses of its role and image.Protection of dignity and human rights of persons with psychosocial disabilities, in the post-CRPD framework, should become a priority for psychiatry. Common ground for search of a new consensus between different views on non-consensual treatment in psychiatry could be equilibrium within the principles of “first, do no harm”, “right to treatment” and “no hierarchy within human rights”. For mental healthcare practice, this would mean that good intentions to provide evidence-based interventions do not justify the use of force and deprivation of liberty which threatens dignity and universal human rights principles.Psychiatry, while rethinking future directions, should critically reconsider its current focus on neurobiological paradigm and tradition of using force in the name of medicine and social control. These two paradigms, traditionally perceived as strengths of psychiatry and sources of its power, are now too often misused and increasingly discussed as lacking evidence, ignoring human rights and thus threatening image of psychiatry. Instead, psychiatry could consider accepting post-CRPD challenge as a unique opportunity for change, through strengthening strategic alliance with human rights mechanisms, social sciences, general and community medicine, modern public health approach and users’ perspective.Disclosure of interestThe author has not supplied his declaration of competing interest.
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Research Interests: Humanities and Vilnius
We propose that a Right to Health Capacity Fund (R2HCF) be created as a central institution of a reimagined global health architecture developed in the aftermath of the COVID-19 pandemic. Such a fund would help ensure the strong health... more
We propose that a Right to Health Capacity Fund (R2HCF) be created as a central institution of a reimagined global health architecture developed in the aftermath of the COVID-19 pandemic. Such a fund would help ensure the strong health systems required to prevent disease outbreaks from becoming devastating global pandemics, while ensuring genuinely universal health coverage that would encompass even the most marginalized populations. The R2HCF's mission would be to promote inclusive participation, equality, and accountability for advancing the right to health. The fund would focus its resources on civil society organizations, supporting their advocacy and strengthening mechanisms for accountability and participation. We propose an initial annual target of US$500 million for the fund, adjusted based on needs assessments. Such a financing level would be both achievable and transformative, given the limited right to health funding presently and the demonstrated potential of right t...
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Šis tyrimas yra viena iš Europos Komisijos finansuoto projekto „Vaikų ir paauglių psichikos sveikata išsiplėtusioje Europos Sąjungoje: efektyvios politikos ir praktikos kūrimas“ sudėtinių dalių. Šeimų, kurių nariai tėvai, turintys... more
Šis tyrimas yra viena iš Europos Komisijos finansuoto projekto „Vaikų ir paauglių psichikos sveikata išsiplėtusioje Europos Sąjungoje: efektyvios politikos ir praktikos kūrimas“ sudėtinių dalių. Šeimų, kurių nariai tėvai, turintys psichikos ligą, yra apgyvendinami stacionarios globos namuose, apklausa parodė, kad veiksmingų tėvystės programų (kaip ir kitos bendruomeninės paslaugos socialinės rizikos šeimoms) gali tapti veiksminga alternatyvia priemone dabar dominuojančiam stigmatizuojančiam ir paternalistiniam požiūriui. Remiantis situacijos stacionarios globos įstaigose apžvalga ir analize, pažymėtina, kad didelę įtaką jose gyvenančių asmenų likimui, jų santykiams su šeimos nariais, šiems santykiams išsaugoti, šeimos nariams bendrauti daro tiek Lietuvoje veikiančios psichikos sveikatos ir socialines apsaugos sistemos, tiek praeityje susiformavę stereotipai, nuomonė apie stacionarios globos įstaigas bei jų gyventojus, tiek visuomenei pateikiamos informacijos pobūdis. Pažymėtina, kad...
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Copyright © 2020 Chapman, Williams, Hannah, and Pūras. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits... more
Copyright © 2020 Chapman, Williams, Hannah, and Pūras. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited. editorial Reimagining the Mental Health Paradigm for Our Collective Well-Being
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Research Interests: Cognitive Science, Education, Mental Health, Global Health, Developing Countries, and 15 moreInternational Cooperation, Health Services Research, Health Policy, Medicine, Humans, Developing Country, Health Research, Developing World, Income, Mental Disorders, Clinical Sciences, Consumer Participation, Bottom Up, Health Care Costs, and Health Priorities
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Research Interests: Human Rights, Political Science, Global Health, Social Determinants of Health, Public Health, and 13 moreMedicine, Humans, Scrutiny, Right to Health, World Health Organization, Pandemics, Pandemic, Betacoronavirus, The Lancet, coronavirus outbreak, Coronavirus Disease 2019 (COVID-19), Coronavirus infections, and Medical and Health Sciences
A research on self-destructive behaviors requires a wider approach: Reply to the review
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Holistic approach to children’s right to health requires that a disorder-oriented approach and a health promoting perspective have to be considered as equal priorities. However mental health policy in many states is still oriented more... more
Holistic approach to children’s right to health requires that a disorder-oriented approach and a health promoting perspective have to be considered as equal priorities. However mental health policy in many states is still oriented more toward biomedical treatment of disorders rather than preventive and promotional measures. In this paper we argue that successful implementation of health promoting approach can be achieved through sustainable investment in sectoral cooperation, capacity building and political will. Using Lithuanian mental health policy example we illustrate how the shortcomings affecting each determinant impede progress in prioritizing health promotion perspective and thus holistic approach to children’s right to health. Our findings suggest that application of holistic approach in Lithuania might face many challenges and obstacles, with regard to high numbers of vulnerable children, quality of support services for children and families, and still minimal and fragment...
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This paper proposes a set of nine critical elements underpinned by human rights principles to support individuals experiencing a serious crisis related to mental health problems or psychosocial disabilities. These elements are distilled... more
This paper proposes a set of nine critical elements underpinned by human rights principles to support individuals experiencing a serious crisis related to mental health problems or psychosocial disabilities. These elements are distilled from a range of viable alternatives to traditional community mental health approaches and are linked to a normative human rights framework. We argue that crisis response is one of the areas of mental health care where there is a heightened risk that the rights of service recipients may be infringed. We further make the case that the nine critical elements found in advanced mental health care models should be used as building blocks for designing services and systems that promote effective rights-based care and supports.
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Vilniaus universiteto Medicinos fakulteto Psichiatrijos klinikaVasaros g. 5, tel. (+370 5) 261 10 43. El. paštas: dainius.puras@gmail.comVilniaus universiteto Filosofijos fakulteto Socialinio darbo katedraUniversiteto g. 9/1, Tel. (+370... more
Vilniaus universiteto Medicinos fakulteto Psichiatrijos klinikaVasaros g. 5, tel. (+370 5) 261 10 43. El. paštas: dainius.puras@gmail.comVilniaus universiteto Filosofijos fakulteto Socialinio darbo katedraUniversiteto g. 9/1, Tel. (+370 5) 266 76 10. El. paštas: egle.sumskiene@gmail.com Straipsnyje nagrinėjama sutrikusios psichikos ir sutrikusio intelekto asmenų globa didelėse uždarose stacionariose globos įstaigose. Iki Sovietų Sąjungos žlugimo šios įstaigos ne tik globojo, bet ir izoliavo sutrikusios psichikos ir sutrikusio intelekto individus. Tvirtas šių įstaigų pozicijas to meto socialinės apsaugos sistemoje lėmė ideologinės priežastys, dominuojantis defektologijos mokslas, sukurta materialinė ir teisinė bazė, neigiamas visuomenės nusistatymas sutrikusios psichikos ir sutrikusio intelekto asmenų atžvilgiu. Žlugus Sovietų Sąjungai, stacionarios globos sistema pasirodė esanti ypač atspari permainoms – ji ne tik atsilaikė prieš bandymus veiksmingai transformuoti, bet ir sulaukė i...
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Strengths and Difficulties Questionnaire (SDQ) developed by R. Goodman (1997) has been widely used in epidemiological studies throughout the world as a screening measure for mental health in children and adolescents. The SDQ comprises 25... more
Strengths and Difficulties Questionnaire (SDQ) developed by R. Goodman (1997) has been widely used in epidemiological studies throughout the world as a screening measure for mental health in children and adolescents. The SDQ comprises 25 items plus supplement on impact of the difficulties for the child and family. There are 5 subscales: Prosocial behaviour, Hyperactivity, Emotional symptoms, Conduct problems and Peers problems, the last four adding up to the Total Difficulties score. The design of the SDQ with both strength’ and difficulties’ items supposedly increases acceptability of the instrument on behalf of informants and make questionnaire especially suitable for studies of general population were the majority of children are healthy. Three SDQ versions (parent, teacher and self-report) were translated into Lithuanian language and psychometric properties of those Lithuanian SDQ versions are presented and analysed in this article. Representative sample of children aged 7–16 ye...
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Parenting is a natural ability of adult persons. The intuitive understanding of child’s needs and ability to ensure that his or her needs are met, alongside with adequate holistic development of a child defines parental competence, while... more
Parenting is a natural ability of adult persons. The intuitive understanding of child’s needs and ability to ensure that his or her needs are met, alongside with adequate holistic development of a child defines parental competence, while its realization defines the expression of these competences. Special situation occurs, when people with mental health problems, including intellectual and mental disabilities become parents. They may have poor abilities to plan their actions and care for the child. Inadequate ability to care for the child, which often may be determined by weak expression of parental competence, is a risk factor that can disrupt the neurobiological development of child’s brain as well as development of his or her psychosocial and cognitive abilities. On the other hand, the state agencies should ensure that these parents receive services which support parents at risk and promote their parental competence. Methods: Review of literature, case report and metods of clinical observation. Research data are based on analysis medical documentation, results of psychodagnostic tests, analysis of attitudes of stakeholders towards problems of parenting competence, and other relevant data. Results: Conclusions and suggestions based on case report and analysis of the context of prevailing societal attitudes.
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Jessica Saunders, Director of Community Engagement at Dayton Children’s Hospital [Moderator] Presentations: Does Human Rights Derogation Limit COVID-19 Infections? (Brian K. Gran, Case Western Reserve University; Reema Sen, Case Western... more
Jessica Saunders, Director of Community Engagement at Dayton Children’s Hospital [Moderator] Presentations: Does Human Rights Derogation Limit COVID-19 Infections? (Brian K. Gran, Case Western Reserve University; Reema Sen, Case Western Reserve University) Lost in Transformation: The Human Rights We Lost during the New State-Centric Order (Caroline de Lima e Silva, Lichtenberg-Kolleg; Gottingen Institute for Advanced Study) Holistic Well-Being and Humanitarian Workers during COVID-19: Concepts, Challenges, and Recommendations (Nicholas Sherwood, George Mason University) Response of International Institutions to COVID-19 (Dainius Puras, Human Rights Monitoring Institute, Lithuania; Former Rapporteur on the Right to Health
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Lithuania: youth mental health – from research to policies, practice and
In many countries of the world, including Lithuania, suicide rates for men are several times higher than for women. Therefore, the phenomenon of men’s suicide is receiving a lot of attention in public, scientific, and political... more
In many countries of the world, including Lithuania, suicide rates for men are several times higher than for women. Therefore, the phenomenon of men’s suicide is receiving a lot of attention in public, scientific, and political discourses. In contrast, much less attention is paid to tackling women’s suicides and women’s mental health problems. Lithuania has been among the countries with the highest suicide rates for both men and women in the world for several decades, but research on the social and demographic aspects of women’s suicide in Lithuania is lacking. This paper aims to examine the demographic losses that Lithuania suffers from women suicides and assess the socio-demographic differentiation of these losses. The empirical part of the study was based on the calculation of years of life lost methodology. The years of life lost method is acknowledged as an accurate measure for assessing the impact of specific causes of death on premature mortality. Data sources for this study ...