Medicine and Health Sciences Commons^™

Use Of Mobile Technology To Identify Behavioral Mechanisms Linked To Mental Health Outcomes In Kenya: Protocol For Development And Validation Of A Predictive Model., Willie Njoroge, Rachel Maina, Lukoye Atwoli, Elena Frank, Zhenke Wu, Anthony Ngugi, Srijan Sen, Linda Khakali, Andrew Aballa, James Orwa, Zul Merali

Brain and Mind Institute

Objective: This study proposes to identify and validate weighted sensor stream signatures that predict near-term risk of a major depressive episode and future mood among healthcare workers in Kenya.

Approach: The study will deploy a mobile application (app) platform and use novel data science analytic approaches (Artificial Intelligence and Machine Learning) to identifying predictors of mental health disorders among 500 randomly sampled healthcare workers from five healthcare facilities in Nairobi, Kenya.

Expectation: This study will lay the basis for creating agile and scalable systems for rapid diagnostics that could inform precise interventions for mitigating depression and ensure a healthy, resilient …

Making Cities Mental Health Friendly For Adolescents And Young Adults, Pamela Y. Collins, Moitreyee Sinha, Tessa Concepcion, George Patton, Thaisa Way, Layla Mccay, Augustina Mensa-Kwao, Helen Herrman, Evelyne De Leeuw, Lukoye Atwoli

Brain and Mind Institute

Urban life shapes the mental health of city dwellers, and although cities provide access to health, education and economic gain, urban environments are often detrimental to mental health1,2. Increasing urbanization over the next three decades will be accompanied by a growing population of children and adolescents living in cities3. Shaping the aspects of urban life that influence youth mental health could have an enormous impact on adolescent well-being and adult trajectories4. We invited a multidisciplinary, global group of researchers, practitioners, advocates and young people to complete sequential surveys to identify and prioritize the characteristics of a mental health-friendly city for …

Macroeconomics And Health: Understanding The Impact Of A Declining Economy On Health Outcomes Of Children And Young Adults In South Africa, Cyprian Mostert

Brain and Mind Institute

Background: The current covid-19 economic crisis continues to weaken economic growth in South Africa. This study was designed to show how a declining economic state affects the mental health conditions, metabolic risk factors, communicable conditions, and non-communicable conditions of adolescent (18-year cohorts) and adult (25-year cohorts) population groups comparatively.

Study design: This was a panel analysis using secondary data issued by Statistic South Africa.

Methods: The author used a Two-stage Least Squared Model (2SLS) to quantify the impact of the declining economy on mental health conditions (depression and traumatic stress), non-communicable conditions (cancer and diabetes), metabolic risk factors …

Addition Of Mental Health To The Lady Health Worker Curriculum In Pakistan: Now Or Never, Fauziah Rabbani, Samina Akhtar, Javeria Nafis, Shahid Khan, Sameen Siddiqi, Zul Merali

Brain and Mind Institute

The technical advisory group of the World Health Organization (Geneva, Switzerland) has suggested person-centered and community-based mental health services in response to the long-term and far-reaching mental health impacts of the COVID-19 pandemic. Task shifting is a pragmatic approach to tackle the mental health treatment gap in low- and middle-income countries. Pakistan is dismally resourced to address the mental health challenges. Pakistan’s government has established a lady health worker’s program (LHW-P) which can be effectively utilized to provide some basic mental health services at community doorsteps. However, lady health workers’ current curriculum does not include mental health as a subject. …

Impact Of Climate Events, Pollution, And Green Spaces On Mental Health: An Umbrella Review Of Meta-Analyses, Pim Cuijpers, Clara Miguel, Marketa Ciharova, Manasi Kumar, Luke Brander, Pushpam Kumar, Eirini Karyotaki

Brain and Mind Institute

Climate change may affect mental health. We conducted an umbrella review of meta-analyses examining the association between mental health and climate events related to climate change, pollution and green spaces. We searched major bibliographic databases and included meta-analyses with at least five primary studies. Results were summarized narratively. We included 24 meta-analyses on mental health and climate events (n = 13), pollution (n = 11), and green spaces (n = 2) (two meta-analyses provided data on two categories). The quality was suboptimal. According to AMSTAR-2, the overall confidence in the results was high for none of the studies, for three …

Does Social Pension Buy Improved Mental Health And Mortality Outcomes For Senior Citizens? Evidence From South Africa's 2008 Pension Reform, Cyprian Mostert, Diana Mackay, Alex Awiti, Manasi Kumar, Zul Merali

Brain and Mind Institute

In South Africa, men were traditionally eligible to receive government pensions at 65 years. However, that eligibility criterion was changed in 2008 to allow men to receive a pension payout at 60 years. This study is designed to quantify the impact of the 2008 pension reform on mental health outcomes (depression and traumatic stress) and deaths among 60-year-old men from disadvantaged households without advanced education. This analysis used secondary data issued by Statistic South Africa- General Household Survey. Men who reported earning a pension at 60 years from 2008 to 2014 were exposed to the 2008 pension reform and thus …

Interpersonal Psychotherapy’S Problem Areas As An Organizing Framework To Understand Depression And Sexual And Reproductive Health Needs Of Kenyan Pregnant And Parenting Adolescents: A Qualitative Study, Manasi Kumar, Obadia Yator, Vincent Nyongesa, Martha Kagoya, Shillah Mwaniga, Joseph Kathono, Isaiah Gitonga, Nancy Grote, Helena Verdeli, Keng Yen Huang

Brain and Mind Institute

Background: Peripartum adolescents experience signifcant interpersonal transitions in their lives. Depression and emotional distress are often exacerbated by adolescents’ responses to these interpersonal changes. Improved understanding of pregnancy-related social changes and maladaptive responses to these shifts may inform novel approaches to addressing the mental health needs of adolescents during the perinatal period. The paper aims to understand the sources of psychological distress in peripartum adolescents and map these to Interpersonal Psychotherapy’s (IPT) problem areas as a framework to understand depression.

Method: We conducted interviews in two Nairobi primary care clinics with peripartum adolescents ages 16–18 years (n=23) with …

Cultural And Contextual Adaptation Of Mental Health Measures In Kenya: An Adolescent-Centered Transcultural Adaptation Of Measures Study, Vincent Nyongesa, Shillah Mwaniga, Joseph Kathono, Obadia Yator, Beatrice Madeghe, Sarah Kanana, Beatrice Amugune, Naomi Anyango, Darius Nyamai, Manasi Kumar

Brain and Mind Institute

Introduction: There is paucity of culturally adapted tools for assessing depression and anxiety in children and adolescents in low-and middle-income countries. This hinders early detection, provision of appropriate and culturally acceptable interventions. In a partnership with the University of Nairobi, Nairobi County, Kenyatta National Hospital, and UNICEF, a rapid cultural adaptation of three adolescent mental health scales was done, i.e., Revised Children’s Anxiety and Depression Scale, Patient Health Questionnaire-9 and additional scales in the UNICEF mental health module for adolescents.

Materials and methods: Using a qualitative approach, we explored adolescent participants’ views on cultural acceptability, comprehensibility, relevance, and completeness of …

Health And Socioeconomic Resource Provision For Older People In South Asian Countries: Bangladesh, India, Nepal, Pakistan And Sri Lanka Evidence From Neesama, Natasha Roya Matthews, George James Porter, Mathew Varghese, Nidesh Sapkota, Murad Khan, Ammu Lukose, Stella-Maria Paddick, Malathie Dissanayake, Naila Zaman Khan, Richard Walker

Brain and Mind Institute

Background: The global population is ageing rapidly, with low- and middle-income countries (LMICs) undergoing a fast demographic transition. As the number of older adults in LMICs increases, services able to effectively address their physical and mental health needs will be increasingly important.

Objective: We review the health and socioeconomic resources currently available for older people in South Asian countries, Bangladesh, India, Nepal, Pakistan and Sri Lanka, to identify gaps in available resources and assess areas for improvement.

Methods: We conducted a search of grey and published literature via Google Search, Compendex, EBSCO, JSTOR, Medline, Ovid, ProQuest databases, …

Prevalence And Risk Factors Associated With Depression In Pregnant Adolescents In Nairobi, Kenya, Albert Tele, Joseph Kathono, Shillah Mwaniga, Vincent Nyongesa, Obadia Yator, Onesmus Gachuno, Dalton Wamalwa, Beatrice Amugune, Zul Merali, Manasi Kumar

Brain and Mind Institute

Background: Adolescent parenthood can be associated with a range of adverse outcomes for young mothers such as depression, substance abuse, and posttraumatic stress disorder. Identification of depression and understanding risk factors among pregnant adolescents is important for development of appropriate interventions and programs focused on adolescent mental health. This paper reports on the findings of the prevalence of depression and its associated risk factors among pregnant adolescents in Nairobi, Kenya.

Methods: We recruited 153 pregnant adolescent (14-18 years) who were accessing maternal health services in one of two Nairobi County primary health care facilities in the cross-sectional survey …

A Call For Prudent Taxation Of Cannabis Corporates To Fund Mental Health Programmes, Cyprian Mostert, Jasmit Shah, Lukoye Atwoli, Zul Merali, Manasi Kumar

Brain and Mind Institute

Cannabis consumption increases the incidence of psychotic disorders, violence, and cognitive impairments [1]. Governments need to implement progressive tax legislation, such as that which requires the cannabis sector to accept responsibility and account for its contribution to the worsening of these mental health conditions in developing countries. Excise taxes are rarely imposed on the cannabis sector [2], despite the lucrative wealth amassed by this industry. For example, current estimates show that the global cannabis sector was valued at $25 billion in 2021 and is projected to reach $176 billion by 2030, driven solely by cannabis inhalation demands [3]. The projected …

Mental Health Problems And Service Gaps Experienced By Pregnant Adolescents And Young Women In Sub-Saharan Africa: A Systematic Review, Joan Mutahi, Anna Larsen, Pim Cuijpers, Stefan Swartling Peterson, Jurgen Unutzer, Mary Mckay, Grace John-Stewart, Teresa Jewell, John Kinuthia, Manasi Kumar

Brain and Mind Institute

Background: Pregnant adolescent girls and young women (AGYW, aged 12–24 years) are at high risk for mental health problems, particularly in the Sub-Saharan African (SSA) region.

Methods: We performed a systematic review of mental health studies among pregnant AGYW in SSA published between January 1, 2007 and December 31, 2020 in PubMed, Embase, CINAHL, PsycInfo, and Global Index Medicus following PRISMA guidelines (PROSPERO: CRD42021230980). We used Bronfenbrenner's bioecological model to frame and synthesize results from included studies.

Findings: Our search yielded 945 articles from which 18 studies were included (N = 8 quantitative, N = 9 qualitative, …

A Four-Component Framework Toward Patient-Centered, Integrated Mental Healthcare In Kenya, Manasi Kumar, Thomas L. Osborn, Cyrus Mugo, Hossein Akbarialiabad, Osman Warfa, Wangui Muthigani Mbuthia, Christine Wambugu, Carol Ngunu, Fatima Gohar, Shillah Mwaniga

Brain and Mind Institute

Background: How can we fast-track the global agenda of integrated mental healthcare in low- and middle-income countries (LMICs) such as Kenya? This is a question that has become increasingly important for individuals with lived experiences, policymakers, mental health advocates and health care providers at the local and international levels.

Discussion: This narrative synthesis and perspective piece encompasses an overview of mental health care competencies, best practices and capacity building needed to fast track patient responsive services. In that vein we also review key policy developments like UHC to make a case for fast-tracking our four-step framework.

Results: While there is …

Depression And Its Associated Factors: Perceived Stress, Social Support, Substance Use And Related Sociodemographic Risk Factors In Medical School Residents In Nairobi, Kenya, Sayed Shah Nur Hussein Shah, Ahmed Laving, Violet Caroline Okech-Helu, Manasi Kumar

Brain and Mind Institute

Abstract: Background: Little data exists regarding depression and its associated factors in medical residents and doctors in Sub-Saharan Africa. Residents are at high risk of developing depression owing to the stressful nature of their medical practice and academic training. Depression in medical residents leads to decreased clinical efficiency, and poor academic performance; it can also lead to substance abuse and suicide. Our primary aim was to measure depression prevalence among medical residents in Kenya’s largest national teaching and referral hospital. Secondary aims were to describe how depression was associated with perceived stress, perceived social support, substance use, and educational environment. …