Background and purpose Most research regarding child and adolescent mental health prevention and promotion in low-and middle-income countries is undertaken in high-income countries. This systematic review set out to synthesise findings from epidemiological studies, published between 2008 and 2020, documenting the prevalence of mental health problems in adolescents from across sub-Saharan Africa. Methods A systematic search of multiple databases (MEDLINE, PsycINFO, Scopus) and Google Scholar was conducted guided by the Joanna Briggs Institute (JBI) Reviewer’s manual for systematic reviews of observational epidemiological studies. Studies included reported prevalence outcomes for adolescents aged 10–19 using either clinical interviews or standardized questionnaires to assess psychopathology. Clinical samples were excluded. Results The search yielded 1 549 records of which 316 studies were assessed for eligibility and 51 met the inclusion criteria. We present a qualitative synthesis of 37 of these 51 included articles. The other 14 studies reporting prevalence rates for adolescents living with HIV are published elsewhere. The prevalence of depression, anxiety disorders, emotional and behavioural difficulties, posttraumatic stress and suicidal behaviour in the general adolescent population and selected at-risk groups in 16 sub-Saharan countries (with a total population of 97 616 adolescents) are reported.
Despite the progress made in HIV treatment and prevention, HIV remains a major cause of adolescent morbidity and mortality in sub-Saharan Africa. As perinatally infected children increasingly survive into adulthood, the quality of life and mental health of this population has increased in importance. This review provides a synthesis of the prevalence of mental health problems in this population and explores associated factors. A systematic database search (Medline, PsycINFO, Scopus) with an additional hand search was conducted. Peer-reviewed studies on adolescents (aged 10–19), published between 2008 and 2019, assessing mental health symptoms or psychiatric disorders, either by standardized questionnaires or by diagnostic interviews, were included. The search identified 1461 articles, of which 301 were eligible for full-text analysis. Fourteen of these, concerning HIV-positive adolescents, met the inclusion criteria and were critically appraised. Mental health problems were highly prevalent among this group, with around 25% scoring positive for any psychiatric disorder and 30–50% showing emotional or behavioral difficulties or significant psychological distress. Associated factors found by regression analysis were older age, not being in school, impaired family functioning, HIV-related stigma and bullying, and poverty. Social support and parental competence were protective factors. Mental health problems among HIV-positive adolescents are highly prevalent and should be addressed as part of regular HIV care.
Literature indicates a high prevalence and burden of mental illness in youths word-wide, which may be even higher in low and middle-income countries, such as South Africa and Zambia. Additionally, there is a lack of knowledge regarding youth depression amongst many primary health care (PHC) practitioners. The principal goal of the mega project is to provide youth with better access to mental health services and appropriate care, by developing a mental health screening mobile application tool to be used in PHC settings in South Africa and Zambia.In this study, we will use a mixed methods multi-center study design. In phase one we will investigate the mental health literacy of PHC practitioners to identify areas in need of development. Based on the needs identified, we will develop and test a mobile health application to screen for common youth mental health problems in phase two. In phase three, we will implement and evaluate a tiered education and training program in the use of the m-health application. In the final phase, we will evaluate the acceptability and feasibility of the m-health application in PHC centres across South Africa and Zambia. Evidence suggests that PHC practitioners should routinely consider mental illness when assessing youth. However, common psychiatric disorders remain largely undetected and untreated in PHC settings. By identifying limitations in PHC knowledge with regard to youth mental health, we aspire to improve the depression care provided to youth in Southern Africa and Zambia by developing and implementing a locally relevant m-health application.
Im Rahmen des EU-Projektes RESME wurden in einer explorativen, qualitativen Studie Fachkräfte der stationären Jugendhilfe und der Kinder- und Jugendpsychiatrie zur gegenseitigen Kooperation befragt. Mit Hilfe umfassender leitfadengestützter Interviews wurden exemplarische Erfahrungen und Einschätzungen gesammelt, um die besonderen Herausforderungen in der Zusammenarbeit besser zu verstehen, Bedingungen und Beispiele für gelungene Kooperation zusammen zu tragen und Ansätze für Verbesserungen zu finden. Zentrale Ergebnisse der Interviews mit Sozialarbeitern und -pädagogen, Kinder- und Jugendpsychiatern und Psychologen werden zusammenfassend dargestellt. Es zeigen sich verschiedene Ansatzpunkte zur Verbesserung der systemübergreifenden und interdisziplinären Zusammenarbeit. Als wesentlich für eine gelungene Kooperation werden neben Fachlichkeit und Wissen, individuelle Einstellungen und Werte, Aspekte der persönlichen Kontakt- und Beziehungsgestaltung sowie organisatorische Rahmenbedingungen und Entwicklungen erachtet. Die Ergebnisse werden zur Entwicklung eines Curriculums genutzt, das sich zur Förderung der Zusammenarbeit gleichzeitig an Mitarbeiter psychiatrisch-psychotherapeutischer Einrichtungen und der Jugendhilfe richtet.
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