Implementing the Mental Health Gap Action Programme in Cox’s Bazar, Bangladesh

Momotaz, Hasina; Ahmed, Helal Uddin; Uddin, Mohammad Main; Karim, Rezaul; Khan, Maruf Ahmed; Al-Amin, Rajib; Anwar, Nazneen; Kessaram, Tara

doi:10.4103/intv.intv_14_19

Cited by 14 publications

(9 citation statements)

References 4 publications

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“…Suicide risk was assessed using the screening item of the Refugee Mental Health Assessment Package (RMHAP) depression module [31], supplemented by the modified suicide module of the mhGAP Humanitarian Intervention Guide (mhGAP-HIG) [32,36]. Participants are categorised as no risk (a score 1), low (a score of 2 'a little'), moderate (a score of 3 'quite a lot'), or high suicide risk (a score of 4 'extremely') based on their responses on the screening item.…”

Section: Methodsmentioning

confidence: 99%

“…Inclusion criteria were (a) presence of at least one of the designated CMDs, that is, current PTSD/CPTSD, MDD, GAD, and PCBD [31]; (b) witnessed or experienced at least one traumatic event related to mass conflict; and (c) endorsed at least one ADAPT-related stressor on each scale of the relevant measure (see hereunder). Exclusion criteria were age lower than 18 years, overt evidence of intellectual disability or cognitive impairment, or manifestations of psychosis (as assessed using WHO mhGAP protocol) [32]. Refugees who met criteria and consented to participate were randomly assigned to either IAT or CBT according to a 1:1 ratio determined by a computer-generated randomisation sequence managed by an off-site research assistant.…”

Section: Study Design and Participantsmentioning

confidence: 99%

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An Integrative Adapt Therapy for common mental health symptoms and adaptive stress amongst Rohingya, Chin, and Kachin refugees living in Malaysia: A randomized controlled trial

et al. 2020

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Background This randomised controlled trial (RCT) aims to compare 6-week posttreatment outcomes of an Integrative Adapt Therapy (IAT) to a Cognitive Behavioural Therapy (CBT) on common mental health symptoms and adaptive capacity amongst refugees from Myanmar. IAT is grounded on psychotherapeutic elements specific to the refugee experience. Methods and findings We conducted a single-blind RCT (October 2017-May 2019) with Chin (39.3%), Kachin (15.7%), and Rohingya (45%) refugees living in Kuala Lumpur, Malaysia. The trial included 170 participants receiving six 45-minute weekly sessions of IAT (97.6% retention, 4 lost to follow-up) and 161 receiving a multicomponent CBT also involving six 45-minute weekly sessions (96.8% retention, 5 lost to follow-up). Participants (mean age: 30.8 years, SD = 9.6) had experienced and/or witnessed an average 10.1 types (SD = 5.9, range = 1-27) of traumatic events. We applied a single-blind design in which independent assessors of preand posttreatment indices were masked in relation to participants' treatment allocation status.

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Section: Methodsmentioning

confidence: 99%

Section: Study Design and Participantsmentioning

confidence: 99%

An Integrative Adapt Therapy for common mental health symptoms and adaptive stress amongst Rohingya, Chin, and Kachin refugees living in Malaysia: A randomized controlled trial

et al. 2020

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“…Table 1 Prevalence of all mental disorders among the adult population in Bangladesh implemented with relative success by the government of Bangladesh to address the humanitarian crisis at Cox's Bazar. 20 However, this programme has yet to be scaled up to the rest of the nation. Although antipsychotics, anxiolytics, antidepressants, mood stabilisers and anti-epileptic drugs are included in the list of essential medicines recommended by the WHO, psychotropic drugs are not widely available in Bangladesh.…”

Section: Mental Healthcare Delivery Services and Systemsmentioning

confidence: 99%

“…In 2017, the Mental Health Gap Action Programme (mhGAP) was implemented with relative success by the government of Bangladesh to address the humanitarian crisis at Cox's Bazar. 20 However, this programme has yet to be scaled up to the rest of the nation.…”

Section: Tablementioning

confidence: 99%

The current state of mental healthcare in Bangladesh: part 1 – an updated country profile

Hasan

Anwar

Christopher³

et al. 2021

BJPsych Int.

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Mental health is a significant factor for a sound and productive life; nevertheless, mental disorders do not often receive adequate research attention and are not addressed as a serious public health issue in countries such as Bangladesh. Part 1 of this two-part profile describes the current situation of mental health in Bangladesh in its wider sociocultural context, outlining existing policies and highlighting mental illness as a neglected healthcare problem in the country using a narrative synthesis method. The prevalence of mental disorders is very high and augmented in nature among different population groups in Bangladesh. A lack of public mental health facilities, scarcity of skilled mental health professionals, insufficient financial resource distribution, inadequately stewarded mental health policies and stigma contribute to making current mental healthcare significantly inadequate in Bangladesh. The country has few community care facilities for psychiatric patients. Furthermore, the current mental health expenditure by the Bangladeshi government is only 0.44% of the total health budget. Less than 0.11% of the population has access to free essential psychotropic medications.

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“…Large-scale epidemiological studies are needed to update national statistics on mental disorders, standardise diagnostic tools, estimate incidence rates and the burden of psychiatric illness more accurately, and quantify impacts in globalised terms such as disability-adjusted life-years (DALYs). With treatment gaps as large as 92% for adults and 94% for children according to some studies, 15 reducing the burden of mental illness should be the ultimate goal of the government health ministry.…”

Section: Research Prioritiesmentioning

confidence: 99%

The current state of mental healthcare in Bangladesh: part 2 – setting priorities

Hasan¹,

Anwar

Christopher³

et al. 2021

BJPsych Int.

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This is the second of a two-part profile on mental healthcare in Bangladesh. It describes the state of mental health research in the country and presents a set of priorities for addressing improvements to the fundamental gaps in mental healthcare highlighted in part 1. Focus on building infrastructure for public mental health facilities, training skilled mental health professionals, adequate distribution of financial resources and addressing stigma are all priorities that will contribute to significantly improving mental healthcare in Bangladesh.

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Implementing the Mental Health Gap Action Programme in Cox’s Bazar, Bangladesh

Cited by 14 publications

References 4 publications

An Integrative Adapt Therapy for common mental health symptoms and adaptive stress amongst Rohingya, Chin, and Kachin refugees living in Malaysia: A randomized controlled trial

An Integrative Adapt Therapy for common mental health symptoms and adaptive stress amongst Rohingya, Chin, and Kachin refugees living in Malaysia: A randomized controlled trial

The current state of mental healthcare in Bangladesh: part 1 – an updated country profile

The current state of mental healthcare in Bangladesh: part 2 – setting priorities

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