Dua Ti Dawa Ti
Access
Community perspective
Exploratory methodologies
Health service needs
Kashmir
Mental health
Psychological distress
Qualitative
Journal
Conflict and health
ISSN: 1752-1505
Titre abrégé: Confl Health
Pays: England
ID NLM: 101286573
Informations de publication
Date de publication:
2019
2019
Historique:
received:
01
07
2019
accepted:
27
11
2019
entrez:
1
1
2020
pubmed:
1
1
2020
medline:
1
1
2020
Statut:
epublish
Résumé
An extensive body of research exists looking at the level of psychological distress in populations affected by political conflict. Recommended response to psychological distress in humanitarian crises is still based on frameworks for interventions developed in western/European contexts including psychological first aid, counselling and group therapy. While there is growing, but limited, evidence that culturally modified interventions can lead to reduction in symptoms of psychological distress in conflict affected populations, there is a need to understand mental health help-seeking behaviour and mental health service needs from the perspective of affected communities. This study employed a qualitative exploratory research design based on principles of grounded theory. A combination of convenience and snowball sampling was used to recruit 186 adults from the general population to 20 focus group discussions; 95 men, median age 40 years, interquartile range (IQR): 27-48 years and 91 women, median age 40 years IQR: 32-50 years. Trained Kashmiri facilitators used a semi-structured interview guide to ascertain community perceptions on mental illness, help-seeking and service needs from the perspective of communities in the Kashmir Valley. Content analysis of transcripts resulted in the identification of seven overarching themes. Common locally recognized symptoms of psychological distress were synonymous with symptoms listed in the Hopkins Symptoms Checklist (HSCL-25) and the Harvard Trauma Questionnaire (HTQ). Protracted political insecurity was highlighted as a major perceived cause of psychological distress in communities. Mental health help-seeking included traditional/spiritual healers in combination with practitioners of western medicine, with access highlighted as the main barrier. Divergent views were expressed on the effectiveness of treatment received. Participants' expressed the need for investment in mental health literacy to improve the community's capacity to recognize and support those suffering from psychological distress. Our findings demonstrate the universality of symptoms of psychological distress whilst simultaneously highlighting the importance of recognizing the cultural, spiritual and contextual framework within which psychological distress is understood and manifest. Co-constructed models of community based mental health services are needed.
Sections du résumé
BACKGROUND
BACKGROUND
An extensive body of research exists looking at the level of psychological distress in populations affected by political conflict. Recommended response to psychological distress in humanitarian crises is still based on frameworks for interventions developed in western/European contexts including psychological first aid, counselling and group therapy. While there is growing, but limited, evidence that culturally modified interventions can lead to reduction in symptoms of psychological distress in conflict affected populations, there is a need to understand mental health help-seeking behaviour and mental health service needs from the perspective of affected communities.
METHODS
METHODS
This study employed a qualitative exploratory research design based on principles of grounded theory. A combination of convenience and snowball sampling was used to recruit 186 adults from the general population to 20 focus group discussions; 95 men, median age 40 years, interquartile range (IQR): 27-48 years and 91 women, median age 40 years IQR: 32-50 years. Trained Kashmiri facilitators used a semi-structured interview guide to ascertain community perceptions on mental illness, help-seeking and service needs from the perspective of communities in the Kashmir Valley. Content analysis of transcripts resulted in the identification of seven overarching themes.
RESULTS
RESULTS
Common locally recognized symptoms of psychological distress were synonymous with symptoms listed in the Hopkins Symptoms Checklist (HSCL-25) and the Harvard Trauma Questionnaire (HTQ). Protracted political insecurity was highlighted as a major perceived cause of psychological distress in communities. Mental health help-seeking included traditional/spiritual healers in combination with practitioners of western medicine, with access highlighted as the main barrier. Divergent views were expressed on the effectiveness of treatment received. Participants' expressed the need for investment in mental health literacy to improve the community's capacity to recognize and support those suffering from psychological distress.
CONCLUSIONS
CONCLUSIONS
Our findings demonstrate the universality of symptoms of psychological distress whilst simultaneously highlighting the importance of recognizing the cultural, spiritual and contextual framework within which psychological distress is understood and manifest. Co-constructed models of community based mental health services are needed.
Identifiants
pubmed: 31889998
doi: 10.1186/s13031-019-0243-8
pii: 243
pmc: PMC6909639
doi:
Types de publication
Journal Article
Langues
eng
Pagination
59Informations de copyright
© The Author(s). 2019.
Déclaration de conflit d'intérêts
Competing interestsAll authors declare they have no competing interests.
Références
Natl Med J India. 2011 Mar-Apr;24(2):98-107
pubmed: 21668056
Lancet Psychiatry. 2016 Feb;3(2):145-53
pubmed: 26796018
Child Psychiatry Hum Dev. 2012 Jun;43(3):323-36
pubmed: 22080367
Confl Health. 2012 Dec 17;6(1):12
pubmed: 23244206
Confl Health. 2016 Aug 03;10:16
pubmed: 27489565
Transcult Psychiatry. 2018 Jun;55(3):361-383
pubmed: 29553303
PLoS Med. 2013;10(5):e1001448
pubmed: 23737736
Int J Soc Psychiatry. 2016 Sep;62(6):589-96
pubmed: 27363860
JAMA. 2004 Aug 4;292(5):626-8
pubmed: 15292090
J Affect Disord. 2011 Apr;130(1-2):268-74
pubmed: 21071091
Indian J Psychol Med. 2018 Nov-Dec;40(6):509-516
pubmed: 30533946
Glob Public Health. 2006;1(1):87-107
pubmed: 19153896
Confl Health. 2008 Oct 14;2:10
pubmed: 18854026
Lancet Glob Health. 2014 May;2(5):e293-300
pubmed: 25103168
Int J Ment Health Syst. 2011 Jan 25;5(1):3
pubmed: 21266051
Lancet. 2019 Jul 20;394(10194):240-248
pubmed: 31200992
Confl Health. 2008 Oct 14;2:11
pubmed: 18854027
BMC Psychiatry. 2015 Oct 14;15:249
pubmed: 26467303
Prehosp Disaster Med. 2007 Nov-Dec;22(6):541-5; discussion 546
pubmed: 18709944
Lancet Psychiatry. 2017 Feb;4(2):128-135
pubmed: 28063879
J Psychosom Res. 2015 May;78(5):466-71
pubmed: 25676335
Med Confl Surviv. 2015 Jan-Mar;31(1):33-56
pubmed: 25875719
BMJ Glob Health. 2017 Oct 15;2(4):e000419
pubmed: 29082026
Natl Med J India. 2011 Mar-Apr;24(2):94-7
pubmed: 21668055
J Psychosom Res. 2016 Jan;80:1-10
pubmed: 26721541