Health Support Services Research Articles

Exploring sustainable health financing strategies in humanitarian settings: Challenges, innovations and efforts towards Achieving Universal Health Coverage

Sustainable health financing is critical in humanitarian settings to ensure that the most vulnerable populations have access to necessary healthcare services. In crises such as conflicts, natural disasters, or prolonged emergencies, healthcare systems are often destabilized, leading to significant challenges in providing adequate care. This review explores innovative financing mechanisms designed to support health services in these contexts, focusing on their potential to achieve Universal Health Coverage (UHC). Key challenges include limited funding, high out-of-pocket costs, and the uneven distribution of healthcare resources. In response, emerging models such as impact bonds, Islamic social finance, disaster risk insurance, and digital financial solutions offer new approaches to mobilizing resources and sustaining health interventions. These strategies are essential to bridging gaps in healthcare access, promoting equity, and strengthening the resilience of health systems. Policy recommendations highlight the importance of integrating emergency and routine health services, engaging communities, and enhancing coordination among stakeholders. Strengthening health financing mechanisms is vital for long-term improvements in health outcomes, especially in fragile settings. This research underscores the need for sustainable, inclusive policies that bolster health systems in the face of humanitarian crises.

Educational Objectives and Student Management Methods in International High Schools in China

Much attention has been given to the challenges and complexities of international education in China. However, there are a lot of areas that have not been fully explored, especially regarding achieving the right blend of globalization and traditional education. This paper examines the development of international high school education in China the changes in educational models, the unique features of international curricula, and the effects of recent policy changes. In the study, it is also found that seemingly beneficial attempts at global citizenship and critical thinking provided by international education introduce a high level of stress originating from conflicting academic requirements and inflexible educational frameworks. Considering the results obtained, the following recommendations have been formulated to improve the situation regarding the development of international education in China. These include balancing intrinsic and extrinsic motivation for the students, strengthening their mental health and academic support services, reducing workload for students, and ensuring more time for students. If these challenges are addressed, China can equip students to fit the world that is shifting towards globalization.

Mental health status and quality of life among Thai people after the COVID-19 outbreak: a cross-sectional study

The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on individuals’ mental health and well-being worldwide. This study investigated the prevalences of and association between mental health and quality of life (QOL) in Thailand after the COVID-19 outbreak. A cross-sectional study was conducted among Thai individuals aged ≥ 20 years across all regions. Descriptive statistics, chi-square tests, and multiple logistic regression analyses were performed to examine the association between mental health and QOL. A total of 1,133 participants (mean age: 35.1 ± 17.2 years) completed the survey. The prevalence of depression with PHQ-9 instrument was 19.4%. Depression was significantly associated with those who have had family members die from COVID-19 infection (adjusted odds ratio [AOR] 2.27, 95% confidence interval [CI] [1.13–4.52]). The percentages of depression, anxiety, and stress with DASS-21 instrument were 32.4%, 45.4%, and 24.1%, respectively. Smokers and alcohol consumption had approximately 1.5-time higher risk of stress compared with non-smokers and no alcohol consumption (AOR = 1.50, 95% CI [1.01–2.24], AOR = 1.48, 95% CI [1.09–2.02], respectively). An association was observed between socioeconomic factors such as job and income loss and mental health outcomes. Depression, anxiety, and stress were significantly negatively associated with QOL. This study demonstrates a strong association between mental health and QOL among Thai people after the COVID-19 outbreak. The findings underscore the need for interventions targeting lifestyles, including those addressing alcohol consumption and smoking, especially among those who have had family members die from COVID-19 infection and mental health support services that can address depression, anxiety, and stress to improve the overall well-being of the population.

Study tours as strategy in building multi-level public health system transformation in Ukraine (UA)

Abstract With 14 million Ukrainians in need of psychological aid (UNDP) and a strained health system, UA urgently requires mental health and psychological support services (MHPSS). As a TA partner on the USAID funded Public Health System Recovery and Resilience project in UA, the Philadelphia (PHL) team supports capacity building for population-based MHPSS at the community level with a study tour strategy. Such approaches apply to other countries interested in remodeling public health systems. The strategy aims to advance community based MHPSS through in person tours in PHL with remote follow up to stimulate vision, exchange ideas and accelerate action among governmental, community, and academic partners. The study tours presented overviews on health policy, system development, program services delivered to children and adults, community interventions, and workforce development of professionals and paraprofessionals. All included the foundational principles of trauma-informed practice. The June 2023 tour hosted 11 decision makers and regional officials who embraced the vision for system development and endorsed further engagement. The December 2023 tour hosted 13 practitioners and coordinators of health and social services to observe community programs. Results include development of PHL NGOs and UA social service hub partnerships to implement train the trainer programs for peers/people with lived experience and for mural arts programs to promote community engagement and empowerment. The September 2024 tour involves university partners from nursing, social work and psychology and PHL counterparts to strengthen curricula to include mental health competencies, support faculty development with potential for collaborative research and student exchange, and design post-graduate continuing education courses for upskilling the incumbent workforce. Study tours and direct exchange are an effective strategy for capacity building for MHPSS in Ukraine to address population health needs. Key messages • The sequenced study tour strategy affects distinct levels of change makers in UA. The results are governmental buy-in, partnerships for programmatic development, and academic advancement. • The study tour model promotes systematic change and offers solutions to MHPSS workforce shortages through information exchange, relationship building, and capacity development.

Loneliness and Social Isolation: qualitative study among youth in vulnerable situations

Abstract Background Loneliness and social isolation are increasing among young people, particularly those in vulnerable NEET (Not in Education, Employment or Training) situations, potentially leading to poor health and well-being outcomes. We aim to explore these challenges from the perspective of NEET youngsters and link workers who support them in co-creating individual action plans for their social and economic integration. Methods Data were collected through in-depth and semi-structured interviews with 15 young people in NEET situations, aged 18-34, and 7 link workers from several social organisations in rural and urban areas in Portugal. The young participants were selected based on their age, educational level, mental health needs, and urban/rural regions. Thematic analysis was used to analyse the interviews. Results The results showed a convergence between the perspectives of young people and link workers on the factors that influence social isolation and loneliness, including social and emotional skill deficits, excessive use of social media platforms, and mental health problems. Young people reported to being heavily involved in social media platforms, which often did not translate into meaningful relationships in real life. Youngsters also highlighted the lack of local support and community resources in rural areas. Link workers identified specific challenges young migrants face in community integration, including language barriers (for the youth with a migrant origin) and lack of familiarity with local resources. Conclusions This study highlights social media platforms, mental health and social and emotional skill deficits as main factors contributing to the social isolation and loneliness of young people in a NEET situation. This emphasizes the importance of integrated proximity-based interventions that incorporate community resource mapping and local support networks, including mental health support services, and promote multi-sector collaboration. Key messages • Social media platforms, mental health needs, and social and emotional skill deficits drive social isolation in NEET youth, stressing integrated, community-focused interventions. • Proximity-based strategies with community mapping and mental health support enhance NEET youths’ social integration, urging cross-sector collaboration.

Loneliness and Social Isolation in Older Adults in Latvia and Iceland During COVID-19

Abstract Background The COVID-19 pandemic has significantly impacted the mental health and wellbeing of older populations across Europe, exacerbating feelings of loneliness and social isolation, known risk factors for poor physical and mental health outcomes. This study aims to understand the extent and implications of these changes in Latvia and Iceland, providing essential insights for targeted public health interventions. Methods This comparative study utilized data from two key sources: the Survey of Health, Ageing, and Retirement in Europe (SHARE) for Latvia and the HL20 study for Iceland, focusing on individuals aged 67 and above. Both quantitative surveys were conducted during the pandemic, offering data on health status, loneliness, and social isolation. A novel approach was applied in analyzing older populations to standardize comparisons between the two distinct datasets. This methodological innovation is part of a bilateral EEA initiative FM2021/23 aimed at strengthening research collaboration between Latvia and Iceland. Descriptive statistics and the Pearson Chi-square test were used to compare outcomes between the two countries and within demographic subgroups. Results The study revealed stark differences between the two countries: 80% of Latvian older adults reported social isolation compared to 42.7% in Iceland. Similarly, 45% of Latvians experienced loneliness versus 30% of Icelanders. Significant associations were found between social isolation, loneliness, and deteriorating mental and physical health, with worse outcomes noted in socially isolated individuals. Conclusions Our findings demonstrate a clear link between social isolation and adverse health outcomes among the older adults, exacerbated by the COVID-19 pandemic. The study supports the need for proactive public health measures in Latvia and Iceland, including the development of community engagement programs and mental health support services tailored to the needs of older adults. Key messages • Study shows significant health impact of social isolation among older adults in Latvia and Iceland, highlighting urgent need for targeted public health interventions. • Effective public health strategies and innovative digital outreach can mitigate adverse effects of loneliness and isolation observed in older populations.

Youth mental health care use during COVID-19: Evidence from administrative data in Alberta, Canada

Abstract Background The COVID-19 pandemic affected health care service delivery and accessibility. Our study examined how Canadian youth used mental health services before and during the COVID-19 pandemic, and whether youth access and use patterns differed for subgroups based on social determinants previously associated with health care access. Methods Cross-sectional population-based administrative health care data from the province of Alberta in Canada was used to examine youth (ages 15-24) mental health care use from 2018/19 to 2021/22. Data was analyzed using an interrupted time series design and segmented regression modeling on type of mental health care use. Outcome measures were mental health care use for: general physician visits, psychiatrist visits, emergency department, hospitalization, and different mental health diagnoses. We stratified by factors related to social determinants, including gender and socioeconomic status. Results The analysis indicates an overall increase in the proportion of youth that used mental health care from 2018/19 to 2021/22 (14.4% vs 17.5%, respectively). There was an immediate drop in use with the onset of the COVID-19 pandemic in Canada, followed by a steady rise during the pandemic years, which was largely due to an increase in general physician visits. This rise was seen for most mental health diagnoses of study (i.e., anxiety, adjustment, attention-deficit/hyperactivity disorder, schizophrenia, and self-harm disorders). Service use increased for young women/girls compared to young men/boys and for youth from wealthier neighborhoods. Conclusions This study provides evidence to support health services planning and delivery to respond to the mental health needs of youth and to prepare for future public health emergencies. Key messages • Our study findings indicate changes in health care use for mental health among Canadian youth (ages 15-24) during the COVID-19 pandemic, with use patterns differing for youth subgroups. • Administrative health data can provide evidence to support health services planning and delivery to respond to the mental health needs of youth and to prepare for future public health emergencies.

Changes in health, lifestyle, and wellbeing of children with type 1 diabetes and their parents during the pandemic

ObjectiveThe COVID-19 pandemic restrictions have substantially affected people’s health and rapidly changed their daily routines. This is a prospective study that investigated the impact of the pandemic on primary school children with Type 1 diabetes and their parents during the first lockdown in Kuwait.MethodsA questionnaire battery related to mental health, well-being, and lifestyle was administered at baseline in Summer 2019 (face-to-face, at a diabetes outpatient clinic) and at follow-up during lockdown in Summer 2020 (via telephone, in adherence with COVID-19 restrictions). Data were collected for 70 dyads with children aged 9–12 years.ResultsSignificant differences were found in most scores for both children and parents. Their mental health worsened to a higher level of depression, anxiety, stress, and a poor level of wellbeing. The average scores on the follow-up tests fell within a clinical range on these measures. Significant differences in their lifestyle, compared to before the lockdown, included decreased levels of physical activity and lower healthy core nutritional intake.ConclusionsOur findings indicate that the COVID-19 lockdown has had a significant psychological and possibly physiological impact on children with Type 1 diabetes and their parents. We conclude that there is a need for mental health support services focusing on these groups. Although full lockdown restrictions will have stopped in the past year, post-pandemic stressors may be expected to continue to adversely affect this cohort.

Barriers to seeking counseling among US military service members

AbstractA stigma toward accessing mental health support services exists in military culture. One of the next steps in this line of research is gaining a better understanding of the barriers or reasons behind why service members can be reluctant to seek counseling. We recruited a national sample (N = 516) of service members to test the dimensionality of scores on the Revised Fit, Stigma, and Value (RFSV) Scale for measuring barriers to seeking counseling. Results demonstrated that the meaning of RFSV scores was invariant by help‐seeking history (past attendance in counseling) and by mental health diagnosis. After establishing adequate construct validity evidence of scores, we found that the Value barrier was a significant predictor of one or more peer‐to‐peer referrals to counseling among service members. Additionally, demographic differences in the Value and Stigma barriers emerged by help‐seeking history and active duty status, respectively.

Impact of Academic Progress on the Mental Health of Young People in Nigeria: A Case Study of Undergraduate Students in South-Western Nigeria

Background: Education is important in forging a pathway to economic opportunity and social mobility. It is widely regarded as a fundamental human right and a cornerstone of personal and social development. Method: This descriptive cross-sectional study employs a quantitative data collection approach. Four hundred individuals were interviewed using semi-structured, interviewer-administered questions through a multi-stage sampling technique. After data analysis with SPSS version 26, a chi-square test statistic was employed to determine whether there was a significant relationship between the categorical variables, with a p-value of less than 0.05. Results: Out of 400 respondents, 211 (52.8%) male and 189 (47.2%) female were questioned. Nearly half of the respondents (49.0%) were between the ages of 19 and 21 years old. According to the survey, most of the respondents (70.0%) asserted that their current academic workload is heavy, while (18.0%) and (9.0%) described their workload as moderate and light, respectively. Additionally, (60.0%) of the respondents rated their overall academic performance as good. However, only (13.0%) acknowledged that academic pressure contributes to stress and anxiety in life and (79.0%) occasionally expressed stress related to academic demands. About (11.8%) and (8.8%) of the respondents reported having been diagnosed with a mental health disorder before and experienced symptoms of depression in the past month respectively. An additional (20.0%) of respondents reported having experienced depression, while (24.5%) and (23.5%) claimed to have experienced anxiety and stress, respectively. Moreover, (11.8%) reported experiencing panic attacks, and (5.3%) mentioned having had suicidal thoughts. More than half of the respondents used to exercise (59.0%) and engaged in hobbies or interests (56.5%) as coping mechanisms for academic stress. Additionally, (45.5%) practiced mindfulness or relaxation techniques, and (25.5%) sought social support to manage their academic stress. About (32.5%) of respondents claimed they were aware of mental health support services available at their institutions, compared to (67.5%) who were unaware of these services. Of those aware, (33.1%) had utilized mental health support services. Additionally, (44.2%) of respondents were satisfied with the mental health support services on campus, while (39.5%) were very satisfied. The study also reveals that there’s no statistically significant association between the age, gender, monthly upkeep of the respondents and utilization of mental health support services. Conclusion: There is a complex connection between academic performance, psychological well-being, and the use of coping strategies and mental health support services among university students. This underscores the importance of addressing students' mental health needs alongside providing academic assistance. Keywords: Mental health, Academic performance, Mental health support services, Stress, Anxiety, Depression, Mental health coping mechanisms

Evaluation of the Sources of Sexual Knowledge and Information among Men in Kenya

AbstractSources of sexual knowledge and information among men have impact on quality of their sexual literacy and decision making. Sexual knowledge impacts on sexual attitudes, which underpin sexual behaviours and in turn impacts the sexual health outcomes of men. A cross-sectional quantitative survey was used to assess the sources of sexual knowledge and information among 484 Kenyan adult men aged 18–54. Data analysis was performed with STATA-16. Results showed that 79% of men learned about sex from school-based sex education, 75% and 72% from peers and mass media respectively while healthcare professionals (35%) and parents (28%) had the lowest influence on sexual knowledge and information. Understanding men’s sources of sexual knowledge and information that informs their sexual decision making can influence sexuality education planning and sexological practice policies targeted to out of school youths and older men. Hence, appraising formal peer educator’s knowledge could provide transformative sexual and reproductive health support services to men.

Clinical experiences of final-year RN and BSc nursing students during the first wave of the COVID-19 pandemic in Guyana: A mixed-methods study

Objective: The study aimed to explore the clinical experiences of final-year RN and BSc nursing students from four selected nursing schools in Guyana during the first wave of the COVID-19 pandemic.Methods: The study utilized a mixed-methods approach. The sampling involved final-year RN and BSc nursing students. The quantitative design included a survey with a convenient sample of 157 students, and the qualitative approach included seven focus group interviews. The survey data were analyzed using inferential statistics and thematic analysis.Results: The findings revealed the psychological and structural challenges experienced by final-year RN and BSc nursing students during the early months of the pandemic in Guyana. Of the respondents, 82.8% indicated fear of contracting coronavirus, 58% felt depressed, and 56.7% were insecure about daily nursing duties. Structural challenges experienced were that 58% needed PPE readily available, 80.9% felt unsafe in the clinical areas, 71.3% did not receive COVID-19 training, and 70.7% experienced financial burden. Positive responses included 91.7% did not take leave intentionally, and 74.5% felt confident. Thematic analysis yielded categories on stigmatization, fear of contracting, mental stress, shortage of staff and PPE, absence of risk allowance, and disaster planning. Coping strategies indicated were supporting one another, sharing information and resources, and praying, which enabled one to navigate the challenges and highlighted the strength of resilience and teamwork.Conclusions: Final-year nursing students encountered psychological, social, and structural challenges during their clinical placements in the early months of the pandemic outbreak. The findings underscored the need to strengthen material, academic resources, and mental health support services. Future research should focus on the experiences of registered nurses and male nurses during the pandemic. Cultivating an empowered and resilient nursing workforce is imperative to combat future healthcare challenges in Guyana.

Child maltreatment and insomnia symptoms among Chinese university students: the buffering role of self-efficacy.

Insomnia symptoms represent a significant public health concern, as it engenders substantial long-term health consequences. Considerable research has established the detrimental impacts of child maltreatment on sleep problems among university students. However, the role of self-efficacy in the association between childhood maltreatment and insomnia remains unclear. This study aimed to examine the associations between child maltreatment and insomnia symptoms among university students, and to investigate whether self-efficacy moderated the effects of child maltreatment on insomnia symptoms. A total of 2014 participants with random cluster sampling method were recruited from Jinan University in Guangzhou, China, from October 2022 to November 2022. Adjusting for covariates, the results of multiple logistic regression indicated that the participants with the experience of any type of child maltreatment (odds ratio [OR] 2.24, 95% confidence interval [CI] 1.63-3.07), childhood emotional abuse (OR 2.58, 95% CI 1.95-3.41), childhood emotional neglect (OR 1.16, 95% CI 0.87-1.54), childhood physical abuse (OR 2.15, 95% CI 1.60-2.8), childhood physical neglect (OR 2.19, 95% CI 1.64-2.92), childhood sexual abuse (OR 1.98, 95% CI 1.46-2.68) were more likely to report insomnia symptoms than those without. Individuals reporting one-two types and three-five types of child maltreatment were 1.81 times (95% CI 1.30-2.52) and 3.77 times (95% CI 2.58-5.50) more likely to report insomnia symptoms than those reporting zero types of child maltreatment, respectively. Furthermore, robust linear regression analysis revealed that self-efficacy moderated the associations between child maltreatment and insomnia symptoms (β = 0.007, 95% CI 0.004-0.010). These findings underscore the need for integrated mental health education, support services, and faculty training to address the impact of child maltreatment on insomnia symptoms among university students. Policy recommendations include advocating for comprehensive mental health services, incorporating self-efficacy initiatives, and fostering community engagement for a holistic approach to student well-being.

Examining multidimensional health poverty and determining factors among rural women of childbearing age in ningxia, china

BackgroundThe multidimensional health poverty afflicting rural women of reproductive age bears profound implications for the sustainable development of families, societies, and healthy villages. Elucidating vulnerable groups at risk of multidimensional health poverty and delineating its determinants can inform refinements and implementation of health-poverty alleviation policies.MethodsBased on the 2022 "Health Status and Health Service Utilization" survey data in rural Ningxia, China, this study analyzes the dimension of health status, capacity for health service utilization, health expenditure and security using the A-F dual-threshold method, logit model, and probit model. It comprehensively evaluates multidimensional health poverty and analyzes its determining factors among rural women of childbearing age.ResultsWith k set at 0.3, the health multidimensional poverty index, incidence, and intensity among rural women of reproductive age were 0.021, 0.053, and 0.392, respectively. Chronic illness, capacity for free gynecological examination utilization, health examination utilization, and borrowing due to illness contributed significantly to multidimensional health poverty. Risk factors for multidimensional health poverty among rural women of childbearing age include age, unemployment, family size, and lack of sanitary toilets. Protective factors include being married, educational level, non-farm or student occupation, receiving government support, separate housing and kitchen, owning a television and computer.ConclusionsEven with the elimination of absolute poverty, the multidimensional health poverty situation among rural women remains important from a gender perspective. It is recommended to strengthen economic assistance and health service support for these groups, improve the level of rural health services from a gender perspective, and enhance housing structure and sanitation toilet usage in rural areas. Efforts should be made to narrow the digital divide in rural areas and promote digital health education. Pre-interventions on multidimensional health poverty can provide new pathways for the development, empowerment, and well-being of rural women of childbearing age.

Ecotherapy for Adolescents Experiencing Mental Health Challenges: Qualitative Exploration of Perspectives of Adolescents and Parents

ABSTRACT Different forms of eco-therapeutic interventions have positively impacted the physical, psychological and social wellbeing status of service users across a range of age groups. However, there has been little evidence exploring the experience and perceived impact of an ecotherapy program for adolescents in the UK. This study explored perceptions of adolescents and their parents of an ecotherapy program targeting improved mental health and wellbeing. This study involved semi-structured interviews with adolescents and their parents. Interviews took place shortly after the program ended (adolescents and parents) and six weeks after (adolescents only). Interviews from the two groups were initially analyzed separately before being triangulated. Eight adolescents and seven parents were interviewed in total. Three themes were generated: building connections, learning and exposure, and comparing and constructing with prior services accessed. Perceived improvements across adolescents included reduced negative emotions and anxiety, and greater self-esteem, confidence, and social skills. For the latter theme, there were reported distinctive experiences of attending this ecotherapy program compared with professional mental health support services. Exploring nature brought adolescents together with benefits of engaging in support services that varied from the norm. Future research should examine the feasibility of using ecotherapy as an alternative treatment to traditional therapy in supporting mental health, and evaluate the economic viability of such a program for non-clinical support provision.

Navigating the Impact of Immigration Policies on Universities: A Leadership Model Approach

This study explores the multifaceted challenges universities may face as a result of alterations in immigration policies. Tightened regulations lead to decreases in international student enrollment. By drawing upon various theoretical frameworks, including transformational leadership, change management, and cultural dimensions, this study offers a comprehensive strategy to address the financial, social, and cultural implications of immigration policy shifts. The study examines the impact of policy changes on employees, highlighting potential challenges such as burnout and disengagement. Proactive measures, including flexible work arrangements and mental health support services, are recommended to mitigate these impacts. Financial implications are addressed through developing contingency plans and reassessing financial strategies to maintain operational stability. Furthermore, the study underscores the importance of preserving campus cultural exchange opportunities and diversity initiatives through virtual programs, partnerships, and curriculum integration. Leadership models, particularly transformational leadership, provide a guiding framework for navigating organizational change. The study advocates for clear communication, employee empowerment, and alignment with the institution’s values to foster resilience. Additionally, Kotter’s 8-Step Model of Change Management offers a structured approach to addressing challenges, emphasizing the importance of urgency, vision, and cultural integration. Through proactive measures informed by theoretical insights, universities can navigate the challenges of immigration policy changes while upholding their commitment to diversity, inclusion, and academic excellence. This study contributes valuable insights for higher education institutions grappling with regulatory shifts, offering actionable recommendations for fostering resilience and adaptation in a rapidly changing landscape.

A model of community youth mental health support services in the global South: A description and use of school-based services delivered by a non-governmental organisation in South Africa

ObjectiveYoung people in low- and middle-income countries (LMICs), including South Africa, are disproportionately affected by multiple risk factors for developing mental health problems and there are numerous barriers to accessing mental health care. In such contexts non-governmental organisations (NGOs) play a key role in providing support. We report on the mental health care services provided by NGO Community Keepers in South Africa. MethodCommunity Keepers (CK) offers psychosocial support to young people, parents, and teachers, during regular school hours, and free of charge. At the end of 2019, CK was based at 23 schools in 12 areas in the Western Cape Province, South Africa. In this paper we describe the model of service provision and present descriptive statistics from retrospective observational service data using routinely collected quantitative data from 2019, including details about referrals received, referral sources and reasons, and feedback received from children, parents, and teachers on the psychosocial support CK delivered. ResultsDuring 2019, 34 676 individuals accessed 18169 psychosocial support sessions rendered by CK. The most common referral source of learners to CK was self-referrals (40.6%), and the main referral reasons were emotional (psychological) problems, behaviour problems, or family (community) problems. At termination of therapy 320 (79.2%) learners said they strongly agreed that they would recommend CK to someone at their school. At termination of therapy with learners, 95 (39.3%) teachers rated CK’s services as excellent, 139 (57.4%) teachers gave a rating of good, and 204 (79.7%) parents reported an improvement in their relationship with their children. ConclusionsCK is an example of how psychosocial support can be embedded in schools in a LMIC. CK’s multifaceted model of service delivery could be used by other school-based mental health care service providers in other LMICs to inform and/or refine the services that they wish to offer.

Healthcare workers’ mental health during the COVID-19 pandemic: a qualitative analysis of a text message-based NHS workforce support line

BackgroundThe National Health Service (NHS) is suffering from a workforce crisis of mental and physical sickness and attrition following the COVID-19 pandemic. An in-depth understanding of healthcare workers’ (HCWs) experiences...

Suicidal behaviors among refugee women in Jordan: post-traumatic stress disorder, social support and post-displacement stressors

BackgroundThis paper examines the frequency of suicidal behaviors (suicidal ideation or attempt) among a sample of Syrian refugee women living in non-camp settings in Jordan. We asked several questions surrounding suicide and examined the associations between post-traumatic stress disorder (PTSD), social connectedness, post-displacement stressors and suicidal behaviors.MethodsParticipants (n = 507) were recruited using a clinic-based systematic sampling from four health clinics throughout Jordan in 2018. We used a multivariable logistic regression to examine the hypothesis of whether positive screening for PTSD (PCL-5), social isolation (have no friends or family members available to help), and greater number of post-displacement stressors (PMLD Checklist) is associated with suicidal behaviors.ResultsApproximately one-tenth (9.86%) of participants surveyed reported suicidal behaviors (suicidal ideation or attempt) in the past six months. Our hypothesis was partially supported. In the adjusted multivariable analyses, screening positive for PTSD [OR:4.02 (95% CI:1.33, 12.15)] increased odds of suicidal behaviors, while having one friend or family member available to help when in need [OR:0.31 (95% CI:0.13, 0.78)] decreased odds of suicidal behaviors. We did not find any associations between the number of post-displacement stressors and suicidal behaviors in the multivariable model.ConclusionAgencies and practitioners addressing suicidal behaviors among Syrian refugee women should provide interventions that aim to reduce PTSD symptoms and social isolation. Potential intervention includes screening for mental health symptoms and suicidal behaviors during routine visits with service providers, as well as providing proper mental health and psychosocial support services according to the mapping of available services.

University students’ access and use of sexual and reproductive health services in Australia

University attendance can lead to changes in sexual behaviour that place people at increased risk of negative sexual and reproductive health (SRH) experiences; however, relatively few studies have explored access to and use of SRH services by university students in Australia. A convenience sample of students (N = 4291) from five universities completed an online survey to examine barriers and facilitators to accessing SRH services. Descriptive statistics were used to analyse variations by gender, sexuality, and enrolment status. Content analyses were conducted on responses to two open-ended questions. Over half (59%, 2934) had never spoken to a health professional about SRH issues. Of the 41% (1357) who had, female, non-binary/gender diverse, and Australian-born students were significantly more likely to have done so than students identifying as male, heterosexual, or as an international student. Frequently reported barriers to use of SRH services were ‘feeling embarrassed’, ‘being judged’ and ‘not knowing where to go’. LGBTQIA+ students along with international and overseas-born domestic students faced specific access barriers. Recommendations targeting student-identified barriers to access are offered, calling for universities to support student wellbeing by providing supportive, non-judgemental, and inclusive SRH promotion and health services that cater to needs of diverse student cohorts.