Preventive psychiatry in india: Preventing on Child Psychiatric FrontDevashish Konar
Parenting training of would-be-parents, early detection of vulnerable children and timely intervention are some of the efforts that will give large dividend. We have very limited number of child psychiatrists. So including general psychiatrists, pediatricians, family physicians, health workers and teachers would be the most suited public health strategy for India. They need to be trained to work within their limits and need to learn to refer at the right time without wasting precious time of the growing children and adolescents.
Patient Directed Care; Why it’s important and what does it really mean?Spectrum Health System
Understanding the importance of effective patient centered communication for patient engagement and improved health outcomes. Will discuss the importance of patient directed care and its relationship to the quadruple aim. Will discuss the barriers and a framework for conversations that are critical to patient directed care and cultural competency.
Effective childhood prevention of mental health problemsKristian Wahlbeck
A short overview of effective childhood interventions to prevent mental health problems and disorders in adulthood. The focus is on public mental health interventions, especially parental support and school mental health interventions. The presentation concludes that cost-effective interventions exist and that they need to be taken to scale.
Presentation in Nice, France March 6, 2018, at the European Psychiatry Association Congress
Preventive psychiatry in india: Preventing on Child Psychiatric FrontDevashish Konar
Parenting training of would-be-parents, early detection of vulnerable children and timely intervention are some of the efforts that will give large dividend. We have very limited number of child psychiatrists. So including general psychiatrists, pediatricians, family physicians, health workers and teachers would be the most suited public health strategy for India. They need to be trained to work within their limits and need to learn to refer at the right time without wasting precious time of the growing children and adolescents.
Patient Directed Care; Why it’s important and what does it really mean?Spectrum Health System
Understanding the importance of effective patient centered communication for patient engagement and improved health outcomes. Will discuss the importance of patient directed care and its relationship to the quadruple aim. Will discuss the barriers and a framework for conversations that are critical to patient directed care and cultural competency.
Effective childhood prevention of mental health problemsKristian Wahlbeck
A short overview of effective childhood interventions to prevent mental health problems and disorders in adulthood. The focus is on public mental health interventions, especially parental support and school mental health interventions. The presentation concludes that cost-effective interventions exist and that they need to be taken to scale.
Presentation in Nice, France March 6, 2018, at the European Psychiatry Association Congress
Resources in community care, caplan's model, psychiatric nursingCelente French
Evaluate Caplan’s approach regarding the contribution of resources in the promotion, maintenance and restoration of mental health in the community.
Analyse psychiatric nursing approaches as professional resource in the promotion, maintenance and restoration of community mental health.
Developing non-clinical approaches and are pathways to fundamental socioeconomic issues that are presented in the primary care and secondary care settings
Background: The numbers of caregivers burdened by dementia is increasing. Depression is also found more in this group and
causes higher morbidity. The aim of this study was to investigate the predictors of depression among Thai family caregivers in order to develop effective interventions in primary care Methods: A total of 177 participants were recruited in primary care setting. They were assessed for sociodemographic data, health status, caregiver burden and depressive symptoms measured by Charlsons Comorbidities (CCI), Zarit Burden Interview (ZBI) and Patient Health Questionnaire (PHQ-9), respectively. The data for dementia patients included severity and functional status. Depression was defi ned as PHQ-9 ≥ 9. Multivariate linear regression model was applied to assess the independent relationship between possible risk factors and risk of depression.
Better outcomes, better value: integrating physical and mental health into clinical practice and commissioning
Tuesday 24 June 2014: 15 Hatfields, Chadwick Court, London
Integrating Behavioral Health into Primary Care – Thought Leaders in Populati...Epstein Becker Green
Although mental health and substance abuse (behavioral health) services have historically been segregated from traditional medical care, its impact on patients’ well-being, physical health and cost-of-care has become increasingly critical to improving clinical quality outcomes while significantly decreasing financial costs by tens of billions of dollars. Drs. Daviss and Coleman will discuss the advances in policy and practice regarding the integration of behavioral health with physical health, as well as some of the gaps in identifying, aggregating, and analyzing data critical to a more holistic and comprehensive view of the individual.
In addition, the speakers will:
* Identify the clinical, legal, social, and financial impacts of behavioral health disorders on chronic medical conditions.
* Describe the challenges involved in improving clinical and financial outcomes in patients with chronic medical conditions who also have behavioral health symptoms and/or conditions.
* Demonstrate the rewards for implementing new information technology applications and analysis for better clinical and financial outcomes for these specific populations.
Moderator
* Mark E. Lutes, Member of the Firm and Chair of Epstein Becker Green's Board of Directors
Speakers
* Charles A. Coleman, PhD, Senior Sponsor of IBM's Population Health Insights and Programs Management of IBM's Healthcare Solutions Board
* Steven R. Daviss, MD, DFAPA, Chief Medical Officer at M3 Information, LLC, a DC-based mobile mental health information technology company that developed the peer-reviewed multi-dimensional, patient-centered mental health screening tool, M3Clinician
Epstein Becker Green Webinar - Moderated by Mark E. Lutes - http://www.ebglaw.com/events/the-challenges-and-rewards-of-integrating-behavioral-health-into-primary-care-%E2%80%93-thought-leaders-in-population-health-webinar-series/
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
Presentation of current evidence for promotion of mental wellbeing and prevention of mental disorders. The presentation argues for moving from research to action, using the mental health in all policies approach.
U.S. Behavioral Health Market Size to Hit Around US$ 132.4 Bn by 2027MichaelCrichton7
The U.S. Behavioral Health Market was valued at US$ 90.5 billion in 2020 and is projected to be worth around US$ 132.4 billion by 2027, registering a CAGR of 5.3% from 2021 to 2027.
Solutions for Improving Mental Health in the WorkplaceCCOHS
Mental health is an organizational, social and personal concern for the workplace and workers. Psychosocial stress is an occupational hazard to which overexposure leads to strain, illness and disability, and can be prevented. This presentation outlines some ideas and solutions that have been researched and collated from a number of global and Canadian research, analysis and publications. Presented at the Alberta Health and Safety Conference on October 28, 2009.
Sj47 -The State of Youth Mental Health in VirginiaAnne Moss Rogers
Children’s Mental Health: Challenges and Opportunities--This is the presentation by Margaret Nimmo Crowe to a special subcommittee of the commonwealth, Executive Director for Voices for Virginia’s Children. More info here: http://1in5kids.org/2014/10/29/sj-47-workgroup-takes-childrens-mental-health/
Better outcomes, better value: integrating physical and mental health into clinical practice and commissioning
Tuesday 24 June 2014: 15 Hatfields, Chadwick Court, London
DESIGN IN MENTAL HEALTH NETWORK - Kingfisher Court presentationArchitects for Health
An imaginative built interpretation of the much mentioned ‘Recovery Model’ of care was presented by Wendy De Silva, Director of P+HS Architects, in her scheme for Kingfisher Court.
Resources in community care, caplan's model, psychiatric nursingCelente French
Evaluate Caplan’s approach regarding the contribution of resources in the promotion, maintenance and restoration of mental health in the community.
Analyse psychiatric nursing approaches as professional resource in the promotion, maintenance and restoration of community mental health.
Developing non-clinical approaches and are pathways to fundamental socioeconomic issues that are presented in the primary care and secondary care settings
Background: The numbers of caregivers burdened by dementia is increasing. Depression is also found more in this group and
causes higher morbidity. The aim of this study was to investigate the predictors of depression among Thai family caregivers in order to develop effective interventions in primary care Methods: A total of 177 participants were recruited in primary care setting. They were assessed for sociodemographic data, health status, caregiver burden and depressive symptoms measured by Charlsons Comorbidities (CCI), Zarit Burden Interview (ZBI) and Patient Health Questionnaire (PHQ-9), respectively. The data for dementia patients included severity and functional status. Depression was defi ned as PHQ-9 ≥ 9. Multivariate linear regression model was applied to assess the independent relationship between possible risk factors and risk of depression.
Better outcomes, better value: integrating physical and mental health into clinical practice and commissioning
Tuesday 24 June 2014: 15 Hatfields, Chadwick Court, London
Integrating Behavioral Health into Primary Care – Thought Leaders in Populati...Epstein Becker Green
Although mental health and substance abuse (behavioral health) services have historically been segregated from traditional medical care, its impact on patients’ well-being, physical health and cost-of-care has become increasingly critical to improving clinical quality outcomes while significantly decreasing financial costs by tens of billions of dollars. Drs. Daviss and Coleman will discuss the advances in policy and practice regarding the integration of behavioral health with physical health, as well as some of the gaps in identifying, aggregating, and analyzing data critical to a more holistic and comprehensive view of the individual.
In addition, the speakers will:
* Identify the clinical, legal, social, and financial impacts of behavioral health disorders on chronic medical conditions.
* Describe the challenges involved in improving clinical and financial outcomes in patients with chronic medical conditions who also have behavioral health symptoms and/or conditions.
* Demonstrate the rewards for implementing new information technology applications and analysis for better clinical and financial outcomes for these specific populations.
Moderator
* Mark E. Lutes, Member of the Firm and Chair of Epstein Becker Green's Board of Directors
Speakers
* Charles A. Coleman, PhD, Senior Sponsor of IBM's Population Health Insights and Programs Management of IBM's Healthcare Solutions Board
* Steven R. Daviss, MD, DFAPA, Chief Medical Officer at M3 Information, LLC, a DC-based mobile mental health information technology company that developed the peer-reviewed multi-dimensional, patient-centered mental health screening tool, M3Clinician
Epstein Becker Green Webinar - Moderated by Mark E. Lutes - http://www.ebglaw.com/events/the-challenges-and-rewards-of-integrating-behavioral-health-into-primary-care-%E2%80%93-thought-leaders-in-population-health-webinar-series/
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
Presentation of current evidence for promotion of mental wellbeing and prevention of mental disorders. The presentation argues for moving from research to action, using the mental health in all policies approach.
U.S. Behavioral Health Market Size to Hit Around US$ 132.4 Bn by 2027MichaelCrichton7
The U.S. Behavioral Health Market was valued at US$ 90.5 billion in 2020 and is projected to be worth around US$ 132.4 billion by 2027, registering a CAGR of 5.3% from 2021 to 2027.
Solutions for Improving Mental Health in the WorkplaceCCOHS
Mental health is an organizational, social and personal concern for the workplace and workers. Psychosocial stress is an occupational hazard to which overexposure leads to strain, illness and disability, and can be prevented. This presentation outlines some ideas and solutions that have been researched and collated from a number of global and Canadian research, analysis and publications. Presented at the Alberta Health and Safety Conference on October 28, 2009.
Sj47 -The State of Youth Mental Health in VirginiaAnne Moss Rogers
Children’s Mental Health: Challenges and Opportunities--This is the presentation by Margaret Nimmo Crowe to a special subcommittee of the commonwealth, Executive Director for Voices for Virginia’s Children. More info here: http://1in5kids.org/2014/10/29/sj-47-workgroup-takes-childrens-mental-health/
Better outcomes, better value: integrating physical and mental health into clinical practice and commissioning
Tuesday 24 June 2014: 15 Hatfields, Chadwick Court, London
DESIGN IN MENTAL HEALTH NETWORK - Kingfisher Court presentationArchitects for Health
An imaginative built interpretation of the much mentioned ‘Recovery Model’ of care was presented by Wendy De Silva, Director of P+HS Architects, in her scheme for Kingfisher Court.
In the realm of mental health recovery, medication management plays a pivotal role in the overall treatment process. As individuals embark on their journey toward healing, the proper administration and monitoring of medications are crucial for achieving stability and fostering sustained well-being. Mental illness refers to a wide range of conditions that affect an individual’s cognitive, emotional, and behavioral well-being, often disrupting their daily functioning, relationships, and overall quality of life. These conditions encompass various disorders, such as depression, anxiety, schizophrenia, bipolar disorder, and post-traumatic stress disorder (PTSD), among others.
Reflective practice is the innovative way of learning through your own actions. This enhance the critical thinking abilities through forming strategies to overcome and prevent the same mistake happening again.
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
2. Mental health in GP
practice
Mental illness is covert or hidden
Primary carers fail to recognize
one out of two patients with mental
illnesses
Incidence of mental illness varies
in different areas and practices and
at different times
Untreated mental illness is time-
consuming and costly
3. The cost of untreated mental
illness:
WHO “Burden of Disease” study
To patient
Morbidity, mortality, financial,
productivity, family suffering,
reputation
To community
Productivity, financial, loss of
community cohesion
To doctor
?
4. Obstacles to mental
health diagnosis
Patient
Ignorance, stigma, fear of the
implications, lack of finances or
resources to treat
Doctor
Knowledge and/or skill deficit,
attitude, misinterpretation or
interest issues, lack of facilities
and resources, time, remuneration
issues, discomfort with emotional
issues (personal or cultural)
5. Society
Different priorities, financial, lack of
community education, health
policy, community attitudes
What are the challenges in
Somaliland/Somalia practice???
6. Association Between Physical & Mental
Problems in Primary Care Patients
10-20% of general population will seek primary
care for a MH problem
Studies show prevalence of mental health
problems:
PRIME-MD: average 26% have psychiatric
disorder while another 13% have significant
functional impairment
WHO: average of 21% had psychiatric
disorders
2/3 of primary care patients with psychiatric
diagnosis have significant physical illness
9. Association Between Physical & Mental
Problems in Primary Care Patients
Chronic medical illness increases probability of depression by
two to three folds
Psychiatric disorders in primary care are less severe than
those in MH settings
Health status, quality of life, functional status-better correlated
with psychosocial factors than physical disease severity
Medical Outcome Study (MOS) indicates functional
impairment due to depression compares to that of COPD,
diabetes, CAD, hypertension, and arthritis
10. Recognition & Treatment of MH Problems
in Primary Care
1/2-2/3 of patients meeting criteria for psychiatric diagnosis go
unrecognized by primary care providers
Even when recognized & treated, dosage & duration of
antidepressant meds are usually inadequate
In naturalistic studies, there was no difference in outcome
between treated and untreated depressed patients in primary
care setting.
11. Health Care Utilization
Studies indicate objective disability or morbidity alone can predict
only 10-25% of health care use
One study found 60% of all medical visits were by “worried well”
with no diagnosable disorder
Patients with MH problems, when compared to unaffected
counterparts, use twice the medical resources.
Patients with somatization disorder use 9 times national norm of
medical resources
12. Why Should Primary Care Providers
Integrate MH Services Into Primary Care?
Primary Care Providers deal with patient’s untreated
psychological problem- identified or not
Psychosocial/behavioral problems take up Primary Care Provider
time regardless of degree to which problems are explicit focus of
practice
1/3-1/2 of Primary Care patients will refuse referral to MH
professional
13. Why Should Primary Care Providers
Integrate MH Services Into Primary Care?
Patients who refuse referral tend to be high utilizers with
unexplained physical symptoms
Dichotomizing patients problems into physical & mental leads to:
Duplication of effort
Undermines comprehensiveness of care
Hamstrings clinicians with incomplete data
Insures that the patient cannot be completely understood
14. Why Should Primary Care Providers
Integrate Mental Health Services Into
Primary Care?
Many prefer to receive MH services in Primary Care because not
construed as “mental healthcare”
With expectation of seriously mentally ill, basic MH services can
be managed in Primary Care setting
Growing evidence that integrated primary care is cost-effective
15. Conclusions
Mental healthcare cannot be divorced from primary
medical care - all attempts to do so are doomed to
failure
Primary care cannot be practiced without addressing
mental health concerns, and all attempts to neglect
them will result in inferior care
deGruy, F.V. (1997). Mental healthcare in the primary care setting:
A paradigm problem. Fam. Syst. & Health 15:3-26.
16. Barriers to Providing Mental Health
Services to Primary Care Patients
Competing Demands and Tasks of Primary Care Providers
Average primary care visit last 13 minutes
Patients have average of 6 problems on problem list
Inadequate time to adequately assess for mental health
problems and manage once assessed
A zero-sum game. No room for provision of new services
without eliminating another or adding resources for additional
work
17. Barriers to Providing Mental Health
Services to Primary Care Patients
Limitations of Specialty Mental Health Service for Primary
Care Setting
Focus of Psychiatry is increasingly on diagnosis of seriously
disturbed patients and prescription/monitoring of psychotropic
medication
Psychiatric diagnostic systems that do not fit clinical
phenomenology
Mental Health Providers not trained to address
psychological/behavioral problems common in primary care
settings
somatization
chronic pain
noncompliance with medical regimens
18. Barriers to Providing Mental Health
Services to Primary Care Patients
Patient Barriers to Providing Mental Health Services
Concerns about stigma of psychiatric diagnosis
Significant negative consequences for pursing mental health
care
Domestic abuse
Criticism from family
Patient Somatization: Problems not perceived as
psychological
Patient has no psychiatric diagnosis, but still in need of
psychological care
19. Conclusion
“The problem of underdiagnosis and
undertreatment cannot be remedied by simple
provision of guidelines and protocols, no matter
how elegant; it will require a reordering of the
actual structure and process of primary care.”
deGruy, F.V. (1997). Mental healthcare in the primary care setting:
A paradigm problem. Fam. Syst. & Health 15:3-26.
20. Models of Collaboration Between Primary
Care and Mental Health Care Providers
Level One: Minimal Collaboration - Providers in
Separate Locations
Separate systems
Rarely communicate about patients
Most private practices and agencies
Handles adequately problems with little biopsychosocial
interplay & few management difficulties
Handles inadequately problems that are refractory to treatment
or have significant biopsychosocial interplay
21. Models of Collaboration Between Primary
Care and Mental Health Care Providers
Level Two: Basic Collaboration on Site
Separate systems but share same facility
No systematic approach to collaboration - do not share common
language or in-depth understanding of each other’s worlds.
Misunderstandings are common
Common in mental health settings
Handles adequately problems with moderate bio-psycho- social
interplay requiring occasional communication about shared
patients
Handles inadequately patients with ongoing and challenging
management problems
22. Models of Collaboration Between Primary
Care and Mental Health Care Providers
Level Three: Close Collaboration in Fully Integrated
System
Same site, same vision, and same system in a seamless
web of biopsychosocial services
Staff committed to biopsychosocial systems paradigm.
In-depth understand of each other’s roles/cultures.
Operates as a team - regular collaboration
23. Models of Collaboration Between Primary
Care and Mental Health Care Providers
Continued...
Level Three: Close Collaboration in Fully Integrated System
Fairly rare. Occurs in some hospice centers and special
training and clinical settings.
Handles adequately most difficult and complex
biopsychosocial problems with challenging management
problems
Handles inadequately problems when resources of health
care team are insufficient or when there is breakdown with
larger service system
24. Somaliland/Somalia
Mental heath integration
into primary health care
There is poor primary health care
level at MCHs and hospital
facilities.
Mental health services are not well
developed and there is no
integration at this time.
Somaliland has one of the highest
mental health disorders prevalence
worldwide.
.
25. Global efforts
In 2008, WHO developed the
MHGAP curriculum guide for the
low and middle income countries.
Several countries have now
adopted it for primary care
physicians.
Amoud medical school will give the
guide as part of mental health
undergraduate teaching in January
2012.
27. Mental health and
physicians
Primary care physicians don’t have
mental health education after
leaving medical school.
Primary care physicians meet with
psychiatric patients suffering from
co-morbid medical conditions.
Some try meds usually without
psychiatric assessment
28. Psychiatry in Borama
There was psychiatric reference till
before 2011.
Physicians were not interested in
mental health as general.
Psychiatric service was not
existing.
Patients were not taken to
hospitals as there was nothing for
MH
29. How we can address
mental health
Integration of MH into primary
health care
Referring hard cases into
psychiatric practice.
Workshops and CME on mental
health for physicians
30. Somaliland
Somaliland mental health service
is restricted.
Mental health ward is located in
Hargeisa now run by GRT
Former prison in Berbera is the
mental hospital in Berbera
Mental health OPD and inpatient
ward in Burao
Mental health OPD in Borama
31. Other towns in Somaliland have no
mental health services.
Traditional healers centers named
centers of care receive so many
patients they use herbal
medication, beating and residential
rooms to keep patients in.
No mental health policy
No mental health integration policy
yet.
32. Mental health education
Amoud and Hargeisa medical
schools have their undergraduate
curriculum developed.
Given in the sixth year by the
King’s College London in support
with THET.
Distance learning support in
mental health teaching for medical
students , interns and junior
doctors on
www.medicineafrica.com
33. Amoud mental health
teaching
Dr. Jibril Handuleh developed OPD
for mental health teaching and
patient care.
Dr. Handuleh is also Somaliland
coordinator for medicineafrica.
The teaching is offered for nurse
and medical students since April
2011.
34. Case presentations, class room
teachings and community mental
health service is given in Amoud
This service is also introducing
mental health gap curriculum into
Somaliland mental health
education for medical students.
35. Puntland
Mental health services in
Bosaso
Galkacayo
Garowe
Traditional healer centers exist
No medical schools
Most of the work is done by GRT
36. South/central Somalia
Mental wards
Traditional healers
Dr. Habeb center is the most
common mental health ward in
Mugadishu.
Some are scattered in places like
Marca etc.
Refer the WHO mental health
situational analysis, Feb, 2011
37. No undergraduate psychiatric
teaching and online support
compared to Somaliland.
THET and King’s College only
operate in Somaliland.
Given the civil war, famine and the
refugees , the problem is much
bigger in the south/central Somalia
compared to relatively stable
regions.
38. Mental health in Borama
Borama had two hospitals at the
end of 2010 with no mental health
service.
Both hospitals are teaching
hospitals for Amoud University
school of health sciences.
Students had no site for psychiatric
bedside teaching.
39. Amoud Mental health
project
Amoud University started mental
health project in Borama.
The medical school asked Dr.Jibril
to come with the mandate to
develop a mental healith service.
40. Students were going to Hargeisa to
have mental health teaching as a
part of undergraduate teaching.
The faculty was interested to
develop mental health OPD first to
offer patient care and clinical
bedside teaching.
41. Jibril, a former mental health rep
ended internship in November
2010.
Amoud University recruited Jibril
as clinical teacher next month.
I was already Pathology lecturer
and clinical assistant in Psychiatry
as part of mental health rep post in
both Amoud and Hargeisa medical
schools
42. Background of Amoud
mental health service
Due to the high demand for
psychiatric patient care and clinical
teaching , it was necessary to
develop a service.
Jibril agreed to come up with
service development plan.
43. Mental health service
To introduce mental health in
Borama a pilot project had to be
developed to
Learn mental health pattern in
Borama
Raise public awareness for mental
health care.
Create suitable environment for
student mentoring and supervision.
44. Mental health and global
partnership
Pilot mental health project had
been in partnership with King’s
college London , Institute of
Psychiatry-UK and tropical health
and educational trust.
Pilot phase was coordinated with
GRT, Italian NGO working in
mental health in Hargeisa, Berbera
and some parts of Puntland
45. Peace ware Somaliland and ICT
department of the University of
Copenhagen, Denmark.
in later stage , started link with
EMRO mental health and
substance misuse department.
Huge technical input from
Keroniski institute of Sweden’s
Psychiatrist Dr. Yakoub Aden Abdi
46. Mental health project
components
Hospital OPD at Alhayett teaching
hospital
Prison mental health
Community based psychiatry
MCH related Perinatal psychiatry
School psychiatry
47. Hospital based service
The only option available was the
development of OPD department
as there is no ward in Borama.
Ward is currently being planned in
Borama and will take time to
develop.
Outpatient and emergency case
management
48. Hospital rotation
Saturday and Wednesday were the
two days allocated for OPD.
Work was from 7.30- 2 P.M
Classes for nurses in the last six
months
Classes for med students in the
coming 8 months continuously.
Intern mentoring
49. Patient care at the OPD
Integrated into medical OPD
Patients receive free consultations
Patients are offered medications-
Poor patients only.
Follow up of patients
Patient education with dedicated
patient education leaflets
Good documentation system
50. Telephone number support in case
of emergencies
Working with 2 local NGOs to refer
patients for treatment
Link with local volunteer networks
bringing in patients
54. Achievements
250 patients in the OPD were
received in the hospital OPD
alone.
The patients had been receiving
free medication and consultations
with mental health service.
Patient follow up scheme was
successful as 90% of patients
came up with follow ups.
55. Community psychiatry
This is the first community based
psychiatry in Somaliland.
it has two components
A. home visits
B. traditional healer link
56. The community
program…
Home visits segment is the
cornerstone part of Borama based
psychiatry.
Amoud nursing school and
concerned citizens are major
partners.
Home visits come through demand
and service provider commitment.
57. Home visits
Patient home visits take place
almost daily at any time possible.
A doctor and a nurse always go to
homes.
Telephone follow up exists to trace
the cases down.
Local pharmacist was trained to
help give depots and educate
patients
58. Traditional healers
Traditional healers link was
established in a desire to reach out
patients.
Patients were kept in a house with
three Sheikhs using so many sorts
of herbal medicines.
They also use water boarding and
beating.
In the last visit even chaining pts.
59. Partnership
They agreed upon referring cases.
They call our service to provide
mental health assessment and
management.
Mental health service follows up
patients after discharge.
My work reduced their stay days.
Stronger follow up to encourage
mental health service
60. Perinatal psychiatry
Introducing mental health into the
maternal care was crucial in our
program.
It is first program again to have
such program in the Somaliland.
It has antenatal and Postnatal
components in partnership with
Amoud nursing school.
61. Global partners
King’s College London, UK with
Perinatal psychiatrist working with
me on this.
University of Cape town school of
Medicine- South Africa. Technical
and academic input in the
development of teaching materials.
62. In the pilot phase
Training the trainers in Perinatal
Psychiatry in both antenatal and
Postnatal care setting in Borama
MCHs
It includes
basic assessments
Common Perinatal psychiatry
presentations
Referral systems
Follow ups
63. Training program
Nursing tutors
Borama MCH workers
It was done in July , 2011
Referral system was introduced
Program will start in January 2012
MCH patients with mental illnesses
will be referred to psychiatry
practice at the teaching hospital.
64. Prison service
The first of its kind in Somaliland.
The program has the following
partners
Somaliland ministry of Justice
Somaliland Custodial corps
Amoud Legal Clinic
Borama prison
Amoud University
65. Objectives of prison
service
Train prison guards on mental
health problems among inmates.
Advocate for patient care and
treatment
Treating for free inmates with
mental illnesses
Training the prison nurse in basic
psychiatric practice
Developing referral system
66. Achievements
Over 30 inmates treated
Training for prison guards done
within three months through
tutorials and on job case scenarios
Referral system is in place
In partnership with Amoud legal
clinic , the service offers forensic
consultation with Borama court.
67. School mental health
service
Again , a major step forward with
mental health in Somaliland.
In a study , 19 suicide cases in
Borama were related to untreated
depression. Handuleh, J. untreated
depression among high school
students in Borama, North
Somalia, Arab journal of
psychiatry, to be published in May
2012.
68. School mental health
service
Schools had no formal health
system.
Mental health was not even
existing.
Students and teachers suffer from
whole sort of mental and
neurological problems
69. Amoud University contacted the
local ministry of education office.
The plan was presented
Ministry of education approved the
project involvement in schools
The project started to work with
school teachers, student union
leaders and the headmasters.
70. Students received patient care at
schools. The headmaster of
schools turned into outpatients
working with parents.
Al-Aqsa school presented with
school children.
The other schools will receive the
same student assessment and
management
71. Mental health workshop
for teachers
• It was set to be in July but schools
went into holidays.
• The workshop will take place in
Mid December.
It will have the following objectives:
Teacher training in school mental
health arena
Communication skills and student
support
Identification and referral systems
72. Lessons learnt
Mental health development is
dynamic and very interactive.
Patient care improved patient life
and family
Community gave huge input and
appreciation
Local NGOs , citizens alike were
very encouraging.
73. Global partnerships
Teaching service development
Community inputs from prison to
homes.
Creating research potentiality
Faculty support, GPs and other
players in Amoud University
75. Opportunities
Creating leaderships in mental
health among med/nurse students
and then at the intern level.
Reaching out villages through
visits and nurse education at
remote places.
Using Skype and 3G technology in
the future.
MANY MORE!!!