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Global mental health and schizophrenia

Asher, Laura; Fekadu, Abebaw; Hanlon, Charlotte

Authors

LAURA ASHER LAURA.ASHER@NOTTINGHAM.AC.UK
Clinical Associate Professor

Abebaw Fekadu

Charlotte Hanlon



Abstract

PURPOSE OF REVIEW: The aim was to synthesize recent evidence on schizophrenia illness experience and outcomes and models of care in low and middle-income countries (LMICs).

RECENT FINDINGS: There is a plurality of explanatory models for psychosis and increasing evidence that context influences experiences of stigma. People with schizophrenia in LMICs are vulnerable to food insecurity, violence and physical health problems, in addition to unmet needs for mental healthcare. Family support may help to improve outcomes if present, but caregivers may be overwhelmed by the challenges faced. Despite efforts to increase availability, evidence-based care remains inaccessible to many people with schizophrenia. Non-randomized evaluations in South Africa and Mexico indicate that psychosocial support groups for people with schizophrenia and caregivers may be acceptable and useful. Randomized controlled trials in Pakistan and China show that culturally adapted cognitive-behavioural therapy can reduce symptom severity. There is emerging evidence that alternative medicine, such as Tai Chi, may be beneficial, but to date most studies are of low quality. The challenges of biomedical-traditional provider collaborations have been highlighted. Evaluations of integrated mental healthcare in primary care are underway and promise to provide vital information about how to scale-up quality care.

SUMMARY: Acceptable and effective responses to schizophrenia in LMICs should be cognisant of both cultural context and universal concerns. Efforts to enhance the quality of family support should be central to models of care.

Citation

Asher, L., Fekadu, A., & Hanlon, C. (2018). Global mental health and schizophrenia. Current Opinion in Psychiatry, 31(3), https://doi.org/10.1097/yco.0000000000000404

Journal Article Type Article
Acceptance Date Feb 12, 2018
Publication Date May 1, 2018
Deposit Date Apr 6, 2018
Publicly Available Date Mar 29, 2024
Journal Current Opinion in Psychiatry
Print ISSN 0951-7367
Electronic ISSN 1473-6578
Publisher Lippincott, Williams & Wilkins
Peer Reviewed Peer Reviewed
Volume 31
Issue 3
DOI https://doi.org/10.1097/yco.0000000000000404
Keywords Schizophrenia, low and middle-income countries, global mental health, mental health Gap Action Programme
Public URL https://nottingham-repository.worktribe.com/output/930530
Publisher URL https://journals.lww.com/co-psychiatry/Abstract/2018/05000/Global_mental_health_and_schizophrenia.6.aspx
Related Public URLs https://insights.ovid.com/crossref?an=00001504-900000000-99298