The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Bayard Roberts - One of the best experts on this subject based on the ideXlab platform.
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mental health care utilisation among internally Displaced Persons in ukraine results from a nation wide survey
Epidemiology and Psychiatric Sciences, 2017Co-Authors: Bayard Roberts, Nino Makhashvili, Jana Darejan Javakhishvili, A Karachevskyy, Natalia Kharchenko, Marina Shpiker, Erica RichardsonAbstract:Aims There are an estimated 1.5 million internally Displaced Persons (IDPs) in Ukraine because of the armed conflict in the east of the country. The aim of this paper is to examine utilisation patterns of mental health and psychosocial support (MHPSS) care among IDPs in Ukraine. A cross-sectional survey design was used. Data were collected from 2203 adult IDPs throughout Ukraine between March and May 2016. Data on mental health care utilisation were collected, along with outcomes including post-traumatic stress disorder (PTSD), depression and anxiety. Descriptive and multivariate regression analyses were used. PTSD prevalence was 32%, depression prevalence was 22%, and anxiety prevalence was 17%. Among those that likely required care (screened positive with one of the three disorders, and also self-reporting a problem) there was a large treatment gap, with 74% of respondents who likely required MHPSS care over the past 12 months not receiving it. For the 26% (N = 180) that had sought care, the most common sources of services/support were pharmacies, family or district doctor/paramedic (feldsher), neurologist at a polyclinic, internist/neurologist at a general hospital, psychologists visiting communities, and non-governmental organisations/volunteer mental health/psychosocial centres. Of the 180 respondents who did seek care, 163 could recall whether they had to pay for their care. Of these 163 respondents, 72 (44%) recalled paying for the care they received despite government care officially being free in Ukraine. The average costs they paid for care was US$107 over the previous 12 months. All 180 respondents reported having to pay for medicines and the average costs for medicines was US$109 over the previous 12 months. Among the 74% had not sought care despite likely needing it; the principal reasons for not seeking care were: thought that they would get better by using their own medications, could not afford to pay for health services or medications, no awareness of where to receive help, poor understanding by health care providers, poor quality of services, and stigma/embarrassment. The findings from multivariate regression analysis show the significant influence of a poor household economic situation on not accessing care. The study highlights a high burden of mental disorders and large MHPSS treatment gap among IDPs in Ukraine. The findings support the need for a scaled-up, comprehensive and trauma-informed response to provision of MHPSS care of IDPs in Ukraine alongside broader health system strengthening.
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mental disorders and their association with disability among internally Displaced Persons and returnees in georgia
Journal of Traumatic Stress, 2014Co-Authors: Nino Makhashvili, Ivdity Chikovani, Martin Mckee, Jonathan Ian Bisson, Vikram Patel, Bayard RobertsAbstract:There remains limited evidence on comorbidity of mental disorders among conflict-affected civilians, particularly internally Displaced Persons (IDPs) and former IDPs who have returned to their home areas (returnees). The study aim was to compare patterns of mental disorders and their influence on disability between IDPs and returnees in the Republic of Georgia. A cross-sectional household survey was conducted with adult IDPs from the conflicts in the 1990s, the 2008 conflict, and returnees. Posttraumatic stress disorder (PTSD), depression, anxiety, and disability were measured using cut scores on Trauma Screening Questionnaire, Patient Health Questionnaire 9, Generalised Anxiety Disorder 7, and the WHO Disability Assessment Schedule 2.0. Among the 3,025 respondents, the probable prevalence of PTSD, depression, anxiety, and comorbidity (>1 condition) was 23.3%, 14.0%, 10.4%, 12.4%, respectively. Pearson correlation coefficients (p < .001) were .40 (PTSD with depression), .38 (PTSD with anxiety), and .52 (depression with anxiety). Characteristics associated with mental disorders in regression analyses included displacement (particularly longer-term), cumulative trauma exposure, female gender, older age, poor community conditions, and bad household economic situation; coefficients ranged from 1.50 to 3.79. PTSD, depression, anxiety, and comorbidity were associated with increases in disability of 6.4%, 9.7%, 6.3%, and 15.9%, respectively. A high burden of psychiatric symptoms and disability persist among conflict-affected Persons in Georgia.
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alcohol disorder amongst forcibly Displaced Persons in northern uganda
Addictive Behaviors, 2011Co-Authors: Bayard Roberts, Kaducu Felix Ocaka, John Browne, Thomas Oyok, Egbert SondorpAbstract:Background Alcohol use may be a coping mechanism for the stressors related to forced displacement. The aim of this study was to investigate levels and determinants of alcohol disorder amongst internally Displaced Persons (IDPs) in northern Uganda.
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an exploration of social determinants of health amongst internally Displaced Persons in northern uganda
Conflict and Health, 2009Co-Authors: Bayard Roberts, Kaducu Felix Ocaka, John Browne, Vicky Norah Odong, Wenzel Geissler, Egbert SondorpAbstract:Social determinants of health describe the conditions in which people are born, grow, live, work and age and their influence on health. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels, which are themselves influenced by policy choices. Armed conflict and forced displacement are important influences on the social determinants of health. There is limited evidence on the social determinants of health of internally Displaced Persons (IDPs) who have been forced from their homes due to armed conflict but remain within the borders of their country. The aim of this study was to explore the social determinants of overall physical and mental health of IDPs, including the response strategies used by IDPs to support their health needs. Northern Uganda was chosen as a case-study, and 21 face-to-face semi-structured interviews with IDPs were conducted in fifteen IDP camps between November and December 2006.
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factors associated with the health status of internally Displaced Persons in northern uganda
Journal of Epidemiology and Community Health, 2009Co-Authors: Bayard Roberts, John Browne, Thomas Oyok, Felix K Ocaka, Egbert SondorpAbstract:Background: Globally, there are over 24 million internally Displaced Persons (IDPs) who have fled their homes due to violence and insecurity but who remain within their own country. There have been up to 2 million IDPs in northern Uganda alone. The objective of this study was to investigate factors associated with mental and physical health status of IDPs in northern Uganda. Methods: A cross-sectional survey was conducted in November 2006 in IDP camps in the Gulu and Amuru districts of northern Uganda. The study outcome of physical and mental health was measured using the SF-8 instrument, which produces physical (PCS) and mental (MCS) component summary measures. Independent demographic, socio-economic, and trauma exposure (using the Harvard Trauma Questionnaire) variables were also measured. Multivariate regression linear regression analysis was conducted to investigate associations of the independent variables on the PCS and MCS outcomes. Results: 1206 interviews were completed. The respective mean PCS and MCS scores were 42.2 (95% CI 41.32 to 43.10) and 39.3 (95% CI 38.42 to 40.13), well below the instrument norm of 50, indicating poor health. Variables with negative associations with physical or mental health included gender, age, marital status, income, distance of camp from home areas, food security, soap availability, and sense of safety in the camp. A number of individual trauma variables and the frequency of trauma exposure also had negative associations with physical and mental health. Conclusions: This study provides evidence on the impact on health of deprivation of basic goods and services, traumatic events, and fear and uncertainty amongst Displaced and crisis affected populations.
Egbert Sondorp - One of the best experts on this subject based on the ideXlab platform.
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alcohol disorder amongst forcibly Displaced Persons in northern uganda
Addictive Behaviors, 2011Co-Authors: Bayard Roberts, Kaducu Felix Ocaka, John Browne, Thomas Oyok, Egbert SondorpAbstract:Background Alcohol use may be a coping mechanism for the stressors related to forced displacement. The aim of this study was to investigate levels and determinants of alcohol disorder amongst internally Displaced Persons (IDPs) in northern Uganda.
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an exploration of social determinants of health amongst internally Displaced Persons in northern uganda
Conflict and Health, 2009Co-Authors: Bayard Roberts, Kaducu Felix Ocaka, John Browne, Vicky Norah Odong, Wenzel Geissler, Egbert SondorpAbstract:Social determinants of health describe the conditions in which people are born, grow, live, work and age and their influence on health. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels, which are themselves influenced by policy choices. Armed conflict and forced displacement are important influences on the social determinants of health. There is limited evidence on the social determinants of health of internally Displaced Persons (IDPs) who have been forced from their homes due to armed conflict but remain within the borders of their country. The aim of this study was to explore the social determinants of overall physical and mental health of IDPs, including the response strategies used by IDPs to support their health needs. Northern Uganda was chosen as a case-study, and 21 face-to-face semi-structured interviews with IDPs were conducted in fifteen IDP camps between November and December 2006.
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factors associated with the health status of internally Displaced Persons in northern uganda
Journal of Epidemiology and Community Health, 2009Co-Authors: Bayard Roberts, John Browne, Thomas Oyok, Felix K Ocaka, Egbert SondorpAbstract:Background: Globally, there are over 24 million internally Displaced Persons (IDPs) who have fled their homes due to violence and insecurity but who remain within their own country. There have been up to 2 million IDPs in northern Uganda alone. The objective of this study was to investigate factors associated with mental and physical health status of IDPs in northern Uganda. Methods: A cross-sectional survey was conducted in November 2006 in IDP camps in the Gulu and Amuru districts of northern Uganda. The study outcome of physical and mental health was measured using the SF-8 instrument, which produces physical (PCS) and mental (MCS) component summary measures. Independent demographic, socio-economic, and trauma exposure (using the Harvard Trauma Questionnaire) variables were also measured. Multivariate regression linear regression analysis was conducted to investigate associations of the independent variables on the PCS and MCS outcomes. Results: 1206 interviews were completed. The respective mean PCS and MCS scores were 42.2 (95% CI 41.32 to 43.10) and 39.3 (95% CI 38.42 to 40.13), well below the instrument norm of 50, indicating poor health. Variables with negative associations with physical or mental health included gender, age, marital status, income, distance of camp from home areas, food security, soap availability, and sense of safety in the camp. A number of individual trauma variables and the frequency of trauma exposure also had negative associations with physical and mental health. Conclusions: This study provides evidence on the impact on health of deprivation of basic goods and services, traumatic events, and fear and uncertainty amongst Displaced and crisis affected populations.
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factors associated with post traumatic stress disorder and depression amongst internally Displaced Persons in northern uganda
BMC Psychiatry, 2008Co-Authors: Bayard Roberts, Kaducu Felix Ocaka, John Browne, Thomas Oyok, Egbert SondorpAbstract:The 20 year war in northern Uganda between the Lord's Resistance Army and the Ugandan government has resulted in the displacement of up to 2 million people within Uganda. The purpose of the study was to measure rates of post-traumatic stress disorder (PTSD) and depression amongst these internally Displaced Persons (IDPs), and investigate associated demographic and trauma exposure risk factors. A cross-sectional multi-staged, random cluster survey with 1210 adult IDPs was conducted in November 2006 in Gulu and Amuru districts of northern Uganda. Levels of exposure to traumatic events and PTSD were measured using the Harvard Trauma Questionnaire (original version), and levels of depression were measured using the Hopkins Symptom Checklist-25. Multivariate logistic regression was used to analyse the association of demographic and trauma exposure variables on the outcomes of PTSD and depression. Over half (54%) of the respondents met symptom criteria for PTSD, and over two thirds (67%) of respondents met symptom criteria for depression. Over half (58%) of respondents had experienced 8 or more of the 16 trauma events covered in the questionnaire. Factors strongly linked with PTSD and depression included gender, marital status, distance of displacement, experiencing ill health without medical care, experiencing rape or sexual abuse, experiencing lack of food or water, and experiencing higher rates of trauma exposure. This study provides evidence of exposure to traumatic events and deprivation of essential goods and services suffered by IDPs, and the resultant effect this has upon their mental health. Protection and social and psychological assistance are urgently required to help IDPs in northern Uganda re-build their lives.
Peter John Winch - One of the best experts on this subject based on the ideXlab platform.
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finding a way out case histories of mental health care seeking and recovery among long term internally Displaced Persons in georgia
Transcultural Psychiatry, 2016Co-Authors: Namrita S Singh, Nino Jakhaia, Nino Amonashvili, Peter John WinchAbstract:Trajectories of illness and recovery are ongoing and incomplete processes cocreated by individuals, their informal support networks, formal care-givers and treatment contexts, and broader social systems. This analysis presents two case histories of care-seeking for, and recovery from, mental illness and psychosocial problems in the context of protracted internal displacement. These case histories present individuals with experiences of schizophrenia and depression drawn from a sample of adult long-term internally Displaced Persons (IDPs) in Georgia, a country in the South Caucasus. Dimensions of care-seeking were compiled into a matrix for analysis. Interviews were open coded, and codes were linked with matrix dimensions to construct each case history. Findings illustrated that individuals moved cyclically among self-care, household support, lay care, and formal services domains to understand and manage their problems. Living with mental illness and within displacement are experiences that intersect at va...
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finding a way out case histories of mental health care seeking and recovery among long term internally Displaced Persons in georgia
Transcultural Psychiatry, 2016Co-Authors: Namrita S Singh, Nino Jakhaia, Nino Amonashvili, Peter John WinchAbstract:Trajectories of illness and recovery are ongoing and incomplete processes cocreated by individuals, their informal support networks, formal care-givers and treatment contexts, and broader social systems. This analysis presents two case histories of care-seeking for, and recovery from, mental illness and psychosocial problems in the context of protracted internal displacement. These case histories present individuals with experiences of schizophrenia and depression drawn from a sample of adult long-term internally Displaced Persons (IDPs) in Georgia, a country in the South Caucasus. Dimensions of care-seeking were compiled into a matrix for analysis. Interviews were open coded, and codes were linked with matrix dimensions to construct each case history. Findings illustrated that individuals moved cyclically among self-care, household support, lay care, and formal services domains to understand and manage their problems. Living with mental illness and within displacement are experiences that intersect at various points, including in the recognition and perceived causes of illness, stressors such as discrimination and isolation, the affordability and availability of services, and the capacity of social networks to provide informal care. Interventions are needed to support informal care-givers and build lay referral networks, as well as to identify intervention points within care-seeking processes. Interventions that target the mental health needs of Displaced Persons have the potential to contribute to the development of an innovative community mental health care system in Georgia.
Namrita S Singh - One of the best experts on this subject based on the ideXlab platform.
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identifying mental health problems and idioms of distress among older adult internally Displaced Persons in georgia
Social Science & Medicine, 2018Co-Authors: Namrita S Singh, Judith Bass, Nana Sumbadze, George W Rebok, Paul Perrin, Nino Paichadze, Courtland W RobinsonAbstract:Abstract The global population of older adults (60 years and older) has been growing steadily; however, inadequate attention is given to the health needs of older Persons, particularly within contexts of conflict and migration. This paper reports findings from the qualitative phase of an investigation assessing the mental health status of older adult internally Displaced Persons (IDPs) in Georgia, a country in the South Caucasus. The study aimed to assess community-wide social and health problems among older adult IDPs, with a focus on mental health problems and healthy functioning, as well as terminology used to describe these problems. Free-list interviews with older adult IDPs (n = 75) and key informant interviews with community members and service providers (n = 45) were conducted in 2010–2011 in three regions of Georgia: Tbilisi, Shida Kartli, and Samegrelo. Findings demonstrated that older IDPs experienced symptoms of distress that could be clustered into depression-like and anxiety-like syndromes. Participants described other psychosocial problems among older IDPs, including feelings of abandonment, isolation, and passivity, as well as conflicts in the family. All problems were linked with displacement-related experiences, such as difficulties with integration, grief, and war trauma. The expression of displacement-related problems was identified as an idiom of distress for this population. Older IDPs coped with these problems through social support mechanisms, including socializing, helping each other, working, and participating in the community. Key modalities for redressing older IDPs' psychosocial problems, improving quality of life, and achieving healthy ‘aging-in-displacement’ include: promoting social connectedness and community engagement, drawing on IDPs' skills, identifying new social roles, and strengthening social support networks.
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finding a way out case histories of mental health care seeking and recovery among long term internally Displaced Persons in georgia
Transcultural Psychiatry, 2016Co-Authors: Namrita S Singh, Nino Jakhaia, Nino Amonashvili, Peter John WinchAbstract:Trajectories of illness and recovery are ongoing and incomplete processes cocreated by individuals, their informal support networks, formal care-givers and treatment contexts, and broader social systems. This analysis presents two case histories of care-seeking for, and recovery from, mental illness and psychosocial problems in the context of protracted internal displacement. These case histories present individuals with experiences of schizophrenia and depression drawn from a sample of adult long-term internally Displaced Persons (IDPs) in Georgia, a country in the South Caucasus. Dimensions of care-seeking were compiled into a matrix for analysis. Interviews were open coded, and codes were linked with matrix dimensions to construct each case history. Findings illustrated that individuals moved cyclically among self-care, household support, lay care, and formal services domains to understand and manage their problems. Living with mental illness and within displacement are experiences that intersect at va...
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finding a way out case histories of mental health care seeking and recovery among long term internally Displaced Persons in georgia
Transcultural Psychiatry, 2016Co-Authors: Namrita S Singh, Nino Jakhaia, Nino Amonashvili, Peter John WinchAbstract:Trajectories of illness and recovery are ongoing and incomplete processes cocreated by individuals, their informal support networks, formal care-givers and treatment contexts, and broader social systems. This analysis presents two case histories of care-seeking for, and recovery from, mental illness and psychosocial problems in the context of protracted internal displacement. These case histories present individuals with experiences of schizophrenia and depression drawn from a sample of adult long-term internally Displaced Persons (IDPs) in Georgia, a country in the South Caucasus. Dimensions of care-seeking were compiled into a matrix for analysis. Interviews were open coded, and codes were linked with matrix dimensions to construct each case history. Findings illustrated that individuals moved cyclically among self-care, household support, lay care, and formal services domains to understand and manage their problems. Living with mental illness and within displacement are experiences that intersect at various points, including in the recognition and perceived causes of illness, stressors such as discrimination and isolation, the affordability and availability of services, and the capacity of social networks to provide informal care. Interventions are needed to support informal care-givers and build lay referral networks, as well as to identify intervention points within care-seeking processes. Interventions that target the mental health needs of Displaced Persons have the potential to contribute to the development of an innovative community mental health care system in Georgia.
Edvard Hauff - One of the best experts on this subject based on the ideXlab platform.
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the mental health of internally Displaced Persons an epidemiological study of adults in two settlements in central sudan
International Journal of Social Psychiatry, 2013Co-Authors: Tarig Taha Mohamed Salah, Abdallah Abdelrahman, Lars Lien, Arne Henning Eide, Priscilla Martinez, Edvard HauffAbstract:Aims:There is a scarcity of data on mental health problems among Sudanese internally Displaced Persons (IDPs). This study aims to assess the prevalence of mental disorders of IDPs in Sudan, and to ...
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perceived needs self reported health and disability among Displaced Persons during an armed conflict in nepal
Social Psychiatry and Psychiatric Epidemiology, 2012Co-Authors: Suraj Bahadur Thapa, Edvard HauffAbstract:Background Most internally Displaced Persons (IDPs) live in low-income countries and have experienced war. Few studies have assessed their psychosocial needs and disability. We carried out a comprehensive assessment of perceived needs, self-reported health, and disability among IDPs in Nepal and examined factors associated with disability.
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psychological distress among Displaced Persons during an armed conflict in nepal
Social Psychiatry and Psychiatric Epidemiology, 2005Co-Authors: Suraj Bahadur Thapa, Edvard HauffAbstract:Most internally Displaced Persons (IDPs) live in low-income countries experiencing a war; their psychosocial health has not been well addressed. We carried out a comprehensive assessment of traumatic experiences, distress symptomatology, and factors independently associated with distress among IDPs in Nepal. A cross-sectional survey was conducted among 290 IDPs in Nepal during June–July 2003. We used the Hopkins Symptom Checklist-25 (HSCL-25) to assess depression and anxiety symptoms, and the Posttraumatic Stress Disorder (PTSD) Checklist—Civilian Version (PCL-C) to assess PTSD symptoms. All these instruments were validated against local corresponding syndromes and diagnoses of Composite International Diagnostic Interviews (CIDIs) as well. Almost everyone reported trauma and 53.4% had PTSD symptomatology. The rates of anxiety and depression symptomatology were 80.7 and 80.3%, respectively. Factors independently associated with anxiety symptomatology were illiteracy and feeling miserable on arrival at a new place. Female gender, age 41–50, and feeling miserable on arrival at a new place were associated with depression symptomatology. On the other hand, experiencing greater than three traumatic events and feeling miserable on arrival at a new place were associated with PTSD symptomatology, whereas evacuation after a weeklong preparation and lower caste appeared as protective factors. High rates of psychological distress and associated factors were identified among highly traumatized IDPs in Nepal, thereby underlining the need for collective assistance, not only for refugees, but also for IDPs. Risk and protective factors that we have identified can thus be utilized for any kind of psychosocial interventions among these IDPs.