RESUMO
Addressing mental health is an important part of the COVID-19 response among historically underserved communities, which have been disproportionately affected. Community Health Workers (CHWs) are well placed to offer insights about barriers to mental health service use in their communities, and they are well positioned to address mental health gaps by providing education, resources, and assistance to bridging the gap for the use of more traditional mental health services. Using the perspectives of CHWs, this project identified barriers faced by CHWs in assisting community members with their mental health needs, along with relevant training needs to more effectively deliver mental health resources, referrals, and recommendations to community members. Survey data along with data from focus groups were collected among 43 CHWs in communities that have been historically underserved near the U.S.-Mexico border region. Quantitative data were analyzed using descriptive statistics whereas qualitative data were analyzed through systematic methods. Identified barriers to assisting community members with their mental health needs exist at the personal, community, environmental and organizational levels, and ranged from fear and mistrust to limited services, resources, funding and training opportunities. To help address the aforementioned barriers and facilitate access to mental health service use in their communities, CHWs identified and described opportunities for training in core areas including communication, mental illness symptom identification, trauma, self-care and stress reduction, and cultural awareness and sensitivity. Needs-based training programs that incorporate the insights of CHWs are a crucial part of promoting community-based mental health to address existing mental health disparities in access to and use of mental health services.
Assuntos
COVID-19 , Agentes Comunitários de Saúde , COVID-19/epidemiologia , Agentes Comunitários de Saúde/psicologia , Hispânico ou Latino , Humanos , Saúde Mental , Pandemias , Pesquisa QualitativaRESUMO
Effective ocean management and the conservation of highly migratory species depend on resolving the overlap between animal movements and distributions, and fishing effort. However, this information is lacking at a global scale. Here we show, using a big-data approach that combines satellite-tracked movements of pelagic sharks and global fishing fleets, that 24% of the mean monthly space used by sharks falls under the footprint of pelagic longline fisheries. Space-use hotspots of commercially valuable sharks and of internationally protected species had the highest overlap with longlines (up to 76% and 64%, respectively), and were also associated with significant increases in fishing effort. We conclude that pelagic sharks have limited spatial refuge from current levels of fishing effort in marine areas beyond national jurisdictions (the high seas). Our results demonstrate an urgent need for conservation and management measures at high-seas hotspots of shark space use, and highlight the potential of simultaneous satellite surveillance of megafauna and fishers as a tool for near-real-time, dynamic management.