Integrating mental health and psychosocial support (MHPSS) into infectious disease outbreak response: Results of an expert consensus study.

Objectives: Outbreaks are associated with increased risk of anxiety disorders, depression, and severe mental conditions. Integrating mental health and psychosocial support (MHPSS) into outbreak response facilitates the delivery of holistic care to the affected community. As there is an increasing incidence of outbreaks globally, integrating MHPSS into preparedness and response plans is paramount to strengthen the capacity of existing health systems and respond to mental health and psychosocial needs. However, the attention given to MHPSS during outbreak response is critically low. The objectives of this study were to identify areas of MHPSS integration and explore the challenges that hinder the delivery of an integrated care during outbreak response. Methods: A participatory qualitative study was conducted to explore how MHPSS can be incorporated into outbreak preparedness and response plans as a cross-cutting intervention in the context of low- and middle-income countries. We brought together civil society representatives, key stakeholders, and public health experts to explore areas of MHPSS integration during outbreak response. Results: Systematic integration of MHPSS into outbreak response was perceived to be feasible. Study participants strongly agreed that MHPSS can be integrated into most of the outbreak response pillars including partner coordination, case management, infection prevention and control, staff health and well-being, and risk communication and community engagement. However, the effort requires multi-sectoral collaboration, political commitment, and adequate recognition in planning and financing. Conclusions: Despite complex challenges, integrating MHPSS into outbreak pillars is possible. Moreover, emphasis should be placed on cultural adaptation of MHPSS guidelines and strong leadership in coordinating MHPSS into outbreak planning and response.

The lived experience of mental disorders in adolescents: a bottom-up review co-designed, co-conducted and co-written by experts by experience and academics.

We provide here the first bottom-up review of the lived experience of mental disorders in adolescents co-designed, co-conducted and co-written by experts by experience and academics. We screened first-person accounts within and outside the medical field, and discussed them in collaborative workshops involving numerous experts by experience - representing different genders, ethnic and cultural backgrounds, and continents - and their family members and carers. Subsequently, the material was enriched by phenomenologically informed perspectives and shared with all collaborators. The inner subjective experience of adolescents is described for mood disorders, psychotic disorders, attention-deficit/hyperactivity disorder, autism spectrum disorders, anxiety disorders, eating disorders, externalizing disorders, and self-harm behaviors. The recollection of individuals' past histories also indexes the prodromal (often transdiagnostic) features predating the psychiatric diagnosis. The experience of adolescents with mental disorders in the wider society is described with respect to their family, their school and peers, and the social and cultural context. Furthermore, their lived experience of mental health care is described with respect to receiving a diagnosis of mental disorder, accessing mental health support, receiving psychopharmacological treatment, receiving psychotherapy, experiencing peer support and mental health activism, and achieving recovery. These findings can impact clinical practice, research, and the whole society. We hope that this co-designed, co-conducted and co-written journey can help us maintain our commitment to protecting adolescents' fragile mental health, and can help them develop into a healthy, fulfilling and contributing adult life.