Evaluating the benefits of a youth mental health curriculum for students in Nicaragua: a parallel-group, controlled pilot investigation.

BACKGROUND: High rates of mental illness and addictions are well documented among youth in Nicaragua. Limited mental health services, poor mental health knowledge and stigma reduce help-seeking. The Mental Health Curriculum (MHC) is a Canadian school-based program that has shown a positive impact on such contributing factors. This pilot project evaluated the impact of the MHC on mental wellness and functioning among youth in Leon, Nicaragua. METHODS: High school and university students (aged 14-25 years) were assigned to intervention (12-week MHC; n  =  567) and control (wait-list; n  =  346) groups in a non-randomized design. Both groups completed measures of mental health knowledge, stigma and function at baseline and 12 weeks. Multivariate analyses and repeated measures analyses were used to compare group outcomes. RESULTS: At baseline, intervention students showed higher substance use (mean difference [MD]  =  0.24) and lower perceived stress (MD = -1.36) than controls (p  <  0.05); there were no other group differences in function. At 12 weeks, controlling for baseline differences, intervention students reported significantly higher mental health knowledge (MD  =  1.75), lower stigma (MD  =  1.78), more adaptive coping (MD  =  0.82), better lifestyle choices (MD  =  0.06) and lower perceived stress (MD = -1.63) (p  <  0.05) than controls. The clinical significance as measured by effect sizes was moderate for mental health knowledge, small to moderate for stigma and modest for the other variables. Substance use also decreased among intervention students to similar levels as controls (MD  =  0.03) (p > 0.05). CONCLUSIONS: This pilot investigation demonstrates the benefits of the MHC in a low-and-middle-income youth population. The findings replicate results found in Canadian student populations and support its cross-cultural applicability.

Mental health care reforms in Latin America: child and adolescent mental health services in Mexico.

This column provides an overview of child and adolescent mental health services in Mexico, where prevalence rates of mental disorders among young people are up to twice as high as U.S. and Canadian rates. The mental health care system in Mexico is underdeveloped and underfunded, and for the approximately 40% of the population with no insurance, access to and quality of care are particularly poor. This column offers policy recommendations aimed at better meeting the needs of this vulnerable population.

Application of a needs-driven, competencies-based mental health training program to a post-disaster situation: the Grenada experience.

This report outlines an innovative approach to address post-natural disaster mental health needs in a region in which natural disasters are common---the Caribbean. Instead of traditional external vertical psychosocial interventions commonly used in this region, the authors developed and implemented a mental health interventions training program, in the island country of Grenada, which is focused on enhancing the capacity of local community-based health service providers to provide immediate and continued mental healthcare following a natural disaster. Soon after this training, a hurricane stuck the island of Grenada. A review of the self-confidence in the application of this training and the mental health intervention activities of these community health providers demonstrated that they felt able to effectively identify, intervene, and address post-disaster mental health needs within their communities and that their care of individuals affected continued beyond the immediate post-disaster period, suggesting that enhancing the capacity of local community-based health providers to deal with post-natural disaster mental health needs may be a useful model that may be applicable in other jurisdictions.

An integrated program to train local health care providers to meet post-disaster mental health needs.

This paper describes a post-disaster mental health training program developed by the International Section of the Department of Psychiatry at Dalhousie University (Halifax, Canada) and delivered in Grenada after Hurricane Ivan struck the country in September 2004. This train-the-trainer program used an integrated community health model to help local health care providers develop the necessary skills for the identification and evidenced-based treatment of mental disorders occurring after a natural disaster. The approach also provided for ongoing, sustainable mental health care delivered in the community setting, as advocated by the World Health Organization and the Pan American Health Organization. This approach is in contrast to the largely ineffective and costly vertical whole-population psychosocial counseling activities that have often been used in the Caribbean following natural disasters.

An integrated program to train local health care providers to meet post-disaster mental health needs

This paper describes a post-disaster mental health training program developed by the International Section of the Department of Psychiatry at Dalhousie University (Halifax, Canada) and delivered in Grenada after Hurricane Ivan struck the country in Septemeber 2004. This train-the-trainer program used an integrated community health model to help local health care providers develop the necessary skills for the identification and evidenced-based treatment of mental disorders occuring after a natural disaster. The approach also provided for ongoing sustainable mental health care delivered in the community setting, as advocated by the World Health Organization and the Pan American Health Organization. This approach is in contrast to the largely ineffective and costly vertical whole-population psychosocial counselling activities that have often been used in the Caribbean following natural disasters(AU)

An integrated program to train local health care providers to meet post-disaster mental health needs / Programa integrado para entrenar a proveedores de servicios sanitarios locales a satisfacer las necesidades de salud mental después de un desastre

En el presente trabajo se describe un programa de entrenamiento para la atención de la salud mental después de desastres, desarrollado por la Sección Internacional del Departamento de Psiquiatría de la Universidad de Dalhousie (Halifax, Canadá) y llevado a cabo en la isla de Granada después de que el huracán Iván azotó ese país en septiembre de 2004. Este programa de entrenamiento para entrenadores utilizó un modelo integrado de salud comunitaria para ayudar a los proveedores de los servicios sanitarios locales a desarrollar las habilidades necesarias para identificar los trastornos mentales frecuentes después de un desastre natural y aplicar tratamientos basados en pruebas científicas. Este programa también favorece el enfoque actual de atención sostenible de salud mental en la comunidad, promovido por la Organización Mundial de la Salud y la Organización Panamericana de la Salud. Además, se contrapone a las actividades verticales de consejería psicosocial dirigidas a toda la población, en su mayoría ineficaces y costosas, que se han venido empleando en el Caribe después de desastres naturales.

This paper describes a post-disaster mental health training program developed by the International Section of the Department of Psychiatry at Dalhousie University (Halifax, Canada) and delivered in Grenada after Hurricane Ivan struck the country in September 2004. This trainthe-trainer program used an integrated community health model to help local health care providers develop the necessary skills for the identification and evidenced-based treatment of mental disorders occurring after a natural disaster. The approach also provided for ongoing, sustainable mental health care delivered in the community setting, as advocated by the World Health Organization and the Pan American Health Organization. This approach is in contrast to the largely ineffective and costly vertical whole-population psychosocial counseling activities that have often been used in the Caribbean following natural disasters