The most recent global refugee figures are staggering, with over 82.4 million people forcibly displaced and 26.4 million registered refugees. The ongoing conflict in Syria is a major contributor. After a decade of violence and destabilization, over 13.4million Syrians have been displaced, including 6.7 million internally displaced persons and 6.7 million refugees registered in other countries. Beyond the immediate political and economic challenges, an essential component of any response to this humanitarian crisis must be health-related, including policies and (...) interventions specific to mental health. This policy and practice review addresses refugee mental health in the context of the Syrian crisis, providing an update and overview of the current situation while exploring new initiatives in mental health research and global health policy that can help strengthen and expand services. Relevant global health policy frameworks are first briefly introduced, followed by a short summary of recent research on refugee mental health. We then provide an update on the current status of research, service provision, and health policy in the leading destinations for Syrians who have been forcibly displaced. This starts within Syria and then turns to Turkey, Lebanon, Jordan, and Germany. Finally, several general recommendations are discussed, including the pressing need for more data at each phase of migration, the expansion of integrated mental health services, and the explicit inclusion and prioritization of refugee mental health in national and global health policy. (shrink)

The COVID-19 outbreak has simultaneously increased the need for mental health services and decreased their availability. Brief online self-help interventions that can be completed in a single session could be especially helpful in improving access to care during the crisis. However, little is known about the uptake, acceptability, and perceived utility of these interventions outside of clinical trials in which participants are compensated. Here, we describe the development, deployment, acceptability ratings, and pre–post effects of a single-session (...) intervention, the Common Elements Toolbox, adapted for the COVID-19 crisis to support graduate and professional students. Participants, who were not compensated, were randomly assigned to two of three modules: behavioral activation, cognitive restructuring, and gratitude. Over 1 week, 263 individuals began and 189 individuals completed the intervention. Participants reported that the intervention modules were acceptable, helpful, engaging, applicable to their lives, and could help them manage COVID-related challenges. Participants reported pre- to post-program improvements in secondary control and in the perceived negative impact of the COVID-19 crisis on their quality of life. On average, differences in their perceived ability to handle lifestyle changes resulting from the pandemic were positive, but small and at the level of a non-significant trend. Our results highlight the acceptability and utility of an online intervention for supporting individuals through the COVID-19 crisis. (shrink)

Psychiatry is increasingly dominated by the reductionist claim that mental illness is caused by neurobiological abnormalities such as chemical imbalances in the brain. Critical psychiatry does not believe that this is the whole story and proposes a more ethical foundation for practice. This book describes an original framework for renewing mental health services in alliance with people with mental health problems. It is an advance over the polarization created by the "anti-psychiatry" of the past.

Social bonds may assist in cultivating a more positive attitude to life through commonly shared meanings about the COVID-19 pandemic. The key challenge, however, is how to foster social bonds meeting the changing demands in a post pandemic world. Yet, it is in the middle of a crisis that the conversation needs to start about how to strategically plan for the recovery. This is important not only in the current pandemic, but also in a post pandemic world. Reinforcing or (...) fostering new social bonds is likely to bring positive experiences. The latter is central to human health and wellbeing, and has potential to contribute greatly in enhancing people’s quality of life. In an attempt to foster place social bonding in the COVID-19 pandemic and beyond to subsequently contribute to wellbeing, this paper develops and proposes a new conceptual framework suggesting the need for adaptive social bonding interventions in the SARS-CoV-2 pandemic. This is an essential measure to manage the significant impacts on our global health services due to a decline in people’s mental health in addition to COVID-19 physical impacts. The paper discusses how promoting adaptive social bonding interventions can make people more resilient. It further discusses how they can be empowered psychologically, socially, and emotionally in the current challenging times. The conceptual framework posits that social bonding interventions can assist in maintaining better mental, physical, emotional, and spiritual wellbeing and discusses how these wellbeing outcomes may also be experienced post the pandemic. This has important benefits and is of relevance to governments, policy makers and healthcare professionals in delivering better health care and equipping people with coping mechanisms both throughout the pandemic and in the long run. (shrink)

Traditional mental health services are often not enough to meet the needs of people at risk for suicide, especially in populations where help-seeking is stigmatized. Stack Up, a non-profit veteran organization whose goal is to use video games to bring veterans together, recognized a need in its gaming-focused online community and created the Overwatch Program. This suicide prevention and crisis intervention program is delivered entirely through the Internet by trained community members through Discord text and (...) voice chat. By combining aspects of virtual gaming communities, veteran mental health, and community-based peer support, this program provides an innovative format for implementing crisis intervention and mental health support programs. We describe here the context and features of the program, an ongoing evaluation project, and lessons learned. (shrink)

Battle lines have been drawn over involuntary treatment. On one side, there are those who oppose involuntary psychiatric treatments under any condition. Activists who take up this cause often don't acknowledge that psychiatric symptoms can render people dangerous to themselves or others. They also don't allow for the idea that the civil rights of an individual may be at odds with the heartbreak of a caring family. On the other side are groups pushing for increased use of involuntary treatment. These (...) proponents are quick to point out that people with psychiatric illnesses often don't recognize that they are ill, which (from their perspective) makes the discussion of civil rights moot. They may gloss over the sometimes dangerous side effects of psychiatric medications, and they often don't admit that patients, even after their symptoms have abated, are sometimes unhappy that treatment was inflicted upon them. In Committed, psychiatrists Dinah Miller and Annette Hanson offer a thought-provoking and engaging account of the controversy surrounding involuntary psychiatric care in the United States. They bring the issue to life with first-hand accounts from patients, clinicians, advocates, and opponents. Looking at practices such as seclusion and restraint, involuntary medication, and involuntary electroconvulsive therapy--all within the context of civil rights-- Miller and Hanson illuminate the personal consequences of this controversial practice through voices of people who have been helped by the treatment they had as well as those who have been traumatized by it. The authors explore the question of whether involuntary treatment has a role in preventing violence, suicide, and mass murder. They delve into the controversial use of court-ordered outpatient treatment at its best and at its worst. Finally, they examine innovative solutions--mental health court, crisis intervention training, and pretrial diversion--that are intended to expand access to care while diverting people who have serious mental illness out of the cycle of repeated hospitalization and incarceration. They also assess what psychiatry knows about the prediction of violence and the limitations of laws designed to protect the public. (shrink)

This study reviews the existing literature on psychiatric interventions for individuals affected by the COVID-19 epidemic. My article cumulates previous research on how extreme stressors associated with COVID-19 may aggravate or cause psychiatric problems. The unpredictability of the COVID-19 epidemic progression may result in significant psychological pressure on vulnerable populations. Persons with psychiatric illnesses may experience worsening symptoms or may develop an altered mental state related to an increased suicide risk. The inspected findings prove that psychological intervention measures (...) for patients affected by the epidemic should be designed and personalized adequately. Preventive measures seek to decrease infection rates and cut down the risk of the public healthcare system to eventually be overburdened. Throughout the COVID-19 crisis, people with psychiatric illnesses may confront a decrease in mental health services. As limitations in the current review, by focusing only on articles published in journals indexed in Web of Science, Scopus, and ProQuest, I inevitably disregarded other valuable sources. Subsequent research directions should clarify the effectiveness of online mental health services in providing remote psychiatric interventions to individuals affected by the COVID-19 epidemic. (shrink)