URC Senior Quality Improvement Advisor Addresses Women's Mental Health in Europe and Eurasia at Global Mental Health Forum

URC Senior Quality Improvement Advisor Dr. Diana Chamrad addressed women's mental health during the inaugural Global Mental Health Forum in London, England, last month. She presented findings from a report documenting the depression and alcohol abuse results from a larger study on noncommunicable diseases (NCDs) in Albania, Armenia, Georgia, and Russia.

Dr. Chamrad co-authored the report, "Integration of Depression and Alcohol Abuse Screening and Care Practices in Primary Care Settings for Women in Albania, Armenia, Georgia, and  Russia," with Dr. Tamar Chitashvili, Chief of Party for Georgia; Dr. Kathleen Hill, Deputy Director of and Maternal and Newborn Health Technical Lead on the USAID Applying Sciences to Strengthen and Improve Systems Project; and Ekaterine Cherkezishvili, URC Knowledge Management Expert. Dr. Chamrad was joined by Kelly Clark of the University College London, who discussed psychological distress among mothers in rural Dhanusha, Nepal, and Linda Murray of the University of Tasmania, who addressed postnatal depression in central Vietnam.

Key Findings

The study collected data from over 45 primary care clinics, reviewing over 650 charts of women of reproductive age (15–49 years), about 400 exit interview questionnaires administered to female patients of that age, and about 270 questionnaires administered to providers.

Key findings include:

  • Half to 80% of patients agreed with the statement that "depression is a common problem for women."
  • Roughly a third reported current or past depression symptoms, ranging from 28% in Albania to 45% in Georgia.
  • Only 13% reported prior treatment for depression, ranging from 8% in Russia to 22% in Armenia.
  • Only 11% of providers reported asking about depression symptoms.
  • In the presence of symptoms suggesting depression, only 34% of providers on average reported asking about it.
  • With little variation among countries, less than 3% of charts documented any mental health intervention, including treatment with an anti-depressant or referral to a mental health counselor, psy­chologist, or psychiatrist.

These results reveal weak delivery of general mental health and depression-specific detection and treatment best practices despite relatively high rates of patient-reported depression in all four countries. The results also highlight service delivery gaps and opportunities for integrating mental health services within primary care.

Recommendations for corrective actions include 1) improving provider capacity to recognize and diagnose individuals at high risk for or suffering from depression and 2) strengthening confidence and competence to diagnose depression and anxiety and to treat or refer for mental health care.

About the Forum

The forum, hosted by the Centre for Global Mental Health, brought together researchers, mental health workers, consumers, clinicians, policy-makers, funders, health service providers, caregivers, advocates, and students to share evidence and experiences to strengthen the case for greater investment in mental health research and services around the world, especially in low- and middle-income countries. Forum topics included capacity-building, mental health integration, program development and implementation, scale-up, evaluation, consumer experiences of care, mental health policies and plans, and mental health financing. The forum follows on the success of previous global mental health events and the 2007 and 2011 Lancet series on the topic.

October 07, 2013
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