Alan J Flisher CPMH Seminar: Depression and HIV/AIDS: adapting…

The CPMH’s seminar programme is an opportunity to share on-going work and invite broader participation in the Centre.

On 7 September 2021 the Alan J Flisher Centre for Public Mental Health hosted a seminar by Biksegn Asrat. He is a lecturer at the Department of Psychiatry at the University of Gondar in Ethiopia. He has worked in the academia for more than six years, and has been offering psychiatry courses for undergraduate and postgraduate students. Biksegn has also been serving as a clinician at the psychiatry clinic at the University of Gondar, and participated in community outreach programs to reach out to people with mental health needs in rural communities. Biksegn attended his PhD studies in Public Mental Health at the Alan J Flisher Centre for Public Mental Health at the University of Cape Town since 2018 and graduated in July 2021.

Abstract

Being diagnosed with HIV/AIDS and commencement of lifelong antiretroviral therapy with the requirement of high adherence exacerbates or triggers depressive symptoms. Prevalence of major depression is substantially higher in people with HIV/AIDS (PWHA) than the general population. However, access for mental health interventions remains very limited in Low and Middle-Income Countries. Although low intensity and effective psychological treatments are emerging, issues in relation to their acceptability, feasibility and effectiveness for the HIV population remain unexplored. The aim of this research was to adapt and pilot group interpersonal therapy (IPT) for treatment of depressive symptoms and to evaluate its acceptability and feasibility for PWHA. This research provides information on the process used in examining acceptability and feasibility of psychological interventions to conducting future trials. Mixed study designs that involved evidence synthesis, and single-arm interventional study nested with quantitative and qualitative evaluation were used for this research. Findings of this research indicated that all the IPT problem areas (life change, disagreement, grief and loneliness) were applicable to and important areas for intervention to address depressive symptoms for PWHA in Ethiopia. Most importantly, disagreement within a family and life change due to HIV/AIDS, such as sickness and separation were faced by almost all PWHA, followed by loneliness or social isolation as result of HIV stigma, and grief due to loss of loved ones including a spouse, a child, a mother or a father. Overall evaluation of the intervention suggested that the procedures and outcomes of group based IPT were perceived as acceptable and feasible. Future studies should focus on examining its cost-feasibility and effectiveness for PWHA in low-income settings.

Please view the presentation below.

PhD protocol presentations by Sue Struengmann Initiative fellows Mirriam…

The Sue Struengmann Initiative (SSI) funded by the Sue Struengmann family was formally established in July 2020. This initiative seeks to ensure the provision of high-quality interventions for the prevention and treatment of mental health problems among this vulnerable group. The scholarships funded by the SSI have been established to provide support for two PhD students to join the team in the Alan J. Flisher Centre for Public Mental Health

Addressing the mental health needs of young adolescents in the Western Cape Province of South Africa by Mirriam Mkhize (20 July 2021)

Abstract

Common mental disorders (namely, anxiety and depression) are prevalent among adolescents throughout the world. Globally, between 10 and 20% of children and adolescents are estimated to be experiencing mental disorders. Particularly in Low and Middle Income Countries (LMICs), data on mental disorders among adolescents is sparce. Given the mental health treatment gap in LMICs, most mental disorders among young adolescents remain underdiagnosed and underreported. The overall aim of this study is to address the mental health needs of young adolescents (specifically aged 10-14years old) in South Africa.  In order to achieve this aim, this study includes the following objectives: (1) To determine the prevalence, risk and protective factors associated with common mental disorders among young adolescents aged 10 to 14 years in school settings in the Western Cape Province; (2) To validate and determine the psychometric properties of mental health screening tools among young adolescents aged 10 to 14 years including the Generalized Anxiety Disorder Screen 7 (GAD-7), Center Epidemiological Studies Depression Scale for children (CES-DC), and the Patient Health Questionnaire Adolescent (PHQ-A); (3) To co-adapt the Early Adolescent Skills for Emotions (EASE) intervention for use among South African adolescents aged 10 to 14 years living in the Western Cape Province, who are experiencing symptoms of anxiety or depression; and (4) To determine the acceptability and feasibility of the adapted EASE program for young adolescents aged 10 to 14 years living in community settings, who have symptoms of anxiety or depression

Please view the presentation below.

An exploration of common mental disorders and emotion regulation among South African adolescents by Chesney Ward-Smith (20 July 2021)

Abstract

Adolescence is a unique, formative, and challenging phase of life, characterised by intersecting physical, emotional, cognitive, interpersonal as well as external contextual changes. Within this milieu of change and challenge, adolescents, especially those living in Africa, bear the burden of common mental disorders (CMDs), specifically depression and anxiety. Furthermore, the majority of the world’s adolescents live in contexts where psychological aid is not always available or accessible. South African adolescent mental health research, although limited, shows that older adolescents (15-18 year olds) also bear the burden of CMDs and that few indicated psychosocial interventions for CMDs are available for this vulnerable population. Transdiagnostic approaches that centralise strengthening adaptive Emotion Regulation (ER) skills may hold promise for addressing CMDs among older adolescents. Using a three-phase mixed-methods design, this study aims to (1) determine local prevalence estimates and determinants of CMDs, as well as examine the psychometric properties of an ER measure for use among older South African adolescents, (2) using a Human-Centered Design approach, co-create an innovative, evidence-based ER intervention for use among older adolescents at risk of CMDs and, (3) determine the acceptability and feasibility of the co-created ER intervention for use among older adolescents at risk of CMDs.

Please view the presentation below.