Margaret Mary Barry

A systematic review of the effectiveness of mental health promotion interventions for young people in low and middle income countries

BackgroundThis systematic review provides a narrative synthesis of the evidence on the effectiveness of mental health promotion interventions for young people in low and middle-income countries (LMICs). Commissioned by the WHO, a review of the evidence for mental health promotion interventions across the lifespan from early years to adulthood was conducted. This paper reports on the findings for interventions promoting the positive mental health of young people (aged 6–18 years) in school and community-based settings.MethodsSearching a range of electronic databases, 22 studies employing RCTs (N = 11) and quasi-experimental designs conducted in LMICs since 2000 were identified. Fourteen studies of school-based interventions implemented in eight LMICs were reviewed; seven of which included interventions for children living in areas of armed conflict and six interventions of multicomponent lifeskills and resilience training. Eight studies evaluating out-of-school community interventions for adolescents were identified in five countries. Using the Effective Public Health Practice Project (EPHPP) criteria, two reviewers independently assessed the quality of the evidence.ResultsThe findings from the majority of the school-based interventions are strong. Structured universal interventions for children living in conflict areas indicate generally significant positive effects on students’ emotional and behavioural wellbeing, including improved self-esteem and coping skills. However, mixed results were also reported, including differential effects for gender and age groups, and two studies reported nonsignficant findings. The majority of the school-based lifeskills and resilience programmes received a moderate quality rating, with findings indicating positive effects on students’ self-esteem, motivation and self-efficacy. The quality of evidence from the community-based interventions for adolescents was moderate to strong with promising findings concerning the potential of multicomponent interventions to impact on youth mental health and social wellbeing.ConclusionsThe review findings indicate that interventions promoting the mental health of young people can be implemented effectively in LMIC school and community settings with moderate to strong evidence of their impact on both positive and negative mental health outcomes. There is a paucity of evidence relating to interventions for younger children in LMIC primary schools. Evidence for the scaling up and sustainability of mental health promotion interventions in LMICs needs to be strengthened.

Mental health promotion works: a review

Positive mental health is a value in its own right; it contributes to the individual’s well-being and quality of life; and also contributes to society and the economy by increasing social functioning and social capital. Positive mental health refers to human qualities and life skills such as cognitive functioning, positive self-esteem, social and problem solving skills, the ability to manage major changes and stresses in life and to influence the social environment, the ability to work productively and fruitfully and to make contributions to the community, and a

The Galway Consensus Conference: international collaboration on the development of core competencies for health promotion and health education

Developing a competent health promotion workforce is a key component of capacity building for the future and is critical to delivering on the vision, values and commitments of global health promotion. This paper reports on an international consensus meeting to identify core competencies, jointly organized by the International Union for Health Promotion and Education (IUHPE), the Society for Public Health Education (SOPHE) and the US Centers for Disease Control (CDC), with participation from international leaders in the field, that took place at the National University of Ireland, Galway, in June 2008. The purpose of the meeting is outlined and the outcomes in terms of strengthening global exchange, collaboration and common approaches to capacity building and workforce development are discussed. The Consensus Statement, based on the proceedings of the meeting, outlines core values and principles, a common definition and eight domains of core competency that are required to engage in effective health promotion practice. The core domains of competency agreed to at the meeting are: catalysing change, leadership, assessment, planning, impementation, evaluation, advocacy and partnerships. A summary of the Consensus Statement is presented and further dialogue and discussion are invited in order to continue the process of building international consensus with regard to health promotion core competencies. (Global Health Promotion, 2009; 16 (2): pp. 5—11)

Quality of life as an outcome measure in evaluating mental health services: a review of the empirical evidence

This paper addresses the question of how well quality of life measures function as valid and sensitive outcome indicators of mental health services. Findings from the major empirical studies of quality of life in the mental health area over the last 15 years are reviewed. The extent to which existing studies provide evidence of the ability of quality of life measures to discriminate the impact of service interventions on the well-being of psychiatric clients is examined. Findings from crosssectional, comparative, repeated-measures and randomised studies are presented. The available empirical evidence is critically examined and the methodological and theoretical implications of current findings for future work are considered.

A mediational model of quality of life for individuals with severe mental health problems

BACKGROUND Despite the increasing importance of quality of life in the mental health field, the theoretical conceptualization of the construct remains poorly developed. A proposed mediational model of quality of life, which links subjective quality of life with self-related constructs, is examined with a group of long-term psychiatric hostel residents. The present study aims to develop a measure of quality of life based on the proposed model, to explore the data and their implications for service development and finally to conduct a preliminary analysis of the models predictions. METHODS A cross-sectional research design was employed. Quality of life interviews, using a modified version of Lehmans Quality of Life Interview, were carried out with 54 psychiatric residents in Greece. The models predictions were examined by using a series of regression analyses. RESULTS The results indicate that perceived improvements in lifestyle, greater autonomy and positive self-concept are significantly and directly associated with better quality of life. In contrast, a direct relationship between objective indicators and subjective quality of life was not found. CONCLUSIONS The traditional two-part quality of life model that includes objective indicators of life circumstances and subjective indicators is extended to included the constructs of self-concept and perceived autonomy. The present extended mediational model of quality of life for individuals with long-term mental health problems appears to have important implications for the planning and delivery of mental health programmes.

People-centred health promotion

Introduction: people-centred health promotion - what is it? PCHP - the key essentials placing PCHP in the theoretical and political spectrum. Basic concepts, issues and approach: the overall aim of PCHP - health and wellbeing in a quality of life context empowerment community development cultural dimensions spiritual dimensions. The practice of PCHP - applying PCHP principles: general considerations and introduction to the people system the people system - a general guide the people system - outcome evaluation case studies 1 - community push and the Birkdale-Beachhaven Community Project case studies 2 - superhealth case studies 3 - the North Shore Community Health Network and the other way project towards a PCHP society.

Domains of Core Competency, Standards, and Quality Assurance for Building Global Capacity in Health Promotion: The Galway Consensus Conference Statement

This paper reports the outcome of the Galway Consensus Conference, an effort undertaken as a first step toward international collaboration on credentialing in health promotion and health education. Twenty-nine leading authorities in health promotion, health education, and public health convened a 2-day meeting in Galway, Ireland, during which the available evidence on credentialing in health promotion was reviewed and discussed. Conference participants reached agreement on core values and principles, a common definition, and eight domains of core competency required to engage in effective health promotion practice. The domains of competency are catalyzing change, leadership, assessment, planning, implementation, evaluation, advocacy, and partnerships. The long-term aim of this work is to stimulate a global dialogue that will lead to the development and widespread adoption of standards and quality assurance systems in all countries to strengthen capacity in health promotion, a critical element in achieving goals for the improvement of global population health.

Addressing the determinants of positive mental health: concepts, evidence and practice

Positive mental health is recognised as a key resource for population well-being and the social and economic prosperity of society. This paper provides an overview of current concepts of positive mental health and its contribution to the health and well-being of society. Frameworks for promoting mental health are presented, together with an overview of key concepts and principles underpinning this multi-disciplinary area of practice. Drawing on empirical studies, the article reviews the determinants of positive mental health across the lifespan. Enhancing factors for promoting mental health at the structural, community and individual levels are identified. The growing evidence base on the effectiveness of mental health promotion interventions is discussed, and the implications of addressing the psychosocial determinants of mental health for policy and practice are considered.

A review of the international literature on health promotion competencies: identifying frameworks and core competencies

Building a competent health promotion workforce with the necessary knowledge and skills to develop, implement and evaluate health promotion policies and practice is fundamental to mainstreaming and sustaining health promotion action. This paper reviews the international literature on competencies in health promotion, examines the competencies developed to date, identifies the methods used in their development and considers what can be learned from the experience of others when establishing international core competencies. The paper considers the advantages and disadvantages of employing a competency approach and the extent to which the competencies identified to date can enhance the quality of practice and update the skill set required to work within changing social, cultural and political contexts.

Living longer and feeling better: healthy lifestyle, self-rated health, obesity and depression in Ireland.

BACKGROUND The combination of four protective lifestyle behaviours (being physically active, a non-smoker, a moderate alcohol consumer and having adequate fruit and vegetable intake) has been estimated to increase life expectancy by 14 years. However, the effect of adopting these lifestyle behaviours on general health, obesity and mental health is less defined. We examined the combined effect of these behaviours on self-rated health, overweight/obesity and depression. METHODS Using data from the Survey of Lifestyle Attitudes and Nutrition (SLAN) 2007 (), a protective lifestyle behaviour (PLB) score was constructed for 10,364 men and women (>18 years), and representative of the Republic of Ireland adult population (response rate 62%). Respondents scored a maximum of four points, one point each for being physically active, consuming five or more fruit and vegetable servings daily, a non-smoker and a moderate drinker. RESULTS One-fifth of respondents (20%) adopted four PLBs, 35% adopted three, 29% two, 13% one and 2% adopted none. Compared to those with zero PLBs, those with four were seven times more likely to rate their general health as excellent/very good [OR 6.8 95% CI (3.64-12.82)] and four times more likely to have better mental health [OR 4.4 95% CI (2.34-8.22)]. CONCLUSIONS Adoption of core protective lifestyle factors known to increase life expectancy is associated with positive self-rated health, healthier weight and better mental health. These lifestyles have the potential to add quality and quantity to life.