Mental health information at your fingertips – WHO launches the MiNDbank

10 December 2013 | GENEVA - MiNDbank, a new WHO database goes online today, presenting a wealth of information about mental health, substance abuse, disability, human rights and the different policies, strategies, laws and service standards being implemented in different countries. It also contains key international documents and information.

Launched on Human Rights Day, the platform is part of WHO’s QualityRights initiative, aiming to end human rights violations against people with mental health conditions.

“People with mental disabilities still face discrimination, violence and abuse in all countries,” says Dr Michelle Funk, from WHO’s Department of Mental Health and Substance Abuse. “The easy-to-use platform was established as a tool to facilitate debate, dialogue, advocacy and research on mental health, to improve care and to promote human rights across the globe.”

The care available in mental health facilities may often not only be of poor quality but can also hinder recovery. It can still be common in some countries for people to be locked away in small, prison-like cells with no human contact or to be chained to their beds, unable to move. The MiNDbank will help decision makers to address these issues, support reform efforts and ultimately improve the lives of people with mental health conditions in line with the Comprehensive Mental Health Action Plan 2013-2020, adopted by the World Health Assembly in May 2013.

The database, established with support from a broad range of partners, allows visitors to tap into the health information of WHO Member States and other partners. Users can review policies, laws and strategies and search for best practices and success stories in the field of mental health.

“If a government, for example, wishes to develop a new mental health policy in line with international human rights standards it can - on the new platform - quickly get an overview about the policies of other countries and benefit from their experiences and an array of international guidance tools and resources,“ explains Nathalie Drew, WHO Technical Officer working on mental health and human rights. So far, already more than 160 countries are sharing key mental health information through the MiNDbank and updates will be provided on a regular basis.

The WHO QualityRights initiative was launched in 2012, as part of the drive to raise human rights and quality standards in mental health and social care. The goal is to end human rights violations against people with mental health conditions and promote high-quality mental health services in the community.

For more information please contact:

Fadela Chaib
Communications Officer/Spokesperson
WHO
Telephone: +41 22 791 3228
Mobile: +41 79 475 5556
E-mail: chaibf@who.int

View the original article here

‘Biggest Loser' trainer says fitness a mental and physical process

By Dorene Internicola

NEW YORK (Reuters) - As celebrity trainer Dolvett Quince challenges and prods obese, unfit contestants to slim down and shape up on the weight-loss TV show "The Biggest Loser" he also uses survivor skills acquired during his childhood to boost their self esteem.

The Los Angeles-based trainer said getting fit is a mental as well as a physical challenge. He can identify with the struggles of his outsized team because as an adopted child he was mentally and physically abused and has experienced his share of self doubt.

"I walked into an environment where education was low and discipline was high," said Quince, 40, who was born in Stamford, Connecticut. "I understand what it's like to feel defeated and because I faced my own demons I can empower others."

Quince said fitness for people who are 100 pounds (45kg) or more overweight, involves a lot more than pushups.

"Health is a four-point component: emotional, physical spiritual and mental," said Quince, whose best-selling book, "The 3-1-2-1 Diet: Eat and Cheat Your Way to Weight Loss - Up to 10 Pounds in 21 Days," was published last month.

The fitness coach, who began his career at the YMCA where his clients included the elderly, mothers, teenagers and children, tries to chip away at people's personal doubts and past disappointments.

"People become extremely vulnerable as their bodies fatigue and they're going through transformations. It's in that vulnerability that the concrete cracks and some light pushes in," he said in a phone interview.

Karate, yoga, hiking and basketball are included in his fitness regime. At the gym he suggests combining cardio training, usually running on a treadmill, with strength training to systematically target different muscle groups.

"Doing intervals keeps your body guessing," he explained.

Lauve Metcalfe, a wellness coach and past president of the International Association for Worksite Health Promotion, believes shows like "The Biggest Loser" can raise public awareness about the importance of fitness.

But she has concerns about the rapid weight loss, often 10 pounds a week or more, expected of contestants.

"A pound and a half per week is a healthier goal," said Metcalfe, who is based in Tucson, Arizona. "And the aspect of every week getting on that scale, and the shame if you haven't met (the goal), is a negative,"

Quince attributes his success in helping people get in shape to his refusal to take no for an answer.

"I think people don't necessarily truly love working out," he said. "I think it's more like, ‘Man, must we work out? Can't we just have a drink?"

His job, he added, is to instill belief as well as to motivate people to move.

(Editing by Andrew Hay)

View the original article here

Racism Takes a Toll on Kids' Mental Health, Research Shows

SUNDAY, Sept. 22 (HealthDay News) -- Being a victim of racism may trigger poor mental health, depression and anxiety in children and teens, according to a new review.

The report, published in the October issue of the journal Social Science & Medicine, looked at 461 cases of links between racism and the health and well-being of youngsters.

"The review showed there are strong and consistent relationships between racial discrimination and a range of detrimental health outcomes such as low self-esteem, reduced resilience, increased behavior problems and lower levels of well-being," lead researcher Naomi Priest, of the University of Melbourne in Australia, said in a university news release.

Most of the racism experienced by children and teens involved discrimination by other people, rather than institutional or systemic racism, according to the findings.

The review also revealed an increased risk of poorer birth outcomes among children whose mothers experienced racism during pregnancy.

Most of the studies included in the review were conducted in the United States with participants aged 12 to 18. Of the racial/ethnic groups included in the studies, the three most common were blacks, Hispanics and Asians.

"We know that children who experience poor health and well-being are less likely to engage in education, employment and other activities that support them to lead healthy and productive lives, and to participate meaningfully in the community," Priest said.

So, she noted, the findings identify an important issue that needs to be addressed in order to improve child and teen health.

More information

CivilRights.org explains the importance of talking to children about racism and diversity.

Copyright c 2013?HealthDay. All rights reserved.

View the original article here

Tamoxifen's Mental Side Effects Are Real, Study Shows

TUESDAY, Sept. 17 (HealthDay News) -- Some women who take tamoxifen to treat or prevent breast cancer report experiencing a mental fogginess while on the drug, and researchers have now confirmed that there's a biological basis for those symptoms.

The researchers were able to isolate the cells in the human brain and nervous system that are harmed by tamoxifen therapy. And, in a second phase of the study conducted with mice, they were also able to find a different drug that could protect healthy cells from tamoxifen toxicity while offering no protection to cancer cells.

"Patients aren't always taken seriously when they report these mental side effects, but now we can say this is an organic syndrome to which we have to pay attention," said Mark Noble, senior study author.

"And, now we know there are paths to protection. This is not a hopeless situation," added Noble, a professor of biomedical genetics, and director of the University of Rochester Stem Cell and Regenerative Medicine Institute, in Rochester, N.Y.

Tamoxifen works by blocking the action of estrogen in breast tissue, which keeps estrogen-sensitive breast cancers from growing, according to the U.S. National Cancer Institute. Compared to other forms of cancer treatments, it has relatively few serious side effects. However, in some women who take it, tamoxifen causes problems with thinking.

One expert was pleased to see new scientific support for what she's observed in her clinical practice.

"There is a subset of women who report this mental fog while on tamoxifen. Often, this improves over time. They initially experience this very noticeable side effect, but then it improves. We often tell women to try to stick it out because it may get better," said Dr. Jane Carleton, a breast cancer specialist at the North Shore-LIJ Cancer Institute in Lake Success, N.Y., who was not involved with the new study.

Carleton said she was happy to see that the current study was able to validate that there was a reason that some women experience the mental fog while taking tamoxifen. And, she said she was even happier to see that there might be a potential treatment for this side effect.

"Every time we can improve quality of life and still treat cancer, it's a win," she said, but noted that it would still be years before this drug might be available.

For the study, Noble and his research team first sought to identify whether brain and central nervous system cells were sensitive to tamoxifen. They found one type of cell that was particularly vulnerable to the drug. After just two days of exposure to tamoxifen at levels similar to those someone in treatment would receive, 75 percent of these cells died.

"Tamoxifen causes cell death and suppression of cell division in these cells," Noble said.

The next step was to try to find a medication that could protect these cells from tamoxifen while still allowing the drug to keep its cancer-fighting ability. The researchers reviewed data on drugs that were already approved for use in humans or that were in clinical trials.

Noble said by looking at these types of drugs, they could save time because they already know that such drugs work in the body and that they're not toxic. They found one drug, currently called AZD6244, that protected the brain cells of mice against tamoxifen in their own study.

Scientists note, however, that research with animals often fails to provide similar results in humans.

"AZD6244 is being studied for cancer therapy. It protects normal cells, but it doesn't protect cancer cells. It may even make cancer cells more sensitive to some types of therapies," Noble said.

Noble said this work needs to be replicated by other researchers, and added that "it's essential that we find ways of treating cancer without causing this type of damage."

Results of the study were published online Sept. 17 in the Journal of Neuroscience.

More information

Learn more about tamoxifen and other hormone therapies for cancer from the U.S. National Cancer Institute.

Copyright c 2013?HealthDay. All rights reserved.

View the original article here

Humanitarian emergencies, an opportunity for fresh start in providing sustainable, long-term mental health services

16 August 2013 | Geneva - Humanitarian agencies work hard to help people with their mental health and psychosocial needs in the aftermath of emergencies, but too often opportunities are missed to strengthen mental health systems for the long-term, according to a new World Health Organization (WHO) report, "Building back better: Sustainable mental health care after emergencies" released for World Humanitarian Day (August 19).

“In spite of their tragic nature, emergency situations are opportunities to improve the lives of large numbers of people through improving mental health services,” says Dr Bruce Aylward, WHO’s Assistant Director-General overseeing the Organization’s work in humanitarian emergencies. "We can do better for emergency-affected populations by working with the government on sustainable mental health care from the outset.”

The report provides guidance for strengthening mental health systems after emergencies and examples from Afghanistan, Burundi, Indonesia (Aceh Province), Iraq, Jordan, Kosovo, Somalia, Sri Lanka, Timor-Leste, and West Bank and Gaza Strip.

Contributors from each area report not only their major achievements, but also their most difficult challenges and how they were overcome. Key overlapping practices emerging from these experiences are summarized.

Findings from the report include:

• Indonesia (Aceh): Like many provinces in Indonesia, Aceh had only institution-based care before the tsunami of 2004. Today, most districts have primary mental health services supported by secondary care at district general hospitals.
• Iraq: Since 2004, significant progress has been made toward the creation of a comprehensive mental health system. More than 50% of general practitioners have received mental health training.
• Kosovo: Starting from a hospital-based model of care in 1999 after the conflict, a system of community-based mental health care is now available.
• Sri Lanka: Since the 2004 tsunami, a new national mental health policy has guided reform, which now extends to most parts of the country. Several new cadres of community-based mental health workers have been developed.
• Timor-Leste: Building from a complete absence of mental health services in 1999, the country today has a comprehensive community-based mental health system.

The possibilities presented by emergency situations are significant because major gaps remain worldwide in the realization of comprehensive, community-based mental health care.

“The current situation is alarming,” says Dr Shekhar Saxena, WHO Director for Mental Health. “Health systems have not yet adequately responded to the burden of mental disorders. We know that the vast majority of people with severe mental disorders receive no treatment whatsoever in low-income and middle-income countries.”

Transforming the mental health care systems in turn would improve the well-being, functioning, and resilience of individuals, societies, and countries recovering from emergencies, the report notes.

By releasing this report, WHO aims to help guide policymakers to reform their mental health systems, especially those which may be susceptible to future emergencies. Already in 2013, the world has witnessed numerous emergency situations, from the crisis in Syria and neighbouring countries to heavy fighting in Mali and the Central African Republic, major flooding in parts of the Americas, Africa, and Asia, and others.

For more information please contact:

Tarik Jasarevic
WHO Communications Officer
Telephone: +41 22 791 5099
Mobile: +41 793 676 214
E-mail: jasarevict@who.int

View the original article here

WHO releases guidance on mental health care after trauma

6 August 2013 | GENEVA - WHO is releasing new clinical protocols and guidelines to health-care workers for treating the mental health consequences of trauma and loss.

Mental disorders are common, disabling and usually untreated, and WHO’s "Mental Health Global Action Programme (mhGAP)" was developed in 2008 to scale-up care for mental, neurological and substance use disorders with simple treatment protocols that can be offered by primary health-care doctors and nurses.

New care protocols for post-traumatic stress disorder and others

Now, WHO is extending this programme by including care for post-traumatic stress disorder (PTSD), acute stress and bereavement within its global programme.

“We have received numerous requests for guidance for mental health care after trauma and loss” says Dr Oleg Chestnov, WHO Assistant Director-General for Noncommunicable Diseases and Mental Health. “Primary health-care providers will now be able to offer basic support consistent with the best available evidence. They will also learn when to refer to more advanced treatment.”

Traumatic events and loss a common experience

Traumatic events and loss are common in people’s lives. In a previous WHO study of 21 countries, more than 10% of respondents reported witnessing violence (21.8%) or experiencing interpersonal violence (18.8%), accidents (17.7%), exposure to war (16.2%) or trauma to a loved one (12.5%). An estimated 3.6% of the world's population has suffered from post-traumatic stress disorder (PTSD) in the previous year, the study showed.

Using the new protocol, which is co-published with the United Nations High Commissioner for Refugees (UNHCR), primary health-care workers can offer basic psychosocial support to refugees as well as people exposed to trauma or loss in other situations.

Types of support offered can include psychological first aid, stress management and helping affected people to identify and strengthen positive coping methods and social supports.

In addition, referral for advanced treatments such as cognitive-behavioural therapy (CBT) or a new technique called eye movement desensitization and reprocessing (EMDR) should be considered for people suffering from PTSD. These techniques help people reduce vivid, unwanted, repeated recollections of traumatic events. More training and supervision is recommended to make these techniques more widely available.

Warnings against some popular treatments

Primary health care staff are also warned against certain popular treatments. For example, benzodiazepines, which are anti-anxiety drugs, should not be offered to reduce acute traumatic stress symptoms or sleep problems in the first month after a potentially traumatic event.

“PTSD needs to be managed along with other common mental disorders” reports Dr Mark van Ommeren, Scientist in the WHO Department of Mental Health and Substance Abuse. “This new, simple WHO-UNHCR treatment protocol will guide health workers around the world to help adults and children who suffer from conditions specifically related to stress.” The new guidelines and protocol were published today in an article in "The Journal of the American Medical Association".

Additional information

There is no evidence on the benefits of benzodiazepines, a common anti-anxiety drug, on symptoms of traumatic stress after a recent potentially traumatic event. Benzodiazepines may slow down the time to recover from potentially traumatic events.

Key concerns about the use of benzodiazepines are that many people develop tolerance to their effects, gain little therapeutic benefit from chronic consumption, become dependent on them and suffer a withdrawal syndrome when they stop taking them.

Thus, the WHO recommendation is that benzodiazepines should not be offered to adults to reduce acute traumatic stress symptoms associated with significant impairment in daily functioning in the first month after a potentially traumatic event.

The WHO recommendation also notes that benzodiazepines can have their use for other mental disorders.

For more information please contact:

Daniel Epstein
Communications Officer
WHO, Geneva
Telephone: +41 22 791 4458
Mobile: +41 79 475 5536
E-mail: epsteind@who.int

Ms Fadela Chaib
Communications Officer
WHO, Geneva
Telephone: +41-22-7913228
Mobile: +41-79-3676214
E-mail: chaibf@who.int

View the original article here

Investigators say 37 dead in Russian mental hospital fire

MOSCOW (Reuters) - A fire at a Russian psychiatric hospital on Friday killed 37 people, the top investigative agency in the province where the blaze occurred said.

The bodies of 10 of the 37 victims were recovered from the ruins of the building that burned down in a pre-dawn fire, the Novgorod regional branch of Russia's Investigative Committee said in a statement, without giving details on the other 27 victims.

(Writing by Steve Gutterman, Editing by Thomas Grove)

View the original article here

WHO releases guidance on mental health care after trauma

6 August 2013 | GENEVA - WHO is releasing new clinical protocols and guidelines to health-care workers for treating the mental health consequences of trauma and loss.

Mental disorders are common, disabling and usually untreated, and WHO’s "Mental Health Global Action Programme (mhGAP)" was developed in 2008 to scale-up care for mental, neurological and substance use disorders with simple treatment protocols that can be offered by primary health-care doctors and nurses.

Now, WHO is extending this programme by including care for post-traumatic stress disorder (PTSD), acute stress and bereavement within its global programme.

“We have received numerous requests for guidance for mental health care after trauma and loss” says Dr Oleg Chestnov, WHO Assistant Director-General for Noncommunicable Diseases and Mental Health. “Primary health-care providers will now be able to offer basic support consistent with the best available evidence. They will also learn when to refer to more advanced treatment.”

Traumatic events and loss are common in people’s lives. In a previous WHO study of 21 countries, more than 10% of respondents reported witnessing violence (21.8%) or experiencing interpersonal violence (18.8%), accidents (17.7%), exposure to war (16.2%) or trauma to a loved one (12.5%). An estimated 3.6% of the world's population has suffered from post-traumatic stress disorder (PTSD) in the previous year, the study showed.

Using the new protocol, which is co-published with the United Nations High Commissioner for Refugees (UNHCR), primary health-care workers can offer basic psychosocial support to refugees as well as people exposed to trauma or loss in other situations.

Types of support offered can include psychological first aid, stress management and helping affected people to identify and strengthen positive coping methods and social supports.

In addition, referral for advanced treatments such as cognitive-behavioural therapy (CBT) or a new technique called eye movement desensitization and reprocessing (EMDR) should be considered for people suffering from PTSD. These techniques help people reduce vivid, unwanted, repeated recollections of traumatic events. More training and supervision is recommended to make these techniques more widely available.

Primary health care staff are also warned against certain popular treatments. For example, benzodiazepines, which are anti-anxiety drugs, should not be offered to reduce acute traumatic stress symptoms or sleep problems in the first month after a potentially traumatic event.

“PTSD needs to be managed along with other common mental disorders” reports Dr Mark van Ommeren, Scientist in the WHO Department of Mental Health and Substance Abuse. “This new, simple WHO-UNHCR treatment protocol will guide health workers around the world to help adults and children who suffer from conditions specifically related to stress.” The new guidelines and protocol were published today in an article in "The Journal of the American Medical Association".

There is no evidence on the benefits of benzodiazepines, a common anti-anxiety drug, on symptoms of traumatic stress after a recent potentially traumatic event. Benzodiazepines may slow down the time to recover from potentially traumatic events.

Key concerns about the use of benzodiazepines are that many people develop tolerance to their effects, gain little therapeutic benefit from chronic consumption, become dependent on them and suffer a withdrawal syndrome when they stop taking them.

Thus, the WHO recommendation is that benzodiazepines should not be offered to adults to reduce acute traumatic stress symptoms associated with significant impairment in daily functioning in the first month after a potentially traumatic event.

The WHO recommendation also notes that benzodiazepines can have their use for other mental disorders.

Daniel Epstein
Communications Officer
WHO, Geneva
Telephone: +41 22 791 4458
Mobile: +41 79 475 5536
E-mail: epsteind@who.int

Ms Fadela Chaib
Communications Officer
WHO, Geneva
Telephone: +41-22-7913228
Mobile: +41-79-3676214
E-mail: chaibf@who.int

View the original article here

Humanitarian emergencies, an opportunity for fresh start in providing sustainable, long-term mental health services

16 August 2013 | Geneva - Humanitarian agencies work hard to help people with their mental health and psychosocial needs in the aftermath of emergencies, but too often opportunities are missed to strengthen mental health systems for the long-term, according to a new World Health Organization (WHO) report, "Building back better: Sustainable mental health care after emergencies" released for World Humanitarian Day (August 19).

“In spite of their tragic nature, emergency situations are opportunities to improve the lives of large numbers of people through improving mental health services,” says Dr Bruce Aylward, WHO’s Assistant Director-General overseeing the Organization’s work in humanitarian emergencies. "We can do better for emergency-affected populations by working with the government on sustainable mental health care from the outset.”

The report provides guidance for strengthening mental health systems after emergencies and examples from Afghanistan, Burundi, Indonesia (Aceh Province), Iraq, Jordan, Kosovo, Somalia, Sri Lanka, Timor-Leste, and West Bank and Gaza Strip.

Contributors from each area report not only their major achievements, but also their most difficult challenges and how they were overcome. Key overlapping practices emerging from these experiences are summarized.

Indonesia (Aceh): Like many provinces in Indonesia, Aceh had only institution-based care before the tsunami of 2004. Today, most districts have primary mental health services supported by secondary care at district general hospitals.Iraq: Since 2004, significant progress has been made toward the creation of a comprehensive mental health system. More than 50% of general practitioners have received mental health training.Kosovo: Starting from a hospital-based model of care in 1999 after the conflict, a system of community-based mental health care is now available. Sri Lanka: Since the 2004 tsunami, a new national mental health policy has guided reform, which now extends to most parts of the country. Several new cadres of community-based mental health workers have been developed. Timor-Leste: Building from a complete absence of mental health services in 1999, the country today has a comprehensive community-based mental health system.

The possibilities presented by emergency situations are significant because major gaps remain worldwide in the realization of comprehensive, community-based mental health care.

“The current situation is alarming,” says Dr Shekhar Saxena, WHO Director for Mental Health. “Health systems have not yet adequately responded to the burden of mental disorders. We know that the vast majority of people with severe mental disorders receive no treatment whatsoever in low-income and middle-income countries.”

Transforming the mental health care systems in turn would improve the well-being, functioning, and resilience of individuals, societies, and countries recovering from emergencies, the report notes.

By releasing this report, WHO aims to help guide policymakers to reform their mental health systems, especially those which may be susceptible to future emergencies. Already in 2013, the world has witnessed numerous emergency situations, from the crisis in Syria and neighbouring countries to heavy fighting in Mali and the Central African Republic, major flooding in parts of the Americas, Africa, and Asia, and others.

Tarik Jasarevic
WHO Communications Officer
Telephone: +41 22 791 5099
Mobile: +41 793 676 214
E-mail: jasarevict@who.int

View the original article here