Psychosocial problems, including problems of mental health

-
Psychosocial problems, including problems of mental health ,alcohol and drug abuse, and domestic violence
Patients whose mental disorders are presented somatically are frequent users of medical services and form a substantial proportion of all patients seen in developing countries. There is evidence that provision of psychiatric care reduces subsequent use of medical services, so there would appear to be economic as well as humanitarian reasons for improving the detection and treatment of mental disorders in medical settings (hamburg, 1989). On the other hand , according to the USPSTF(1989),it has not been demonstrated in a controlled setting that the detection and treatment after signs and symptoms become apparent…however…some studies support the efficacy of counseling once the signs or symptoms of problem drinking…are detected.
Screening for psychological problems may be desirable under certain circumstances, for example, where it is suspected that such problems account for a high proportion of medical service use without bemefit, or after the occurrence of major disaster (lima et al,. 1987).the literature contains references to apparently successful experiments in which primary care workers with little formal education and limited training conducted screening with standardized instruments designed for use in developing countries, including the rural areas (sen et al ,.1987;khare et al ,. 1988).
Why and how . mental health problems, alcohol and drug abuse, and domestic violence are important public health problems in whose management routine screening would appear not to have a significant place. Where referral resources exist, health workers should be trained to recognize psychosocial problems and make appropriate referrals. Studies show a low pick-up rate of mental disorders by providers not performing formal screening. Formal self –report questionnaires may have limited validity for screening a general population (hoeper et al .,1984; oduwole & ogunyemi,1989)
Resource levels required. Low for screening by primary care worker; low or medium for definitive diagnosis ; low, medium, or high for intervention by specialized counseling personnel.
Recommendation on use of screening/early detection, uncertain recommendation on opportunistic screening because of the lack of firm evidence o f the effectiveness of intervention when the person affected does not seek help. Early detection of household risks for children recommended . the primary prevention of psychosocial problems should be emphasized.

Research priority. A very high priority should be placed on research to develop effective primary prevention, early detection, and treatment methods at the primary care level . 

Popular posts from this blog

Screening of children and adults to prevent and control communicable diseases

-
Image
Screening of children and adults to prevent and control communicable diseases This chapter discusses infectious diseases that endanger the health of the individual affected and sometimes others in the community. Because this material is generally relevant for all age groups , it was thought most convenient to present this as a separate chapter. Prevention and control of communicable diseases should be integral components of comprehensive primary health care programmes  for each general age group and should not be organized into separate vertical programmes focused on specific diseases. General comments on screening for communicable diseases In general, in dealing with highly prevalent communicable diseases that are a significant public health problem, the screening of asymptomatic persons will play a limited role and should be primarily an adjunct to other measures. Emphasis should be placed on primary prevention (often requiring environmental measures )and on public educatio
Read more

How do children get pneumonia?

-
Image
  Children can get pneumonia through various means, and the most common cause is infection with bacteria, viruses, or other microorganisms. The infection typically enters the lungs, causing inflammation of the air sacs and leading to the development of pneumonia. Here are some common ways children can contract pneumonia: Bacterial Infections: Bacteria such as Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus can cause bacterial pneumonia. These bacteria can be spread through respiratory droplets when an infected person coughs or sneezes. Viral Infections: Viruses, including respiratory syncytial virus (RSV), influenza (flu), and adenovirus, are common causes of viral pneumonia. Viruses can be transmitted through respiratory secretions or by touching surfaces contaminated with the virus. Aspiration: Inhaling foreign objects, such as food, liquids, or vomit, can lead to aspiration pneumonia. This is more common in young children who may not have fully developed
Read more

Is the cost of the screening and timely intervention operation warranted,given all the considerations covered in items 1-6 above, in comparison with alternative uses of the resources

-
Will the operation divert resources from other measures that are likely to be more effective? What other ways are there of addressing the problem that do not involve screening ? are these better? Will the screening operation divert health workers attention from more crucial efforts addressing the principal health problems of the population ? will it accomplish little but create the impression among the public that their problems are being dealt with and divert their attention from issues of higher priority ? In order to answer these questions , the costs and benefits of the proposed screening and intervention activities must be weighed against those of alternative strategies, taking into account both direct and indirect, as well as immediate and future , benefits . When planned thoughtfully and implemented in a population-based fashion, screening can provide a rational bases for resource allocation. it can be used to ensure that preventive measures are applied where they will have
Read more