No health without mental health.

Patients and Healers in the Context of Culture: An Exploration of the Borderland Between Anthropology, Medicine, and Psychiatry

Rethinking Psychiatry: From Cultural Category to Personal Experience

Vikram Patel, Harry Minas, Alex Cohen, Martin J Prince, Eds. Oxford University Press USA. 2013. 480pp. £38.99 (paperback). ISBN: 978-0-19-992018

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Recent years have seen a dramatic increase in our awareness and understanding of the impact mental disorders have on the global

Global Mental Health

List of Illustrations ix Acknowledgments xi Chapter One: Introduction: Local Forces of Medicalization 1 Part One: Depression in History 19 Chapter Two: Reading Emotions in the Body: The Premodern Language of Depression 23 Chapter Three: The Expansion of Psychiatry into Everyday Life 40 Chapter Four: Pathology of Overwork or Personality Weakness?: The Rise of Neurasthenia in Early-Twentieth-Century Japan 54 Chapter Five: Socializing the "Biological" in Depression: Japanese Psychiatric Debates about Typus Melancholicus 67 Part Two: Depression in Clinical Practice 83 Chapter Six: Containing Reflexivity: The Interdiction against Psychotherapy for Depression 89 Chapter Seven: Diagnosing Suicides of Resolve 107 Chapter Eight: The Gendering of Depression and the Selective Recognition of Pain 129 Part Three: Depression in Society 151 Chapter Nine: Advancing a Social Cause through Psychiatry: The Case of Overwork Suicide 155 Chapter Ten: The Emergent Psychiatric Science of Work: Rethinking the Biological and the Social 174 Chapter Eleven: The Future of Depression: Beyond Psychopharmaceuticals 193 References 201 Index 231

Depression in Japan : psychiatric cures for a society in distress

Mobile electrocardiograph (ECG) monitoring provides crucial information about the cardiac rhythm and system anomaly helping doctors to efficiently diagnose heart diseases. This paper presents the development of a low cost mobile ECG monitoring device, which early warms abnormalities throughout long-term ECG observation. For user convenience, two active dry electrodes are used as touch sensors. A buffer circuit is applied to remove the over-sensitivity effect of the electrodes. Experimental results indicated that ECG quality when using active dry electrodes is equivalent to that of wet Ag/AgCl electrodes application.

A low cost mobile ECG monitoring device using two active dry electrodes

Depression is an important and growing contributor to the burden of disease around the world and evidence suggests the experience of depression varies cross-culturally. Efforts to improve the integration of services for depression in primary care are increasing globally, meaning that culturally valid measures that are acceptable for use in primary care settings are needed. We conducted a scoping review of 27 studies that validated or used 10 measures of depression in Vietnamese populations. We reviewed the validity of the instruments as reported in the studies and qualitatively assessed cultural validity and acceptability for use in primary care. We found much variation in the methods used to validate the measures, with an emphasis on criterion validity and reliability. Enhanced evaluation of content and construct validity is needed to ensure validity within diverse cultural contexts such as Vietnam. For effective use in primary care, measures must be further evaluated for their brevity and ease of use. To identify appropriate measures for use in primary care in diverse populations, assessment must balance standard validity testing with enhanced testing for appropriateness in terms of culture, language, and gender and for acceptability for use in primary care.

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Selection of depression measures for use among Vietnamese populations in primary care settings: a scoping review.

Although the prevalence of depression in Vietnam is on par with global rates, services for depression are limited. The government of Vietnam has prioritized enhancing depression care through primary healthcare (PHC) and efforts are currently underway to test and scale-up psychosocial interventions throughout the country. With these initiatives in progress, it is important to understand implementation factors that might influence the successful integration of depression services into PHC. As the implementers of these new interventions, primary care providers (PHPs) are well placed to provide important insight into implementation factors affecting the integration of depression services into PHC. This mixed-methods study examines factors at the individual, organizational and structural levels that may act as barriers and facilitators to the integration of depression services into PHC in Vietnam from the perspective of PHPs. Data collection took place in Hanoi, Vietnam in 2014. We conducted semi-structured interviews with PHPs (n = 30) at commune health centres and outpatient clinics in one rural and one urban district of Hanoi. Theoretical thematic analysis was used to analyse interview data. We administered an online survey to PHPs at n = 150 randomly selected communes across Hanoi. N = 226 PHPs responded to the survey. We used descriptive statistics to describe the study variables acting as barriers and facilitators and used a chi-square test of independence to indicate statistically significant (p < .05) associations between study variables and the profession, location and gender of PHPs. Individual-level barriers include low level of knowledge and familiarity with depression among PHPs. Organizational barriers include low resource availability in PHC and low managerial discretion. Barriers at the structural level include limited mental health training among all PHPs and the existing programmatic structure of PHC in Vietnam, which sets mental health apart from general services. Facilitators at the individual level include positive attitudes among PHPs towards people with depression and interest in undergoing enhanced training in depression service delivery. While facilitating factors at the individual level are encouraging, considerable barriers at the structural level must be addressed to ensure the successful integration of depression services into PHC in Vietnam.

/pdf/barriers-and-facilitators-to-the-integration-of-depression-1twel8n3ld.pdf

Barriers and facilitators to the integration of depression services in primary care in Vietnam: a mixed methods study.

The purpose of this qualitative study was to elicit the explanatory models (EMs) of primary healthcare providers (PHPs) in Vietnam in order to (a) understand if and how the concept of depression is...

Conceptualizing depression in Vietnam: Primary health care providers' explanatory models of depression.

Among low- and middle-income countries, there is evidence that populations experiencing rapid political and economic transition have particularly high burdens of disease and disability from mental health conditions. This paper undertakes a political economy analysis of mental health in Vietnam to enhance knowledge translation, notably how both explicit and tacit knowledge can be used to promote evidence-based policy making. It argues that Vietnam's experience illustrates the need to better understand, not only how transition transforms societies, but how it impacts on the mental health needs and care of populations. The political economy of transition in Vietnam has so far given highest priority to economic growth through integration with the world economy and public sector reform. There is a need to recognise that transition in Vietnam poses both a potential threat to the care of people with mental health needs, and an opportunity to develop mental health services appropriate to local contexts.

Vu Cong Nguyen

Papers

A low cost mobile ECG monitoring device using two active dry electrodes

Selection of depression measures for use among Vietnamese populations in primary care settings: a scoping review.

Barriers and facilitators to the integration of depression services in primary care in Vietnam: a mixed methods study.

Conceptualizing depression in Vietnam: Primary health care providers' explanatory models of depression.

The Political Economy of Mental Health in Vietnam: Key Lessons for Countries in Transition