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Mental, neurological and substance use (MNS) disorders are highly prevalent, accounting for a substantial burden of disease and disability globally. In order to bridge the gap between available resources and the significant need for services, the World Health Organization launched the Mental Health Gap Action Programme (mhGAP). The objective of mhGAP is to scale-up care and services using evidence-based interventions for prevention and management of priority MNS conditions. The mhGAP Intervention Guide version 1.0 for MNS disorders for non-specialist health settings was developed in 2010 as a simple technical tool to allow for integrated management of priority MNS conditions using protocols for clinical decision-making. With uptake in over 90 countries, mhGAP-IG 1.0 version has had widespread success. It is our pleasure to present mhGAP version 2.0, with updates incorporating new evidence-based guidance, enhanced usability, and new sections to expand its use by both health care providers as well as programme managers. It is our hope that this guide will continue to provide the road-map to deliver care and services for people with MNS disorders around the world and lead us closer to achieving the goal of universal health coverage.
The mhGAP Intervention Guide (IG) is a clinical guide on mental neurological and substance use disorders for general health care workers who work in non-specialized health care settings particularly in low- and middle-income countries. These health care workers include general physicians family physicians nurses and clinical officers. The mhGAP programme provides a range of tools to support the work of health care providers as well as health policy makers and planners The proposed guide is an adaptation of the mhGAP Intervention Guide to be used in humanitarian settings. These settings include a broad range of acute and chronic emergency situations arising from armed conflicts natural disasters and industrial disasters and may include mass displacement of populations (eg refugees and/or internally displaced people).
Mental, neurological, and substance use disorders are common, highly disabling, and associated with significant premature mortality. The impact of these disorders on the social and economic well-being of individuals, families, and societies is large, growing, and underestimated. Despite this burden, these disorders have been systematically neglected, particularly in low- and middle-income countries, with pitifully small contributions to scaling up cost-effective prevention and treatment strategies. Systematically compiling the substantial existing knowledge to address this inequity is the central goal of this volume. This evidence-base can help policy makers in resource-constrained settings as they prioritize programs and interventions to address these disorders.
This manual attempts to provide simple, adequate and evidence-based information to health care professionals in primary health care especially in low- and middle-income countries to be able to provide pharmacological treatment to persons with mental disorders. The manual contains basic principles of prescribing followed by chapters on medicines used in psychotic disorders; depressive disorders; bipolar disorders; generalized anxiety and sleep disorders; obsessive compulsive disorders and panic attacks; and alcohol and opioid dependence. The annexes provide information on evidence retrieval, assessment and synthesis and the peer view process.
Depending on the health profile of the traveller, the type of travel to be undertaken, and the place of transit and destination, travellers may face various health risks during travel. The International travel and health collection serves as an entry point for other World Health Organization (WHO) publications that provide further information. Its primary target audience is travel health practitioners and travel health professionals, who provide health advice to travellers on appropriate precautions to be taken to minimize any travel-related health risks in unfamiliar environments, before, during and after travel. Module 5 lays out the various aspects relevant to mental, neurological and substance use (MNS) conditions that travel health practitioners should be aware of when supporting travellers, or people with these conditions who are considering travelling. International travel can be a stressful experience. Travellers may face separation from family and familiar social support systems as well as having to adjust to foreign cultures and languages. Coping with high levels of stress may result in physical, social and psychological problems. Changes to the circadian rhythm and sleep deprivation can trigger seizures in people with epilepsy, provoke migraine attacks and exacerbate behavioural symptoms in people living with dementia. Under the stress of travel, pre-existing MNS conditions may be exacerbated or become apparent for the first time.
Over the course of the last decade, political and mental entities at large have embraced global mental health: the idea that psychiatric health is vital to improved quality of life. Physicians globally have implemented guidelines recommended by the National Institute of Mental Health (NIMH) in 2007, thereby breaking down barriers to care and improving quality of life in areas where these practices have been implemented. Programs for training and education have expanded as a result. Clinicians benefit more from both local resources in some regions as well as in international collaboration and technological advancements. Even amidst all of these positive outcomes, clinicians still face some stumbling blocks. With worldwide statistics estimating that 450 million people struggle with mental, neuropsychiatric, and neurological disorders—25 percent of the world’s non-communicable disease burden—rising to these challenges prove to be no small feat, even in wealthy Western nations. Various articles and books have been published on global mental health, but few of them thoroughly cover the clinical, research, innovative, and social implications as they pertain to psychiatry; often, only one of these aspects is covered. A comprehensive text that can keep pace with the rapidly evolving literature grows more and more valuable each day as clinicians struggle to piece together the changes around the world that leave open the possibility for improved outcomes in care. This book seeks to boldly rectify this situation by identifying innovative models of service delivery, training, education, research funding, and payment systems that have proven to be exemplary in implementation and scalability or have potential for scalability. Chapters describe specific barriers and challenges, illuminating effective strategies for improved outcomes. This text is the first peer-reviewed resource to gather prestigious physicians in global mental health from around the world and disseminate their expertise in the medical community at large in a format that is updateable, making it a truly cutting-edge resource in a world constantly changed by medical, scientific, and technological advances. Innovations in Global Mental Health is the ultimate resource for psychiatrists, psychologists, primary care physicians, hospitalists, policy makers, and all medical professionals at the forefront of global mental health and its implications for the future.
Addressing comorbidities and risk factors for tuberculosis (TB) is a crucial component of the World Health Organization (WHO)’s End TB Strategy. This WHO operational handbook on tuberculosis. Module 6: tuberculosis and comorbidities aims to support countries in scaling up people-centred care, based on the latest WHO recommendations on TB and key comorbidities, and drawing upon additional evidence, best practices and inputs from various experts and stakeholders obtained during WHO processes. It is intended for use by people working in ministries of health, particularly TB programmes and the relevant departments or programmes responsible for comorbidities and health-related risk factors for TB such as HIV, diabetes, undernutrition, substance use, and tobacco use, as well as programmes addressing mental health and lung health. This operational handbook is a living document and will include a separate section for each of the key TB comorbidities or health-related risk factors. The second edition includes guidance for HIV-associated TB and on mental health conditions, which are two conditions strongly associated with TB and which result in higher mortality, poorer TB treatment outcomes and negatively impact health-related quality of life. The operational handbook aims to facilitate early detection, proper assessment and adequate management of people affected by TB and comorbidities. Full implementation of this guidance is expected to have a significant impact on TB treatment outcomes and health-related quality of life for people affected by TB.
The Guidelines on promotive and preventive mental health interventions for adolescents - Helping Adolescents thrive (HAT), provide evidence-informed recommendations on psychosocial interventions to promote mental health, prevent mental disorders, and reduce self-harm and other risk behaviours among adolescents. The HAT Guidelines aims to inform policy development, service planning and the strengthening of health and education systems, and facilitate mainstreaming of adolescent mental health promotion and prevention strategies across sectors and delivery platforms.
Guidelines on Mental Health at Work An estimated 15% of working-age adults have a mental disorder at any point in time. Depression and anxiety are estimated to cost the global economy US $1 trillion each year driven predominantly by lost productivity. People living with severe mental health conditions are largely excluded from work despite participation in economic activities being important for recovery. The WHO guidelines on mental health at work provide evidence-based recommendations to promote mental health, prevent mental health conditions, and enable people living with mental health conditions to participate and thrive in work. The recommendations cover organizational interventions, manager training and worker training, individual interventions, return to work, and gaining employment. The guidelines on mental health at work aim to improve the implementation of evidence-based interventions for mental health at work.