C Hanlon
Dados Biográficos
| ID | 49458 |
|---|---|
| NOME | C Hanlon |
| PRENOMES | C |
| SOBRENOME | Hanlon |
| ASSINATURA | HANLON C |
| AFILIAÇÕES | King's College London |
| ORCID | 0000-0002-7937-3226 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 65 |
| TOTAL DE CITAÇÕES | 47 |
| TOTAL COMO AUTOR | 64 |
| TOTAL COMO EDITOR | 1 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2009 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 4 |
Poverty alleviation for people with severe mental health conditions in South Africa
People with severe mental health conditions (SMHC) and caregivers in South Africa often experience poverty. The PRIZE trial found that recovery groups were acceptable, feasible and potentially effective in reducing relapse. Addressing economic needs was identified as a means to increase impact. This study aimed to understand the acceptability of poverty alleviation interventions as an adjunct to psychosocial interventions.We conducted two focus g…
Connections between science and care within public and global health research
Connections between science and care are common, such as when people access particular therapies through participating in research. However, interactions go far beyond medical treatment per se, with other kinds of advice and support (including direct financial support) also warranting consideration. Such complexities of the science-care relationship are often not fully accounted for by formal ethical and governance processes and approvals. This c…
Endeavour, endurance, entrapment
Personal recovery is a mainstream concept in mental health research and practice in the West. The applicability of personal recovery to other cultural and economic contexts is not well understood. This study aimed to characterise the recovery narratives of people living with psychosis in rural Ethiopia. We carried out in-depth interviews with 13 individuals with psychosis, and repeated interviews after 12 months. We conducted an inductive narrati…
Responding to experienced and anticipated discrimination training for health professionals working in mental health services (Read-MH)
BACKGROUND: Stigmatisation and discrimination towards people with mental health problems in low- and middle-income countries (LMICs) is pervasive. Health professionals working in mental health services can play a critical role in stigma reduction. This study examines the feasibility, costs, and potential effectiveness of READ-MH for such professionals in LMICs. METHODS: This multisite, nonrandomized pre–post mixed-methods feasibility study was co…
Barriers and facilitators to sexual and reproductive healthcare access for women with severe mental illness in low- and middle-income countries
Women with severe mental illnesses (SMI) in low- and middle-income countries (LMICs) appear to have poorer sexual and reproductive health (SRH) compared to women without SMI and men with SMI. Previous research suggests that women with SMI experience higher rates of HIV and other sexually transmitted diseases, sexual violence and variable contraceptive use. This review seeks to identify key barriers and facilitators affecting access to SRH service…
Experiences, needs and priorities of family caregivers of people with severe mental health conditions in low- and middle-income countries
Family caregivers in low- and middle-income countries (LMICs) provide the lion’s share of care for their relatives with severe mental health conditions amid vast treatment gaps. Yet, their lived experiences are not adequately explored. This systematic review synthesizes evidence on the lived experiences, priorities and needs of these caregivers across diverse LMIC settings. We analyzed 76 articles identified across nine databases. Data were synth…
Identification of psychosocial problems in routine antenatal care in Ethiopia
In this facility-based cross-sectional survey in primary health care centres in southern Ethiopia, women attending for antenatal care (ANC) were screened for depression (PHQ-9; score ≥ 5 and functionally impaired), anxiety symptoms (GAD-7; score ≥ 10), post-traumatic stress disorder (PCL-5 score ≥ 31), intimate partner violence (IPV; non-graphic language screening test) and risky substance use (ASSIST). Clinical notes were reviewed post-consultat…
Adaptation of a PTSD intervention for use in primary care in a low-income country
Posttraumatic Stress Disorder (PTSD) symptoms amongst people with serious mental illness (SMI) are prevalent in Ethiopia and throughout the world, yet treatment is scarce, particularly in low-resource settings with few mental health providers. This study describes the process of adapting a PTSD treatment, originally designed to be delivered by mental health providers in specialty mental health clinics in the US, to be appropriate, acceptable and …
Training antenatal care providers to deliver brief problem-solving therapy in rural Ethiopia
Background Task-sharing is the redistribution of tasks usually performed by specialists, to staff with less training and fewer qualifications. Despite the established clinical efficacy of task-shared brief psychological interventions in low and middle-income countries, training and supervision models are infrequently reported and rarely evaluated. Methods From the interpretive paradigm, we conducted a developmental evaluation of training, supervi…
Economic evaluation of caregiver interventions for children with developmental disabilities
Globally, families with children with developmental disabilities (DDs) experience challenges, including social isolation, stigma, and poverty, especially in low-income settings in Africa. Most children with DDs in Africa remain unidentified and receive no formal support. Caregiver interventions focusing on education and training for the carers/parents have been shown to be adaptable and low intensity in implementation, although the economic evide…
Impact of co-morbid common mental disorder symptoms in people with epilepsy in Ethiopia on quality of life and functional disability
The objective of this study was to investigate the impact of common mental disorder (CMD; depression/anxiety) symptoms and risky substance use in people with epilepsy in Ethiopia (four districts) on quality of life (QoL) and functioning over 6 months. A prospective cohort study was carried out. Multivariable linear regression followed by structural equation modelling (SEM) was employed. In the multivariable regression model, neither CMD symptoms …
No peace in my heart
Ethiopian primary healthcare clinical guidelines 5 years on—processes and lessons learnt from scaling up a primary healthcare initiative
Many effective health system innovations fail to reach those who need them most, falling short of the goal of universal health coverage. In the 5 years since the Federal Ministry of Health in Ethiopia localised the Practical Approach to Care Kit (PACK) programme to support primary care reforms, PACK has been scaled-up to over 90% of the country’s primary care health centres. Known as the Ethiopian Primary Healthcare Clinical Guideline (EPHCG), th…
Revisiting health systems to integrate perinatal mental health into maternal and child health services
box There is a growing call for actionable recommendations to promote perinatal mental health and to prevent and treat perinatal mental health conditions, particularly in Africa
Developing peer-led recovery groups (PRIZE) for people with psychosis and their caregivers in a low resource South African setting
Aim In South Africa and other low- and middle-income countries (LMIC), personal recovery for people with a severe mental health condition (SMHC) is hampered by lack of community-based support. This paper describes the development of a non-specialist and peer-facilitated recovery intervention (PRIZE) intended as an adjunct to psychiatric care. Methods Intervention development was guided by the MRC framework for complex interventions. Evidence revi…
Establishing partnerships with people with lived experience of mental illness for stigma reduction in low- and middle-income settings
Social contact refers to the facilitation of connection and interactions between people with and without mental health conditions. It can be achieved, for example, through people sharing their lived experience of mental health conditions, which is an effective strategy for stigma reduction. Meaningful involvement of people with lived experience (PWLE) in leading and co-leading anti-stigma interventions can/may promote autonomy and resilience. Our…
Understanding mental health stigma and discrimination in Ethiopia
Stigma and exclusion are prominent in the experiences of people with mental health conditions and their caregivers in this rural Ethiopian setting. Measurement of stigma and the development of interventions should consider how stigma is socially constructed. Anti-stigma interventions need to be implemented alongside expanded local access to mental healthcare
Adapting and piloting a social contact-based intervention to reduce mental health stigma among primary care providers
Stigma among primary care providers (PCPs) is a barrier to successful integration of mental health services in primary healthcare settings globally. Therefore, cross-culturally adaptable and feasible strategies are needed to reduce stigma among PCPs. This protocol is for a multi-site pilot study that aims to adapt and evaluate cross-cultural feasibility and acceptability of a social contact-based primary healthcare intervention in 7 sites in 5 lo…
Problem-solving therapy for pregnant women experiencing depressive symptoms and intimate partner violence
Evidence for the feasibility of brief psychological interventions for pregnant women experiencing intimate partner violence (IPV) in rural, low-income country settings is scarce. In rural Ethiopia, the prevalence of antenatal depressive symptoms and lifetime IPV are 29% and 61%, respectively. We aimed to assess the feasibility and related implementation outcomes of brief problem-solving therapy (PST) adapted for pregnant women experiencing IPV (P…
Stress and resilience during pregnancy
Background Stress during pregnancy is associated with perturbances in maternal psychology and physiology, and results in adverse pregnancy and birth outcomes. However, little attention has been given to understand maternal stress and its potential negative consequences in many low- and middle-income countries. We aimed to investigate whether pregnancy is associated with greater stress and lower psychological resilience among women living in Jimma…
Community-based rehabilitation intervention for people with schizophrenia in Ethiopia (Rise) cluster-randomised controlled trial
We evaluated the effectiveness of community-based rehabilitation (CBR) in reducing depressive symptoms, alcohol use disorder, food insecurity and underweight in people with schizophrenia. This cluster-randomised controlled trial was conducted in a rural district of Ethiopia. Fifty-four sub-districts were allocated in a 1:1 ratio to the facility-based care [FBC] plus CBR arm and the FBC alone arm. Lay workers delivered CBR over 12 months. We asses…
Adverse sequelae of the Covid -19 pandemic on mental health services in Chile
Objective. This study seeks to describe the adverse effects of the COVID-19 pandemic on mental health services in Chile. Methods. This study is part of ongoing multicountry research known as the Mental Health Care – Adverse Sequelae of COVID-19 study (or the MASC study) that includes seven countries. Chile is the only one in Latin America. This study used a convergent mixed methods design. The quantitative component analyzed data about public men…
Understandings of depression among community members and primary healthcare attendees in rural Ethiopia
Available evidence in Africa suggests that the prevalence of depression in primary care settings is high but it often goes unrecognized. In this study, we explored how depression is conceptualized and communicated among community members and primary care attendees diagnosed with depression in rural Ethiopia with the view to informing the development of interventions to improve detection. We conducted individual interviews with purposively selecte…
The Lancet Commission on ending stigma and discrimination in mental health
Developing shared understanding of pre-eclampsia in Haiti and Zimbabwe using Theory of Change
Pre-eclampsia, a complex and multi-system disorder specific to pregnancy, is a leading cause of preventable maternal and perinatal deaths in low-resource settings. Early detection and appropriate intervention with management of hypertension, prevention of eclampsia and timely delivery are effective at reducing mortality and morbidity. Outcomes can be greatly improved with the provision and uptake of good quality care. Cultural contexts of materna…
Acceptability and feasibility of using non-specialist health workers to deliver mental health care
Three-quarters of the global mental health burden exists in low- and middle-income countries (LMICs), yet the lack of mental health services in resource-poor settings is striking. Task-sharing (also, task-shifting), where mental health care is provided by non-specialists, has been proposed to improve access to mental health care in LMICs. This multi-site qualitative study investigates the acceptability and feasibility of task-sharing mental healt…
Strengthening mental health system governance in six low- and middle-income countries in Africa and South Asia
Poor governance has been identified as a barrier to effective integration of mental health care in low- and middle-income countries. Governance includes providing the necessary policy and legislative framework to promote and protect the mental health of a population, as well as health system design and quality assurance to ensure optimal policy implementation. The aim of this study was to identify key governance challenges, needs and potential st…
Explanatory models of depression in sub-Saharan Africa
Debate about the cross-cultural relevance of depression has been central to cross-cultural psychiatry and global mental health. Although there is now a wealth of evidence pertaining to symptoms across different cultural settings, the role of the health system in addressing these problems remains contentious. Depression is undetected among people attending health facilities. We carried out a thematic synthesis of qualitative evidence published in …
Perceptions and experiences of stigma among parents of children with developmental disorders in Ethiopia
Khat chewing in persons with severe mental illness in Ethiopia
People with severe mental illness (SMI) in Ethiopia chew khat despite advice from their physicians to desist. We wanted to better understand their reasons for khat chewing, including any benefits that they might gain. A qualitative study was conducted involving patients with SMI and their caregivers in Butajira. Reasons given by patients as well as caregivers were more or less congruent: social pressure, a means for survival by improving function…
Postnatal mental distress in relation to the sociocultural practices of childbirth
Sociocultural patterning of the postnatal period in non-Western settings has been hypothesised to protect against postnatal depression. In 2004, in a predominantly rural area of Ethiopia, we conducted 25 in-depth interviews and five focus group discussions with purposively selected participants including perinatal women, fathers, grandmothers, traditional and religious leaders, birth attendants and community leaders. Our main objectives were (1) …
Participatory planning of a primary care service for people with severe mental disorders in rural Ethiopia
Little is understood about the feasibility and acceptability of primary care-based models of task-sharing care for people with severe mental disorders (SMDs) in low- and middle-income countries (LMICs). A participatory planning approach was adopted in preparation for the transition from hospital-delivered psychiatric care for SMD to a primary care-based, task-sharing model in a rural Ethiopian community. In this article, we present findings from …
People and work in events and conventions
The part of the tourism industry which covers events, conventions and meetings is a substantial part of the global economy and provides employment for a very large number of people worldwide. The breakdown of employees in this sector is complex - employees can be full-time, casual labour or part of a volunteer workforce, and events can be as diverse as the Olympic Games and a local meeting. This book examines the role of people who work in events…
Migration and Mental Health
Background: Few studies have explored influences on mental health of migrants moving between non-Western countries. Methods: Focus group discussions were used to explore the experiences of Ethiopian female domestic migrants to Middle Eastern countries, comparing those who developed severe mental illness with those remaining mentally well. Discussion: Prominent self-identified threats to mental health included exploitative treatment, enforced cult…
Postnatal mental distress in relation to the sociocultural practices of childbirth
Sociocultural patterning of the postnatal period in non-Western settings has been hypothesised to protect against postnatal depression. In 2004, in a predominantly rural area of Ethiopia, we conducted 25 in-depth interviews and five focus group discussions with purposively selected participants including perinatal women, fathers, grandmothers, traditional and religious leaders, birth attendants and community leaders. Our main objectives were (1) …
Prevalence and predictors of undernutrition among infants aged six and twelve months in Butajira, Ethiopia
There was a high prevalence of undernutrition in the first year of infancy in this rural Ethiopia population, with significant gender imbalance. Our prospective study highlighted the importance of prenatal maternal nutritional status and household sanitary facilities as potential targets for intervention
Maternal common mental disorders and infant development in Ethiopia
The study supports the hypothesis that it is the accumulation of risk exposures across time rather than early exposure to maternal CMD per se that is more likely to affect child development. Further investigation of the impact of chronicity of maternal CMD upon child development in LAMICs is indicated. In the Ethiopian setting, poverty, interpersonal violence and infant undernutrition should be targets for interventions to reduce the loss of chil…
Prevalence and risk factors for soil-transmitted helminth infection in mothers and their infants in Butajira, Ethiopia
In this rural Ethiopian community with a relatively high prevalence of STH infection, we found a reduced risk of infection in relation to maternal hygiene and urban living. Daily use of soap and a safe supply of water are likely to reduce the risk of STH infection
Khat chewing in persons with severe mental illness in Ethiopia
People with severe mental illness (SMI) in Ethiopia chew khat despite advice from their physicians to desist. We wanted to better understand their reasons for khat chewing, including any benefits that they might gain. A qualitative study was conducted involving patients with SMI and their caregivers in Butajira. Reasons given by patients as well as caregivers were more or less congruent: social pressure, a means for survival by improving function…
Prime
The Policy Forum allows health policy makers around the world to discuss challenges and opportunities for improving
Challenges and Opportunities for Implementing Integrated Mental Health Care
BACKGROUND: Little is known about how to tailor implementation of mental health services in low- and middle-income countries (LMICs) to the diverse settings encountered within and between countries. In this paper we compare the baseline context, challenges and opportunities in districts in five LMICs (Ethiopia, India, Nepal, South Africa and Uganda) participating in the PRogramme for Improving Mental health carE (PRIME). The purpose was to inform…
Acceptability and feasibility of using non-specialist health workers to deliver mental health care
Three-quarters of the global mental health burden exists in low- and middle-income countries (LMICs), yet the lack of mental health services in resource-poor settings is striking. Task-sharing (also, task-shifting), where mental health care is provided by non-specialists, has been proposed to improve access to mental health care in LMICs. This multi-site qualitative study investigates the acceptability and feasibility of task-sharing mental healt…
Mental health care in Nepal
This study describes many challenges facing mental health care in Nepal. Most of these challenges are not new, yet this study contributes to our understanding of these difficulties by outlining the national and district level factors that have a direct influence on the development of a district level mental health care plan
Developing mental health research in sub-Saharan Africa
Having protected time for research is a barrier to carrying out research activities for busy clinicians. Funders could support sustainability of capacity-building initiatives through funds for travel and study leave. Adoption of a train-the-trainers model for specialist skills training and strategies for improving the rigor of evaluation of capacity-building activities should be considered
Equitable access to integrated primary mental healthcare for people with severe mental disorders in Ethiopia
Establishing an affordable service within reach, raising awareness and financial support to families from low socioeconomic backgrounds were suggested to improve equitable access to mental healthcare by vulnerable groups including perinatal women and people with disabilities. Innovative approaches, such as telephone consultations with psychiatric nurses based in nearby towns and home outreach need to be developed and evaluated
Hazardous alcohol use and associated factors in a rural Ethiopian district
High level of hazardous alcohol use was detected in this predominantly rural Ethiopian setting. The finding informed the need to integrate services for hazardous alcohol use such as brief intervention at different levels of primary care services in the district. Public health interventions to reduce hazardous alcohol use also need to be launched
Participatory planning of a primary care service for people with severe mental disorders in rural Ethiopia
Little is understood about the feasibility and acceptability of primary care-based models of task-sharing care for people with severe mental disorders (SMDs) in low- and middle-income countries (LMICs). A participatory planning approach was adopted in preparation for the transition from hospital-delivered psychiatric care for SMD to a primary care-based, task-sharing model in a rural Ethiopian community. In this article, we present findings from …
Indicators for routine monitoring of effective mental healthcare coverage in low- and middle-income settings
High-quality information to measure the need for, and the uptake, cost, quality and impact of care is essential in the pursuit of scaling up mental health care in low- and middle-income countries (LMIC). The aim of this study was to identify indicators for the measurement of effective coverage of mental health treatment. We conducted a two-round Delphi study (n = 93 experts from primarily LMIC countries Ethiopia, India, Nepal, Nigeria, South Afri…
“I cry every day and night, I have my son tied in chains”
BACKGROUND: A primary rationale for scaling up mental health services in low and middle-income countries is to address human rights violations, including physical restraint in community settings. The voices of those with intimate experiences of restraint, in particular people with mental illness and their families, are rarely heard. The aim of this study was to understand the experiences of, and reasons for, restraint of people with schizophrenia…
Engaging and staying engaged
Economic interventions may be needed to support ongoing engagement in care for people with SMD. Systems of care for chronic illness need to be strengthened in combination with legal frameworks. Expanded options for affordable and effective medication and psychosocial interventions are required for person-centred care
Strengthening mental health system governance in six low- and middle-income countries in Africa and South Asia
Poor governance has been identified as a barrier to effective integration of mental health care in low- and middle-income countries. Governance includes providing the necessary policy and legislative framework to promote and protect the mental health of a population, as well as health system design and quality assurance to ensure optimal policy implementation. The aim of this study was to identify key governance challenges, needs and potential st…
Involvement of people with schizophrenia in decision-making in rural Ethiopia
BACKGROUND: The involvement of people with psychosocial disabilities in decision-making is a fundamental component of a person-centred and recovery-oriented model of care, but there has been little investigation of this approach in low- and middle-income countries. The aim of this study was to explore the involvement of people with schizophrenia in decision-making relating to their care in rural Ethiopia. METHODS: A qualitative study was conducte…
Maternal depression symptoms are highly prevalent among food-insecure households in Ethiopia
Objective We aimed to evaluate the association between household food insecurity and maternal depression in Ethiopia. Design/Setting/Subjects In 2014, we conducted a cross-sectional study in southern Ethiopia, including 591 food-secure and 2500 food-insecure households. We measured depression status of women using the Patient Health Questionnaire-9 validated for Ethiopia, with a cut-off of ≥5. We evaluated household-level food insecurity using a …
Is depression associated with pathways to care and diagnosis delay in people with tuberculosis in Ethiopia
People with TB who had co-morbid probable depression visited the modern health care as directly as and as soon as those without co-morbid depression. How socio-demographic factors influence pathways to care and diagnosis delay require qualitative exploration
Mental health problems and socioeconomic disadvantage
Households with a member who had either SMD or depression were socioeconomically disadvantaged compared to the general population. Moreover, higher disability was associated with worse socio-economic disadvantage. Prospective studies are needed to determine the direction of association. This study indicates a need to consider households of people with SMD or depression as a vulnerable group requiring economic support alongside access to evidence-…
Catastrophic health expenditure and impoverishment in households of persons with depression
Households of people with depression and high disability were more likely to face catastrophic expenditures and impoverishment from OOP payments. Financial protection interventions through prepayment schemes, exemptions and fee waiver strategies need to target households of persons with depression
Contextual equipoise
The call for universal health coverage requires the urgent implementation and scale-up of interventions that are known to be effective, in resource-poor settings. Achieving this objective requires high-quality implementation research (IR) that evaluates the complex phenomenon of the influence of context on the ability to effectively deliver evidence-based practice. Nevertheless, IR for global health is failing to apply a robust, theoretically dri…
Medicine (54 obras) · Psychiatry (41 obras) · Mental health (37 obras) · Psychology (31 obras) · Mental Health Treatment and Access (29 obras) · Nursing (24 obras) · Environmental health (19 obras) · Economic growth (18 obras) · Health care (18 obras) · Public health (16 obras)