RESUMO
BACKGROUND: On March 5th, Guatemala declared a 'State of Calamity' in response to the COVID-19 pandemic and strict lockdown measures were initiated. The psychological consequences of these measures are yet to be fully understood. There is limited research on the psychological impact of the virus in the general population, and even less focused on Latin America and high-risk communities characterized by poverty, limited mental health resources, and high rates of stigma around mental illness. The goal of this study is to examine the psychological impact of COVID-19 across several highly vulnerable districts in Guatemala. METHODS: A semi-structured phone interview was conducted of 295 individuals in multiple districts in Guatemala City to assess self-perceived mental health consequences related to the pandemic. Sociodemographic, medical, and mental health data were collected. Chisquares and t-tests used for categorical and continuous variables, as appropriate, to describe the sample. Binary logistic regressions were estimated to examine associations between sociodemographic characteristics and mental health symptoms (anxiety, stress, depression, burnout, escalation of pre-existing mental health symptoms, and a sense of safety). RESULTS: The results indicate high levels of anxiety and stress in all target communities. Significant differences based on gender, age, and the number of children in the household were identified: women and older adults experience higher rates of stress and anxiety associated with the pandemic; while families with greater number of children experience higher levels of burnout. CONCLUSION: Contextualizing the current pandemic as a complex emergency can help inform further studies focusing on socioeconomic challenges and higher vulnerabilities as preconditions affecting the impact of the pandemic on mental health. Given the limited available resources for mental health care in Guatemala, informal networks of care may play an important role in meeting the needs of those individuals experiencing increased psychological distress resulting from the pandemic.
Assuntos
COVID-19 , Pandemias , Idoso , Ansiedade/epidemiologia , Ansiedade/psicologia , COVID-19/epidemiologia , Criança , Controle de Doenças Transmissíveis , Depressão/epidemiologia , Depressão/psicologia , Feminino , Guatemala/epidemiologia , Humanos , Saúde Mental , SARS-CoV-2RESUMO
BACKGROUND: Resources for mental healthcare are lacking in Guatemala, yet rates of mental illness and suicide are quite high. Mental healthcare providers often lack the knowledge needed to effectively work with young at-risk of suicide. To address this gap, we developed a training program for mental health professionals focused on increasing knowledge and understanding of engaging and working with youth at risk of suicide and present its acceptability and preliminary effectiveness. METHODS: Mental health providers (N = 17) from a low SES community participated in the training, Formacion CUIDAR (Comunidades Unidos para Individuales De Alto Riesgo; CARE Training; Communities United for Individuals at High Risk). Mixed methods were used to explore outcomes including, self-reported knowledge and understanding of warning signs; risk and protective factors; effective risk assessment; and, techniques for working with at-risk youth. RESULTS: Findings indicate that the training was effective at increasing all targeted domains of knowledge (t = 2.46, p < .05, Cohen's d = .56). Acceptability was also rated as high. CONCLUSION: Scarcity of mental health specialists and lack of training on suicide assessment and management have resulted in inadequate resources for at-risk youth in need of mental health services in Guatemala. Results of our study demonstrate that our training is an acceptable, effective program for practicing mental health providers to address their lack of specialized training on how to work with individuals at risk of suicide. Further examination of the training in a larger RCT is required to attain more robust indictors of effectiveness and to assess long-term impact.
Assuntos
Transtornos Mentais , Serviços de Saúde Mental , Prevenção do Suicídio , Adolescente , Guatemala , Humanos , Saúde MentalRESUMO
BACKGROUND: Domestic violence, childhood physical and sexual abuse, and gang violence are prevalent and growing problems for Guatemalan youth, particularly in low socioeconomic (SES) areas. Resources in the community for psychosocial support are greatly lacking. Schools often serve as the main source of support for these highly vulnerable adolescents. Yet, many teachers lack the training to manage the psychological distress of their at-risk students and to properly engage, assess, and manage the psychological needs of their students. We developed a brief risk assessment and management training for teachers to address this gap. AIMS: We present the acceptability and preliminary effectiveness of the training at increasing teacher's knowledge and understanding of how to engage and work with their at-risk students around their thoughts and feelings of suicide. METHOD: Twenty-two teachers from a school in a low SES community in Guatemala participated in the training program. Mixed methods were used to explore effectiveness, acceptability, and satisfaction with the training. Primary outcomes assessed were changes in self-reported knowledge and understanding of engaging and working with students at risk of suicide. RESULTS: Participants reported increased knowledge and understanding of all training targets (p < .05). Acceptability was high as no participants dropped out and all participants rated the training as useful for their professional development, meeting their expectations, and as highly satisfying. CONCLUSION: Brief, focused training on suicidality can be effective and is acceptable to lay professionals. Further examination of the effectiveness of the training in a larger sample is required to assess the long-term impact of the training and its transportability to other communities.