Afghan mental health and psychosocial well-being: thematic review of four decades of research and interventions

被引：25

作者：

Alemi, Qais ^{[1
]}

Panter-Brick, Catherine ^{[2
,3
]}

Oriya, Spozhmay ^{[4
]}

Ahmady, Mariam ^{[5
]}

Alimi, Abdul Qawi ^{[6
]}

Faiz, Hafizullah ^{[7
]}

Hakim, Nadia ^{[8
]}

Hashemi, Sayed A. Sami A. ^{[9
]}

Manaly, Muhammad Amin ^{[10
]}

Naseri, Roman ^{[11
]}

Parwiz, Khesraw

Sadat, Sayed Javid ^{[12
]}

Sharifi, Mohammad Zahid ^{[13
]}

Shinwari, Zalmai ^{[14
]}

Ahmadi, Sayed Jafar ^{[15
]}

Amin, Rohullah ^{[16
]}

Azimi, Sayed

Hewad, Atal ^{[17
]}

Musavi, Zeinab ^{[18
]}

Siddiqi, Abdul Majeed ^{[19
]}

Bragin, Martha ^{[20
]}

Kashino, Wataru ^{[21
]}

Lavdas, Michalis ^{[22
]}

Miller, Kenneth E. ^{[23
]}

Missmahl, Inge ^{[24
]}

Omidian, Patricia A. ^{[25
]}

Trani, Jean-Francois ^{[26
]}

van der Walt, Sarah Kate ^{[27
]}

Silove, Derrick ^{[28
]}

Ventevogel, Peter ^{[29
]}

机构：

[1] Loma Linda Univ, Sch Behav Hlth, Loma Linda, CA USA

[2] Yale Univ, Jackson Inst Global Affairs, New Haven, CT USA

[3] Yale Univ, Dept Anthropol, New Haven, CT USA

[4] Simon Fraser Univ, Sch Educ, Burnaby, BC, Canada

[5] Kabul Univ, Fac Psychol & Educ Sci, Dept Counselling, Kabul, Afghanistan

[6] World Hlth Org, Kabul, Afghanistan

[7] Swedish Comm Afghanistan, Jalalabad Reg Management Off, Jalalabad, Afghanistan

[8] Int Org Migrat, Migrat Hlth Unit, Kabul, Afghanistan

[9] UNICEF, Child Protect Sect, Kabul, Afghanistan

[10] Act Hunger, Kabul, Afghanistan

[11] Int Med Corps, Mental Hlth & Psychosocial Support Unit, Kabul, Afghanistan

[12] Int Assistance Mission, Mental Hlth & Peacebldg Program, Herat, Afghanistan

[13] HealthNet TPO, Kabul Mental Hlth Hosp Support Project, Kabul, Afghanistan

[14] HealthNet TPO, Mental Hlth & Psychosocial Support Unit, Kabul, Afghanistan

[15] Bard Coll, Dept Psychol, New York, NY USA

[16] Helmut Schmidt Univ, Fac Humanities & Social Sci, Hamburg, Germany

[17] Int Psychosocial Org, Dept Ipso Acad & Qual Management, Constance, Germany

[18] Behrawan Res & Psychol Serv Org, Kabul, Afghanistan

[19] HealthNet TPO, Amsterdam, Netherlands

[20] City Univ New York, Silberman Sch Social Work, New York, NY USA

[21] United Nations Off Drugs & Crime, Prevent Treatment & Rehabil Sect, Vienna, Austria

[22] Univ Bergen, Fac Psychol, Dept Psychosocial Sci, Bergen, Norway

[23] Univ British Columbia, Fac Educ, Vancouver, BC, Canada

[24] Int Psychosocial Org, Constance, Germany

[25] Focusing Initiat Int, Corvallis, OR USA

[26] Washington Univ St Louis, Brown Sch, St Louis, MO USA

[27] Premiere Urgence Aide Med Int, Mental Hlth & Psychosocial Support Unit, Kabul, Afghanistan

[28] Univ New South Wales, Sch Psychiat, Sydney, NSW, Australia

[29] United Nations High Commissioner Refugees, Publ Hlth Sect, Geneva, Switzerland

来源：

BJPSYCH OPEN | 2023年 / 9卷 / 04期

关键词：

Transcultural psychiatry; epidemiology; refugees; Afghanistan; conflict and war; POSTTRAUMATIC-STRESS-DISORDER; DELIBERATE SELF-HARM; ASYLUM SEEKERS; PSYCHOLOGICAL DISTRESS; RESIDENCE STATUS; HUMAN-RIGHTS; PSYCHIATRIC-DISORDERS; COUNSELING PSYCHOLOGY; MEMORY SPECIFICITY; DOMESTIC VIOLENCE;

D O I：

10.1192/bjo.2023.502

中图分类号：

R749 [精神病学];

学科分类号：

100205 ;

摘要：

BackgroundFour decades of war, political upheaval, economic deprivation and forced displacement have profoundly affected both in-country and refugee Afghan populations. AimsWe reviewed literature on mental health and psychosocial well-being, to assess the current evidence and describe mental healthcare systems, including government programmes and community-based interventions. MethodIn 2022, we conducted a systematic search in Google Scholar, PTSDpubs, PubMed and PsycINFO, and a hand search of grey literature (N = 214 papers). We identified the main factors driving the epidemiology of mental health problems, culturally salient understandings of psychological distress, coping strategies and help-seeking behaviours, and interventions for mental health and psychosocial support. ResultsMental health problems and psychological distress show higher risks for women, ethnic minorities, people with disabilities and youth. Issues of suicidality and drug use are emerging problems that are understudied. Afghans use specific vocabulary to convey psychological distress, drawing on culturally relevant concepts of body-mind relationships. Coping strategies are largely embedded in one's faith and family. Over the past two decades, concerted efforts were made to integrate mental health into the nation's healthcare system, train cadres of psychosocial counsellors, and develop community-based psychosocial initiatives with the help of non-governmental organisations. A small but growing body of research is emerging around psychological interventions adapted to Afghan contexts and culture. ConclusionsWe make four recommendations to promote health equity and sustainable systems of care. Interventions must build cultural relevance, invest in community-based psychosocial support and evidence-based psychological interventions, maintain core mental health services at logical points of access and foster integrated systems of care.

引用

页数：18

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