Rachel Jenkins

• BA (Hons), MB, BChir, MD (Cantab)
• Professor Emeritus at King's College London

The intersecting impacts of mental ill-health and money problems on the financial wellbeing of people from ethnic minority communities.

Climate change is closely linked to rising levels of atmospheric carbon dioxide and methane due to human activities, and soaring temperatures might themselves pose a risk to natural carbon sequestration in the land. This editorial introduces three papers in the current issue exploring the adverse effects on mental health of climate-related loss of...

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Introduction: Coronavirus disease 2019 (COVID-19) has caused >3.5 million deaths worldwide and affected >160 million people. At least twice as many have been infected but remained asymptomatic or minimally symptomatic. COVID-19 includes central nervous system manifestations mediated by inflammation and cerebrovascular, anoxic, and/or viral neurotox...

Background Poor social circumstances can induce, exacerbate and prolong symptoms of mental health conditions, while having a mental health condition can also lead to worse social outcomes. Many people with mental health conditions prioritise improvement in social and functional outcomes over reduction in clinical symptoms. Interventions that improv...

Background: Suicide is an important contributor to the burden of mental health disorders, but community-based suicide data are scarce in many low- and middle-income countries (LMIC) including Kenya. Available data on suicide underestimates the true burden due to underreporting related to stigma and legal restrictions, and under-representation of t...

Objective: To assess knowledge, attitude and competency among mental health care professionals working in primary care. Method: Fifty mental health care workers in groups of two participated in the study. Both groups received training for 5 days. Structured pre-test and post-test questionnaires were used as assessment instruments. Results: On th...

https://science.sciencemag.org/content/370/6522/eaay0214/tab-e-letters

Introduction The increasing evidence of SARS‐CoV‐2 impact on the central nervous system (CNS) raises key questions on its impact for risk of later life cognitive decline, Alzheimer's disease (AD), and other dementia. Methods The Alzheimer's Association and representatives from more than 30 countries—with technical guidance from the World Health...

Introduction: The increasing evidence of SARS-CoV-2 impact on the central nervous system (CNS) raises key questions on its impact for risk of later life cognitive decline, Alzheimer's disease (AD), and other dementia. Methods: The Alzheimer's Association and representatives from more than 30 countries-with technical guidance from the World Healt...

Available online. https://www.springer.com/gp/book/9783030234546 Offers a global perspective on promoting mental health and well-being Details planning and implementation of interventions with different populations across diverse settings Illustrates evidence-based methods for implementing policies and programs outside of controlled research condit...

This chapter provides an overview of the context and rationale for mental health promotion within mental health services. The case for the inclusion of mental health promotion within mental services is considered in the context of addressing the heavy burden of mental disorders, integration within the Sustainable Development Goals, the social exclu...

Background The number of people presenting to hospital emergency departments after self-harming has increased in England. However, most people who self-harm do not present to hospitals, so whether this rise reflects an increase in the prevalence of self-harm in the community is unknown. Also unknown is whether the prevalence of non-suicidal self-h...

The Lancet Commission summarises some of the history of mental health concepts, recent developments in scientific understanding, mental health programmes and threats to progress, and proposes a way forward. Although ostensibly aiming to reframe global mental health within the paradigm of sustainable development, in practice it has taken a narrower...

Background Both malaria and mental disorders are associated with immune changes. We have previously reported the associations between malaria and mental disorders. We now report associations between malaria, mental disorders and immunity. Methods A household survey of malaria, mental disorders and immunity was conducted in a health and demographic...

The need for support for good mental health is enormous. General support for good mental health is needed for 100% of the population, and at all stages of life, from early childhood to end of life. Focused support is needed for the 17.6% of adults who have a mental disorder at any time, including those who also have a mental health problem amongst...

Mental health policy development is long overdue in many countries, but it is increasingly gaining the attention of governments. This is partly through a growing realization of the economic and social burden of mental disorder and the significant contribution of mental health to physical disability, partly because of the impetus within the mental h...

Common mental disorders (CMDs) comprise different types of depression and anxiety. They cause marked emotional distress and interfere with daily function,but do not usually affect insight or cognition. Although usually less disabling than major psychiatric disorders, their higher prevalence means the cumulative cost of CMDs to society is great. The...

In this issue, three papers discuss the issue of the brain drain: of psychiatrists from Egypt and Nigeria, and of nurses from East Africa. They explore the complexities of professional migration and its impact on the health of populations in source and recipient countries; they also review how recommendations for changes in policy and practice migh...

Background: The National Psychiatric Morbidity Surveys include English cross-sectional household samples surveyed in 1993, 2000 and 2007. Aims: To evaluate frequency of common mental disorders (CMDs), service contact and treatment. Method: Common mental disorders were identified with the Clinical Interview Schedule - Revised (CIS-R). Service c...

This paper calls for the routine integration of mental health promotion and prevention into UK General Practice in order to reduce the burden of mental and physical disorders and the ensuing pressure on General Practice. The proposals & the resulting document (https://ethicscharity.files.wordpress.com/2015/09/rcgp_keymsg_150925_v5.pdf) arise from a...

Background Repeat household surveys are useful to assess change in prevalence over time, but there have been no repeat surveys of common mental disorder (CMD) in Kenya, or indeed sub-Saharan Africa. Therefore a repeat household survey of CMD and its associated risk factors was conducted in Maseno area, Kisumu county in Kenya, using a demographic su...

This study aimed to assess the prevalence of probable post-traumatic stress disorder (PTSD), and its associated risk factors in a general household population in Kenya. Data were drawn from a cross-sectional household survey of mental disorders and their associated risk factors. The participants received a structured epidemiological assessment of c...

Background: Alcohol use and hazardous drinking have been studied in school children and in urban areas of Kenya, but there has been no adult survey of these issues in a rural household population. Methods: This study reports the prevalence of alcohol consumption and hazardous drinking in a household survey of a demographic surveillance site in r...

On the 1st and 2nd May 2015, participants at the RCGP London City Health Conference debated practical ways to achieve integrated care at community level. In five connected workshops, participants reviewed current work and identified ways to overcome some of the problems that had become apparent. In this paper, we summarise the conclusions of each w...

There has been no previous household population study of suicidal ideation and attempts in Kenya. Therefore this study aimed to establish the prevalence of suicidal ideation and attempts in a rural population in Kenya, and to assess risk factors. An epidemiological survey of a household population, using standardised structured interviews. We exami...

The prevalence of malaria parasites in adults in Africa is less well researched than in children. Therefore, a demographic surveillance site was used to conduct a household survey of adults in the malaria endemic area of Maseno division in Kisumu County near Lake Victoria. A random survey of 1,190 adults living in a demographic health surveillance...

Background There have been no household surveys of adult attention deficit and hyperactivity disorder (ADHD) in Kenya, and only one in sub-Saharan Africa. Methods Data on ADHD was used from a household survey of mental disorders and their associated risk factors conducted in Maseno area (population 70 805), near Lake Victoria in Kenya, using a dem...

Abstract: There have been no repeat surveys of psychotic symptoms in Kenya or indeed subSaharan Africa. A mental health epidemiological survey was therefore conducted in a demographic surveillance site of a Kenyan household population in 2013 to test the hypothesis that the prevalence of psychotic symptoms would be similar to that found in an earli...

Factors influencing cross-national diffusion of mental health policy are important to understand but complex to research. This commentary discusses Shen's research study on cross-national diffusion of mental health policy; examines the extent to which the three questions researched by Shen (whether countries are more likely to have a mental health...

Suicidal ideation is more strongly associated with suicidal intent in later life, so risk factors may also differ by age. We investigated whether the relationship between suicidal ideation and established correlates varied by age in a representative population. We used data from the 2007 Adult Psychiatric Morbidity Survey of England to assess the r...

Traditional and complementary systems of medicine (TCM) encompass a broad range of practices which are commonly embedded within contextual cultural milieu, reflecting community beliefs, experiences, religion and spirituality. Evidence from across the world, especially from low- and middle-income countries (LMIC), suggests that TCM is commonly used...

Traditional and complementary systems of medicine include a broad range of practices, which are commonly embedded in cultural milieus and reflect community beliefs, experiences, religion, and spirituality. Two major components of this system are discernible: complementary alternative medicine and traditional medicine, with different clientele and c...

Purpose: A considerable excess of psychosis in black ethnic minorities is apparent from clinical studies, in Britain, as in other developed economies with white majority populations. This excess is not so marked in population surveys. Equitable health service provision should be informed by the best estimates of the excess. We used national survey...

Background: Despite the life threatening nature of an HIV diagnosis and the multidimensional problems experienced by this patient population during antiretroviral therapy, the effectiveness of a palliative care approach for HIV positive patients on ART is as yet unknown. Findings: A randomised controlled trial (RCT) was conducted in a sample of...

Blenner and Augustyn state that the Centers for Disease Control and Prevention (CDC) study design cannot answer the question of whether autism spectrum disorder is increasing.1 We agree, but we do not agree with the implication that such evidence does …

The policy of any organisation is a setting out of the purposes for which it exists - its mission statement. Governments spend money on mental health services and therefore need a coherent mission statement for the use and goals to which that money is put. Moreover, the consequences of mental illness pervade all aspects of a nation's existence. The...

Trial design: A pragmatic cluster randomised controlled trial. Participants: Clusters were primary health care clinics on the Ministry of Health list. Clients were eligible if they were aged 18 and over. Interventions: Two members of staff from each intervention clinic received the training programme. Clients in both intervention and control clinic...

Health system weaknesses in Africa are broadly well known, constraining progress on reducing the burden of both communicable and non-communicable disease (Afr Health Monitor, Special issue, 2011, 14-24), and the key challenges in leadership, governance, health workforce, medical products, vaccines and technologies, information, finance and service...

This systematic review provides a narrative synthesis of the evidence on the effectiveness of mental health promotion interventions for young people in low and middle-income countries (LMICs). Commissioned by the WHO, a review of the evidence for mental health promotion interventions across the lifespan from early years to adulthood was conducted....

Objective: Gang members engage in many high-risk activities associated with psychiatric morbidity, particularly violence-related ones. The authors investigated associations between gang membership, violent behavior, psychiatric morbidity, and use of mental health services. Method: The authors conducted a cross-sectional survey of 4,664 men 18-34...

There are currently no practising psychiatrists in Somaliland. In 2007 the first medical students graduated from universities in Somaliland without mental health training. We aimed to pilot an intensive but flexible package of mental health training to all senior medical students and interns using interactive training techniques and to evaluate its...

Background: Mental health problems are common in primary care, with prevalence rates of up to 40% reported in developing countries. The study aim was to evaluate the impact of a specially designed toolkit used to train primary health care (PHC) workers in mental health on the rates of diagnosed cases of common mental disorders, malaria and non-spe...

Background There is a general lack of knowledge regarding disability and especially factors that are associated with disability in low-income countries. We aimed to study the overall and gender-specific prevalence of disability, and the association between exposure to traumatic events and disability in a post-conflict setting. Methods We conducted...

Background: Recent falls in suicide rates should be accompanied by a decline in the prevalence of suicidal ideation. Method: We used a pseudo-cohort analytic strategy to examine trends in suicidal ideation measured identically in 2000 and 2007, in nationally representative English probability samples of adults aged ≥ 16 years. Suicidal ideation...

Background Psychotic phenomena appear to form a continuum with normal experience and beliefs, and may build upon common emotional interpersonal concerns. Aims We tested predictions that paranoid ideation is exponentially distributed and hierarchically arranged in the general population, and that persecutory ideas build on more common cognitions of...

A cluster randomised controlled trial (RCT) of a national Kenyan mental health primary care training programme demonstrated a significant impact for health workers on the health, disability and quality of life of their clients, despite a severe shortage of medicines in the clinics. In order to better understand the potential reasons for the improve...

A cluster randomised controlled trial (RCT) of a national Kenyan mental health primary care training programme demonstrated a significant impact on the health, disability and quality of life of clients, despite a severe shortage of medicines in the clinics (Jenkins et al. Submitted 2012). As focus group methodology has been found to be a useful met...

Countries must learn how to capitalize on their citizens’ cognitive resources if they are to prosper, both economically and socially. Early interventions will be key.

This project was a cross-sectional exploratory study examining the use of traditional healers in the management of pain in Eastern Kenya. Research shows traditional medicine is a valued and highly utilised resource especially in developing countries. However, due to the lack of supporting evidence proving its efficacy, it is also viewed with scepti...

Objective: To find out change in Pakistani teacher's perception about mental health and whole school approach after training workshops. Design: Experimental Place and Duration of study: Trainings were held at department of Psychiatry, Pakistan Institute of Medical Sciences in collaboration with British council, THET, federal directorate of educatio...

Background Patients with HIV/AIDS on Antiretroviral Therapy (ART) suffer from physical, psychological and spiritual problems. Despite international policy explicitly stating that a multidimensional approach such as palliative care should be delivered throughout the disease trajectory and alongside treatment, the effectiveness of this approach has n...

Background The present study aimed to assess the prevalence of common mental disorders (CMDs) by occupation in a representative sample of the English adult population. Another aim was to examine whether the increased risk of CMD in some occupations could be explained by adverse work characteristics. Method We derived a sample of 3425 working-age r...

Purpose: The purpose of this study is to investigate whether minority ethnic people were less likely to receive treatment for mental health problems than the white population were, controlling for symptom severity. Method: We analysed data from 23,917 participants in the 1993, 2000 and 2007 National Psychiatric Morbidity Surveys. Survey response...

Purpose Loneliness can affect people at any time and for some it can be an overwhelming feeling leading to negative thoughts and feelings. The current study, based on the Adult Psychiatric Morbidity Survey in England, 2007, quantified the association of loneliness with a range of specific mental disorders and tested whether the relationship was inf...

The PLoS Medicine editors announce the launch of a new series on Global Mental Health Practice, and issue a call for papers.

There have been few epidemiological surveys to establish prevalence and associated risk factors of psychosis in Sub-Saharan Africa. This paper reports a population-based epidemiological survey in rural Kenya of the prevalence of psychotic symptoms and their relationship with demographic, socio-economic and other risk factors. A random sample of 2%...

Association between common mental disorders (CMDs), equity, poverty and socio-economic functioning are relatively well explored in high income countries, but there have been fewer studies in low and middle income countries, despite the considerable burden posed by mental disorders, especially in Africa, and their potential impact on development. Th...

The relationship between physical ill health, disability, and depression is not straightforward. Both cross-sectional and longitudinal studies have clearly shown that medical illness and physical disability are strongly associated with depression. To test the hypothesis that disability is associated with an increased prevalence of depression irresp...

Disability has long-term practical and social consequences, and is associated with mental disorders, in particular with depressive disorder. In this paper we investigate disability in relation to suicide attempts. We hypothesised that such attempts would be more common in people with a disability, and that this would be commensurate with the number...

Background: Personal debt is now recognized as one of the many factors associated with common mental disorders (CMD). We aim to estimate the prevalence of 'specific' mental disorders based on ICD-10 research diagnostic criteria by type of debt and quantify the additional influence of addictive behaviours. Method: A random probability sample comp...

To investigate changes over 15 years in the prevalence of insomnia and its association with demographic characteristics and hypnotic medication use. Analysis of 3 cross-sectional national mental health surveys carried out in 1993, 2000, and 2007, which used comparable sampling methods and identical insomnia assessments. Adults living in private hou...

Background Like most low- and middle-income countries, Nigeria has a huge treatment gap for mental disorders. The World Health Organization has proposed the integration of mental health care into primary health service delivery as one of the ways to bridge this treatment gap. Studies have shown an immediate positive impact of mental health training...

Background: The National Psychiatric Morbidity Survey (NPMS) programme was partly designed to monitor trends in mental disorders, including depression, with comparable data spanning 1993 to 2007. Findings already published from this programme suggest that concerns about increasing prevalence of common mental disorders (CMDs) may be unfounded. This...

Background: Depression contributes significantly to the global burden of disease in developing countries. Poor case detection and inadequate numbers of mental health staff have been associated with increased morbidity among individuals with depression presenting to primary care. In Nigeria, as in most developing countries, general practitioners (GP...

Introduction Sri Lanka has one of the highest suicide rates in the world, with recent protracted conflict and the tsunami aggravating mental health needs. This paper describes a project to establish a systematic "train the trainers" programme to integrate mental health into primary care in Sri Lanka's public health system and private sector.Methods...

Background There is a huge unmet need for mental health services in low- and middle-in-come countries such as Nigeria. It has been suggested that one way of bridging the service gap is to plan for the effective integration of mental health services into primary care. We present the impact of a one-week training workshop on attitudes to and knowledg...

Public mental health incorporates a number of strategies from mental well-being promotion to primary prevention and other forms of prevention. There is considerable evidence in the literature to suggest that early interventions and public education can work well for reducing psychiatric morbidity and resulting burden of disease. Educational strateg...

The new United Nations Convention on the Rights of Persons with Disabilities creates a new paradigm for mental health law, moving from a focus on institutional care to a focus on community-based services and treatment. This article considers implementation of this approach in Africa.

Evidence for an effect of work stressors on common mental disorders (CMD) has increased over the past decade. However, studies have not considered whether the effects of work stressors on CMD remain after taking co-occurring non-work stressors into account. Data were from the 2007 Adult Psychiatric Morbidity Survey, a national population survey of...

we measured subjective memory impairment (SMI) across the whole adult age range in a representative, national survey. Age is the strongest risk factor for dementia and SMI may be a precursor of objective cognitive impairment. We therefore hypothesised that SMI prevalence would rise with age in a non-demented population. we analysed data from the En...

This rapid review analyses the evidence on the effectiveness of mental health promotion interventions in low and middle-income countries (LAMICs). The review provides a narrative synthesis, based on a systematic review of the evidence under four key areas; interventions targeting individuals, communities, the health sector and intersectoral actions...

This rapid review analyses the evidence on the effectiveness of mental health promotion interventions in low and middle-income countries (LAMICs). The review provides a narrative synthesis, based on a systematic review of the evidence under four key areas; interventions targeting individuals, communities, the health sector and intersectoral actions...

In the context of increasing concerns for the health of UK armed forces veterans, this study aims to compare the prevalence of current mental, physical and behavioural difficulties in conscripted national service veterans with population controls, and to assess the impact of length of service in the military. The compulsory nature of national servi...

Mental well-being underpins many aspects of health and social functioning, and is economically important. To describe mental well-being in a general population sample and to determine the extent to which mental well-being and mental illness are independent of one another. Secondary analysis of a survey of 7293 adults in England. Nine survey questio...

Purpose This paper seeks to report the findings of a half‐day workshop on the impact and control of Qat, held in Yemen in February 2010. Senior mental health policy makers, professionals and leaders of mental health non‐governmental organizations (NGOs), were present as part of a wider five‐day national stakeholder conference to develop national me...