Dimitar Karadzhov’s research while affiliated with University of Strathclyde and other places

Concerned with sustainably alleviating mental distress and promoting the right to health worldwide, global mental health (GMH) is practised across various contexts spanning the humanitarian-development-peace nexus. The inherently intersectoral and multidisciplinary nature of GMH calls for competency frameworks and training programmes that embody diversity, decolonisation and multiprofessionalism. Existing competency frameworks have failed to capture the multi-sectoral, inter-professional nature of contemporary GMH practice. In response to these needs, a qualitative content analysis of relevant job advertisements was conducted to distil a comprehensive set of professional competencies in contemporary GMH practice. Approximately 200 distinct skills and competencies were extracted from 70 job advertisements and organised into four meta-dimensions: ‘skills’, ‘sector’, ‘self’ and ‘subject’. The first known systematic attempt at a multi-sectoral GMH competency framework, it offers a springboard for exploring vital yet overlooked professional competencies such as resilience, self-reflection, political skills and entrepreneurialism. On this basis, recommendations for building a competent, agile and effective GMH workforce with diversified and future-proof skillsets are proposed. The framework can also inform inter-professional training and curriculum design, and capacity-building initiatives aimed at early-career professional development, particularly in low- and middle-income settings.

Cost-effective and user-friendly, mobile phone-assisted methods have remained underutilized in qualitative social science research. The scarce methodological guidance, together with recruitment and ethical challenges, has arguably stifled advancements in this area. COVID-19 exposed the need to better equip researchers with the expertise and tools to conduct remote research effectively. In 2020, we designed and launched a smartphone survey application to collect real-time data from children’s sector professionals across the globe regarding best practices in, and challenges to, responding to the pandemic. In this short article, we reflect on the efficiency, quality, and acceptability afforded by the smartphone app survey, and outline recommendations for enhancing rigor and feasibility. We also present data snippets illustrating the positive impact of participation on respondents—a seldom-documented aspect of app-based research. Altogether, we advocate a flexible, pragmatic, and user-centered study and app design that aligns with respondents’ specific, situational needs, and preferences.

Concerned with sustainably alleviating mental distress and promoting the right to health worldwide, global mental health (GMH) is practised across various contexts spanning the humanitarian-development-peace nexus. The inherently intersectoral and multidisciplinary nature of GMH calls for competency frameworks and training programmes that embody diversity, decolonisation and multiprofessionalism. Existing competency frameworks have failed to capture the multi-sectoral, inter-professional nature of contemporary GMH practice. In response to these needs, a qualitative content analysis of relevant job advertisements was conducted to distil a comprehensive set of professional competencies in contemporary GMH practice. Approximately 200 distinct skills and competencies were extracted from 70 job advertisements and organised into four meta-dimensions: ‘ skills ’, ‘ sector ’, ‘ self ’ and ‘ subject ’. The first known systematic attempt at a multi-sectoral GMH competency framework, it offers a springboard for exploring vital yet overlooked professional competencies such as resilience, self-reflection, political skills and entrepreneurialism. On this basis, recommendations for building a competent, agile and social justice-oriented GMH workforce with diversified and future-proof skillsets are proposed. The framework can also inform inter-professional training and curriculum design, and capacity-building initiatives aimed at early-career professional development, particularly in low- and middle-income settings. Impact Statement Professional competency frameworks play an important role in the education, training, employability and continuous professional development of the diverse – multi-disciplinary and multi-professional – global mental health workforce. To reflect this diversity, a novel, multi-sectoral global mental health competency framework was developed from a job market analysis and a stakeholder consultation. This framework encompasses a range of job families such as advocacy, policy, service delivery, programme management, capacity development and research and teaching. As such, it is applicable across geographical settings, career stages and global mental health-related job titles. Far from being a definitive list, the framework highlights the immense variety of interpersonal, technical, cognitive and knowledge-based competencies demanded from employers across sectors and roles. Alongside the well-recognised, quintessential competencies such as collaboration, cultural sensitivity, integrity and intervention delivery, educators, trainers, managers and other leaders should develop trainees’ and professionals’ resilience and adaptability; creativity and curiosity; and entrepreneurial and reflective skills. The professional development tool documented in this article can foster inter-professional mobility and education, together with the design of courses and curricula that are aligned with employer needs and contemporary challenges. Ultimately, the framework is designed to trigger reflection and professional skills analysis, and inspire lifelong learning.

Purpose The purpose of this study was to explore 232 service providers’ and policymakers’ experiences of supporting children’s well-being during the pandemic, across sectors, in 22 countries – including Kenya, the Philippines, South Africa, India, Scotland, Sweden, Canada and the USA, in the last quarter of 2020. Design/methodology/approach A smartphone survey delivered via a custom-built app containing mostly open-ended questions was used. Respondents were recruited via professional networks, newsletters and social media. Qualitative content analysis was used. Findings The findings reveal numerous system-level challenges to supporting children’s well-being, particularly virus containment measures, resource deficiencies and inadequate governance and stakeholder coordination. Those challenges compounded preexisting inequalities and poorly affected the quality, effectiveness and reach of services. As a result, children’s rights to an adequate standard of living; protection from violence; education; play; and right to be heard were impinged upon. Concurrently, the findings illustrate a range of adaptive and innovative practices in humanitarian and subsistence support; child protection; capacity-building; advocacy; digitalisation; and psychosocial and educational support. Respondents identified several priority areas – increasing service capacity and equity; expanding technology use; mobilising cross-sectoral partnerships; involving children in decision-making; and ensuring more effective child protection mechanisms. Practical implications This study seeks to inform resilience-enabling policies and practices that foster equity, child and community empowerment and organisational resilience and innovation, particularly in anticipation of future crises. Originality/value Using a novel approach to gather in-the-moment insights remotely, this study offers a unique international and multi-sectoral perspective, particularly from low- and middle-income countries.

Aims Sierra Leone has a 98% mental health treatment gap. This has been attributed to lack of resources and attitudinal/cultural barriers. Community health workers (CHWs) are the backbone of healthcare delivery in the country, constituting 1,500 of the general health workforce. The government has trained CHWs to improve mental health care. However, evidence have shown that this training is inadequate, leading to poor mental health literacy among CHWs. Sierra Leonean CHWs' perceptions of mental health and experiences of mental healthcare delivery have not been investigated. Therefore, this study aims to assess CHWs' knowledge regarding depression and suicidality, as well as their perceptions of barriers to, and facilitators of, mental health care in Sierra Leone. Methods Purposive sampling and snowballing were used in this qualitative descriptive study (N = 10) to recruit CHWs in Kono and Freetown, Sierra Leone. Participants were interviewed remotely using Zoom. A short vignette on depression and suicidality was employed, together with remote semi-structured interviews exploring mental health literacy, perceptions of mental health care, and experiences in providing care during COVID-19. Thematic analysis was utilized. Results Five themes and 10 subthemes were derived from the thematic analysis. More than two-thirds of the participants viewed the problem as 'depression', while none mentioned suicidal ideation. Life events were the most commonly identified causes of depression, with no mention of spiritual, supernatural or biological attribution as possible causes. The inductively coded themes include the need for change; barriers to mental health care; accessing care; and COVID-19-related mental health care challenges. All participants agree that seeking counselling or speaking with a mental health expert is preferred. Stigma, prejudice, misconceptions, religious and traditional beliefs and insufficient government support were perceived as key impediments to care. Community health workers' experiences during COVID-19 were mixed. Awareness campaigns, training, establishing mental health policies, and integrating mental health into communities were identified as facilitators of mental health care. Conclusion The findings have shown that developing and implementing a comprehensive multi-agency approach is fundamental in dealing with mental health problems in Sierra Leone. In addition, future larger-scale research should be conducted on the underlying cultural principles and traditions regarding mental illness and the status of mental health care provision in Sierra Leone.

Relatively few studies have explicitly examined whether and how shelter-type, temporary or emergency accommodation shapes homeless clients’ personal (mental health) recovery. A transatlantic phenomenological qualitative study was conducted to examine the influence of those services on personal recovery. Eighteen chronically homeless adults with a history of serious mental illness were recruited from several temporary accommodation services in New York City (NYC), U.S., and Glasgow, Scotland. Participants completed repeat in-depth interviews and a novel one-week multimedia mobile phone diary. The interpretative phenomenological analysis (IPA) produced three overarching group experiential themes: ‘everything was just starting to fall into place’; ‘caught in a trap’; and ‘trials and tribulations’. Collectively, the findings underscore the duality of influence of temporary accommodation on recovery. Those ambiguous spaces confronted participants with existential uncertainty, volatility and chronic boredom, but also proffered opportunities for envisioning and enacting recovery. Embarking on recovery while residing in temporary accommodation is possible, even for those enduring chronic life adversity. However, it is contingent upon enabling socio-material, affective and relational resources. Implications are discussed for theorising recovery as a contextually embedded, relational phenomenon, and for providing recovery-oriented support across the housing continuum.

This qualitative investigation explored how 18 chronically homeless adults with serious mental illness residing in emergency and temporary supportive housing facilities in Glasgow, Scotland, and New York City conceptualized personal recovery. Thirty-six interviews were conducted and analyzed using interpretative phenomenological analysis. The analysis produced four superordinate themes revealing how participants engaged with, envisioned, or disidentified with, the recovery idea, in the context of chronic life adversity, co-occurring conditions, a precarious present and an uncertain future. Health and social care providers should be responsive to clients’ diverse ideas about recovery and facilitate their exploration of authentic pathways to a “good life.”

Psychiatry requires a unique blend of knowledge, skills and attitudes, with important ethical and philosophical issues intrinsic to the specialty. Although teaching is an important part of training and working as a psychiatrist, this is often carried out without any specific training in educational theory or practice. This book teaches readers how to apply educational theory in this complex setting to provide the best possible learning experience for students. Chapters are short and focused, allowing the busy psychiatrist or other professional involved in undergraduate psychiatry teaching to pick it up, absorb some of the principles, and start applying them straight away to improve their teaching. Contributions from individuals with lived experience throughout the book provide insight into the patient experience and how this can be sensitively and effectively incorporated into undergraduate teaching and the benefits that can be gained from doing so.

Purpose This paper aims to present findings from 440 responses regarding the experiences of supervision, coping and well-being of 83 service providers and policymakers from eight countries working to support children’s well-being during the COVID-19 pandemic. Design/methodology/approach A smartphone survey hosted on a custom-built app was used. The data were analysed using qualitative content analysis. The data were gathered in the last quarter of 2020. Findings While most respondents described the supervision they received as “useful” – both personally and professionally – and reported several characteristics of effective supervision practices, concerns about not receiving optimal support were also voiced. Respondents shared a range of stress management and other self-care practices they used but also revealed their difficulties optimally managing the stresses and anxieties during the COVID-19 pandemic. As a result, some respondents shared they were feeling helpless, unmotivated and unproductive. Yet, overall, responses were imbued with messages about hope, perseverance and self-compassion. Originality/value Using a bespoke smartphone app, rich and intimate insights were generated in real time from a wide range of professionals across high- and low- and middle-income countries – indicating the need to better support their well-being and service delivery.