Evidence on the global burden of depression

Major Depression in the Population: A Public Health Approach AND
You are the coordinator of an international nutrition program in refugee camps, including a refugee camp in Tanzania. Most of the refugees in this camp have fled violence from the Democratic Republic of the Congo, and the size of the camp is increasing because of the intensification of armed violence there. The nutrition organization that you have been working for has been implementing programs to promote breastfeeding, and appropriate infant and young child feeding practices. You have been told that program staff are facing difficulties, and you decide to visit the site to see for yourself what is going on. In your meeting with some of the community health workers who are implementing the program, you hear of women living in very challenging circumstances. A group of women seems to be very tired and have lost the energy to engage with daily routines. You suspect that mental health may play a role, and decide to ask further questions and write a report about this to your organization’s headquarters.

Question 1:

Recognizing depression: What would you ask the community health workers in order to identify if maternal depression may be an important factor in this scenario? Name at least five types of problems that depressed women may describe. Also, provide an example – based on the lectures or other experiences – of how emotional difficulties may be experienced differently across cultures.

The maternal depression is one of common public health problem that spread widely. In given scenario many risk factors that could cause maternal depression for women within this camp. Most important risk factor is being a refugee, as well as no or low-income women and women with low levels of education. Also women feel insecure and unsafe environment they live in consider a risk factor for maternal women to get maternal depression. However,

The burden of depression: Citing existing evidence on the global burden of depression from lectures 1 and 2, describe why thinking of depression makes sense in this scenario.

Relations with functioning: Describe how depression may interfere with daily functioning in this camp. Discussing findings on the natural history of depression, what is one reason why depression has such a large impact on people’s functioning?

Question 2:

You have conducted further assessments and found that maternal depression is indeed a major factor that impacts women. Your organization responds positively to your report, and provides additional resources to address maternal depression as part of your nutrition program.

Describe how you would develop an intervention, based on the following considerations:

– Emic perspectives: Which qualitative research methods could you use to understand the causes and consequences of emotional difficulties from the camp’s inhabitants perspectives?

– Etic perspectives: What are some of the studied risk factors for depression that women may face in this scenario (name at least 2)?

– Protective factors: What are some of the studied protective factors for depression that women may benefit from in this scenario (name at least 2)?

– Intervention options: Name a treatment that has been shown to effectively reduce (maternal) depressive symptoms. Who in the camps could potentially be trained to deliver the intervention?

If depression would indeed be a major concern, what types of interventions would be available?

You have been assigned a new position in the agency DepressionCare, a non-governmental organization with the goal of expanding and improving diagnosis and treatment of depression in a disadvantaged community setting. You have limited resources, but numerous options. You can invest all your resources in (1) a public campaign to de-stigmatize treatment seeking for depression, (2) an initiative to improve detection and treatment of major depression in primary care settings, or (3) an initiative to improve the quality of care for patients with depression treated in specialty mental health clinics and hospitals.

Question 1:

Which one of these initiatives will you choose? Remember, you cannot choose more than one. Describe your program in some detail. Justify your choice of program by giving at least two reasons based on the lectures in the course, scientific literature, and/or your relevant experiences. Be sure to identify the information sources you used to inform your decision. Your justifications could relate to the cost of the program, the type and number of individuals who would most benefit from the program, or the outcomes of similar initiatives used for depression or other health conditions in the past. You must also justify why you decided NOT to select the other two alternatives, again based on cost, type of individuals, or outcomes.

Question 2:

What health, mental health or social outcomes linked to depression did you consider when choosing one initiative over another? How would you go about measuring and monitoring to see if your initiative has had the desired outcome? Use what you have learned from the lectures, scientific literature, or past experience to choose an outcome measure and a research design to measure and monitor the outcome. Identify one potential outcome that would not serve as a good indicator of program success and justify your decision to exclude this outcome. Again, be sure to identify the information sources (lectures, scientific literature, and/or relevant experience) that you have used to inform your decision.

Its four questions no criteria maximum 750 words for each question the first 2 are about refugee health (maternal depression) the last 2 questions are about depression care

(1)

Recognizing depression: What would you ask the community health workers in order to identify if maternal depression may be an important factor in this scenario? Name AT LEAST FIVE types of problems that depressed women may describe. Also, provide an example – based on the lectures or other experiences – of how emotional difficulties may be experienced differently across cultures.

The burden of depression: Citing existing evidence on the global burden of depression from lectures 1 and 2, describe why thinking of depression makes sense in this scenario.

Relations with functioning: Describe how depression may interfere with daily functioning in this camp. Discussing findings on the natural history of depression, what is one reason why depression has such a large impact on people’s functioning?

(2)

You have conducted further assessments and found that maternal depression is indeed a major factor that impacts women. Your organization responds positively to your report, and provides additional resources to address maternal depression as part of your nutrition program.

Describe how you would develop an intervention, based on the following considerations:

Emic perspectives: Which qualitative research methods could you use to understand the causes and consequences of emotional difficulties from the camp’s inhabitants perspectives?

Etic perspectives: What are some of the studied risk factors for depression that women may face in this scenario (name at least 2)?

Protective factors: What are some of the studied protective factors for depression that women may benefit from in this scenario (name at least 2)?

Intervention options: Name a treatment that has been shown to effectively reduce (maternal) depressive symptoms. Who in the camps could potentially be trained to deliver the intervention?

If depression would indeed be a major concern, what types of interventions would be available.

(3 & 4)

You have been assigned a new position in the agency DepressionCare, a non-governmental organization with the goal of expanding and improving diagnosis and treatment of depression in a disadvantaged community setting. You have limited resources, but numerous options. You can invest all your resources in (1) a public campaign to de-stigmatize treatment seeking for depression, (2) an initiative to improve detection and treatment of major depression in primary care settings, or (3) an initiative to improve the quality of care for patients with depression treated in specialty mental health clinics and hospitals.

(3)

Which one of these initiatives will you choose? Remember, you cannot choose more than one. Describe your program in some detail. Justify your choice of program by giving at least two reasons based on the lectures in the course, scientific literature, and/or your relevant experiences. Be sure to identify the information sources you used to inform your decision. Your justifications could relate to the cost of the program, the type and number of individuals who would most benefit from the program, or the outcomes of similar initiatives used for depression or other health conditions in the past. You must also justify why you decided NOT to select the other two alternatives, again based on cost, type of individuals, or outcomes.

(4)

What health, mental health or social outcomes linked to depression did you consider when choosing one initiative over another? How would you go about measuring and monitoring to see if your initiative has had the desired outcome? Use what you have learned from the lectures, scientific literature, or past experience to choose an outcome measure and a research design to measure and monitor the outcome. Identify one potential outcome that would not serve as a good indicator of program success and justify your decision to exclude this outcome. Again, be sure to identify the information sources (lectures, scientific literature, and/or relevant experience) that you have used to inform your decision.

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