Department of Psychiatry, Kampala International University Western Campus, P.O BOX 71, Bushenyi, Uganda.
Department of Internal Medicine, Masereka General Referral Hospital, Goma, North-Kivu, Democratic Republic of the Congo.
Global Health. 2022 Jul 14;18(1):71. doi: 10.1186/s12992-022-00862-0.
Mental health is mostly affected by numerous socioeconomic factors that need to be addressed through comprehensive strategies. The aftermath of armed conflict and natural disasters such as Ebola disease virus (EVD) outbreaks is frequently associated with poor access to mental healthcare. To design the basis of improving mental health services via the integration of mental health into primary health care in the Democratic Republic of Congo (DRC), we conducted a scoping review of available literature regarding mental illness in armed conflict and EVD outbreak settings.
This scoping review of studies conducted in armed conflict and EVD outbreak of DRC settings synthesize the findings and suggestions related to improve the provision of mental health services. We sued the extension of Preferred Reporting Items for Systematic Reviews and Meta-Analyses to scoping studies. A mapping of evidence related to mental disorders in the eastern part of DRC from studies identified through searches of electronic databases (MEDLINE, Scopus, Psych Info, Google Scholar, and CINAHL). Screening and extraction of data were conducted by two reviewers independently.
This review identified seven papers and described the findings in a narrative approach. It reveals that the burden of mental illness is consistent, although mental healthcare is not integrated into primary health care. Access to mental healthcare requires the involvement of affected communities in their problem-solving process. This review highlights the basis of the implementation of a comprehensive mental health care, through the application of mental health Gap Action Program (mhGAP) at community level. Lastly, it calls for further implementation research perspectives on the integration of mental healthcare into the health system of areas affecting by civil instability and natural disasters.
This paper acknowledges poor implementation of community mental health services into primary health care in regions affected by armed conflict and natural disasters. All relevant stakeholders involved in the provision of mental health services should need to rethink to implementation of mhGAP into the emergency response against outbreaks and natural disasters.
心理健康受众多社会经济因素影响，需要通过综合策略加以解决。武装冲突和埃博拉病毒病（EVD）等自然灾害爆发的后果常常导致获得精神卫生保健的机会减少。为了通过将精神卫生纳入刚果民主共和国（DRC）初级卫生保健来改善精神卫生服务，我们对武装冲突和 EVD 爆发环境中精神疾病的现有文献进行了范围综述。
本研究对 DRC 武装冲突和 EVD 爆发环境中的研究进行了范围综述，综合了与改善精神卫生服务提供有关的研究结果和建议。我们使用了对系统评价和荟萃分析的扩展来进行范围综述。对通过对电子数据库（MEDLINE、Scopus、Psych Info、Google Scholar 和 CINAHL）进行搜索确定的 DRC 东部地区精神障碍相关证据进行了映射。由两名评审员独立进行筛选和数据提取。
本次综述确定了七篇论文，并以叙述方式描述了研究结果。结果表明，精神疾病负担是一致的，尽管精神卫生保健并未纳入初级卫生保健。获得精神卫生保健需要让受影响的社区参与到他们的解决问题过程中。本次综述强调了通过在社区一级实施心理健康差距行动方案（mhGAP）来全面实施精神卫生保健的基础。最后，它呼吁对将精神卫生保健纳入受内乱和自然灾害影响地区卫生系统的整合进行进一步的实施研究。
本文承认在武装冲突和自然灾害影响地区，将社区精神卫生服务纳入初级卫生保健的实施情况不佳。所有参与提供精神卫生服务的相关利益攸关方都需要重新考虑将 mhGAP 纳入针对疫情和自然灾害的应急响应。
