Deborah Oyine Aluh

Health-related quality of life (HRQOL) is a crucial aspect of overall well-being. The study employed a cross-sectional design using the EuroQol-5 Dimensions-5 Levels (EQ-5D-5L) and EuroQol-Visual Analogue Scale (EQ-VAS) to evaluate the HRQOL of 280 randomly selected small-scale farmers in rural communities in southeastern Nigeria. Pearson's correlations were used to examine the nature of associations between socio-demographic factors and the EQ-5D and EQ-VAS index scores. All statistical tests were considered significant at < 0.05. Results showed that the means of EQ5D index and EQVAS scores were 0.838 ± 0.091 and 81.88 ± 27.38 respectively. Findings revealed that the most prevalent problems reported were pain/discomfort and anxiety/depression. The level and ways which these problems impact on the farmers and their livelihood were discussed. Understanding the impacts is important, especially as economic diversification agendas in emerging economies focus on sustainable agriculture. The study highlights the importance of mental health of the farmers and job satisfaction to food production and sustainability. Achieving sustainable agriculture in the fourth industrial revolution requires comprehensive policies focused beyond products to include farmer's mental health.

Women with disabilities are two to five times more likely to experience domestic violence (DV), including intimate partner violence (IPV), when compared with women without disabilities. Survivors of DV and IPV are around three times more likely than women without this life experience to develop mental health conditions or a psychosocial disability.
To explore the perspectives of women with disabilities who are survivors of DV and IPV about their help-seeking experiences and their use of mental health services in Lithuania.
A qualitative explorative study was implemented within an experiential framework. Semi-structured interviews (n = 15) were conducted with women-survivors of DV who have sensory, physical, psychosocial, and intellectual disabilities. Audio recordings were transcribed verbatim and analysed thematically using MAXQDA software.
The key findings highlight the complex intersection between gender, disability, and DV, including IPV. Women with disabilities may be extremely dependent on their abusers for daily individual support and may also experience disability-based violence as a result of this situation. Societal stigma and victim-blaming attitudes, as well as the lack of community-based services, may prevent survivors from seeking help. However, those who do may benefit greatly from support provided by mental health services.
Further qualitative and quantitative research concerning the interlink between the areas of gender, disability, DV and IPV, and the provision of mental health services is needed, especially about what interventions might be the most effective for this particular population.

Survivors of intimate partner violence (IPV) are at an increased risk of developing mental health conditions.
To examine the perspectives and perceptions of mental health professionals on their provision of mental healthcare to IPV survivors and to hear the lived experiences of IPV survivors regarding their use of mental health services in Portugal.
An online survey was conducted to gather data on the experiences of IPV survivors who had or had not accessed mental health services in Portugal. Additionally, two focus groups involving 17 mental health professionals were held. Audio recordings were transcribed verbatim, and the data were thematically analysed using MAXQDA software.
Both IPV survivors and mental health professionals frequently acknowledged the critical role of mental health support in the recovery process for individuals who experienced IPV. However, professionals often lack sufficient specialised knowledge to address the complexities of IPV, potentially leaving survivors' mental healthcare needs inadequately met.
Comprehensive approaches are required, including trauma- and violence-informed care, multi-disciplinary collaboration, and inter-sectoral efforts. Further research is essential to investigate the nuances of mental health service utilisation by IPV survivors and to identify the most effective interventions for this population across diverse geographical and cultural settings.

Postpartum depression (PPD) is an important public health problem which often goes unrecognized and untreated, especially in low-income settings. Poor mental health literacy of community members has been shown to create barriers to help-seeking for PPD.
The study assessed the mental health literacy of postpartum depression (PPD) among staff members in a Nigerian university.
This was a cross-sectional survey that employed a case vignette format. A questionnaire, consisting of a socio-demographic form and a case vignette, was distributed to a convenient sample of 400 staff members in the faculties of pharmaceutical sciences, veterinary medicine, and agricultural sciences. Data were analysed using the IBM SPSS Statistics (version - 20). Descriptive analysis (frequencies, percentages, mean, and standard deviations) were used to summarize the findings. The relationship between socio-demographic characteristics and knowledge score of PPD was assessed using chi-square analysis. Statistical significance was set at p-value ˂0.05.
The majority of the respondents were females 195 (54.0%) and were between 18 and 30 years of age (35.5%). Only 16.3% of respondents correctly identified PPD and nearly half (44.9%) of the respondents opined that the condition is 'very serious. Poor knowledge of PPD was statistically significant associated with age [X
(4) = 18.252, p = 0.001], marital status [X
(3) = 16.888, p = 0.001], and educational qualification [X
(3) = 59.729, p = < 0.001], while medical help- seeking of PPD was statistically significant associated with age [X
(4) = 13.982, p = < 0.007], and educational qualification [X
(3) = 10.716, p = < 0.013].
The overall knowledge of postpartum depression among the staff members of the university was relatively poor and more female staff members than male staff members could identify postpartum depression. The study findings highlight the need to create awareness and improve knowledge of PPD through campaign-specific mental health programmes, educational programmes, integration of mental health programmes for university staff development to aid in early identification, intervention, media, and other targeted strategies such as creating a culture that encourages open discussions about mental health and provides accessible support services and, developing and implementing policies that address mental health in the university and the country at large.

The subjective experience of coercion may have a more significant impact on clinical outcomes than formal coercive measures. This study aimed to investigate the subjective experience of coercion among patients on admission in Portuguese psychiatric departments by assessing their perceived coercion, procedural justice, and negative pressures during admission. The study also investigated whether this subjective experience of coercion changed with time during admission, and the predictors of this change. Validated instruments, including the McArthur Admission Experience Survey (AES) and the Client Assessment of Treatment Scale, were used to collect information from 208 adults admitted to five public psychiatric inpatient departments in rural and urban regions of Portugal. About a third (32.24%, n = 49) of the sample had a legal involuntary admission status, while more than a third of them perceived their admission to be involuntary (40.13%, n = 61). The subjective experience of coercion was significantly higher among people who perceived their admission to be involuntary compared to people who perceived their admission to be voluntary (Median = 10, IQR = 5.5 vs. Median = 3, IQR = 6; p < 0.001). Satisfaction with their care was significantly inversely correlated with the subjective experience of coercion (p < 0.01). The changes in the subjective experience of coercion at the second assessment were predicted by the perceived admission status rather than the legal admission status, and the initial procedural justice (p < 0.05). The study findings highlight the importance of improving procedural justice in psychiatric admissions, regardless of the legal status of admission.

Purpose: Most studies on supported accommodations (SAs) for people with serious mental disorders have focused on effectiveness. Very few analysed the experiences and expectations of residents and professionals of SAs, which is fundamental to improving care. This study aimed to explore in depth the perspectives of residents and professionals of SAs in Portugal regarding the residents' previous contacts with mental health services, current experiences, and expectations. Methods: A purposeful sample of 11 residents and 11 professionals from 11 different organisations managing SAs in Portugal was included. Semi-structured interviews were conducted using interview guides to assess previous experiences with mental health services, expectations, and suggestions to improve care. Thematic analysis was used. Findings: Residents had a long history of mental health problems and contact with mental health services. Most had been referred to SAs due to poor family or social conditions. The majority of residents expected to stay at the SAs in the long-term, and did not mention major suggestions to improve. Professionals suggested several improvements, such as having more time allocation to work with the residents and revising maximum limits of lengths of stay. Conclusions: Residents are seldom involved in decision-making. However, most were satisfied with care and hoped to remain in the SAs. Implications of this study apply to the political level (regarding the financing of SAs and the provision of community mental health care and other social supports) and to the clinical level (regarding training and family interventions).

For the first time, Nigeria has enacted a new mental health law that regulates the use of coercive measures in mental health care.
The study aimed to investigate the extent to which the Nigerian public accepts the use of coercive measures in the treatment of people with mental health conditions and to understand the impact of stigma and other sociodemographic characteristics.
A cross-sectional survey was conducted among 615 adult respondents from Nigeria's six geopolitical zones. The study instrument included a case-specific vignette, a social distance scale, and a brief sociodemographic form. Descriptive and inferential statistics were conducted with SPSS v.25 software.
More than half of the study respondents agreed that the vignette character should be forced to go to the hospital if he refuses to go (65%,
 = 400), and he should be forced to take medications at the psychiatric hospital (55.1%,
 = 339). The least accepted coercive measure was Isolation (28.8%,
 = 177). There were significant associations between social distance and the acceptance of involuntary admissions, forced medication, mechanical restraints, and isolation (
 < .05). Social distance score was highest among respondents who agreed that the vignette character should be isolated (24.023 ± 5.503;
 = 24.672,
 < .001).
The study highlights variations in public attitudes toward coercive psychiatric measures, within the Nigerian context compared to other countries. The lower acceptance rates for isolation as a coercive measure underscore the cultural importance of social interaction in Nigeria. The relatively recent implementation of Nigeria's Mental Health Act also suggests a potential gap in public knowledge regarding the criteria for coercive measures. Future research should aim to include diverse populations and consider longitudinal approaches to assess changes in public attitudes as awareness of mental health legislation increases.

In this chapter, we introduce some of the key ideas relating to the use of coercion in mental health services around the world. This introduction focuses upon clarifying the key terms in the area, providing an historical overview of the topic, and considering current evidence on contextual factors which are linked to high and low rates of coercion. We also consider attempts to estimate coercion rates in different countries around the world and start to examine the question of whether coercion can ever be justified on the basis of ‘best interest’. Finally, we note some of the interventions which have shown the most promise in enabling organisations to reduce their reliance on coercive interventions and move towards a fully human rights-based approach to mental health care. This chapter therefore provides a basis for consideration of the many issues raised throughout this volume.