Thursday, 31 August 2017

Youth in Mental Health Series: #1

INTRODUCTION TO THE SUSTAINABLE DEVELOPMENT GOALS (SDGs)

At the beginning of the new millennium, 189 members of the United Nations (UN) signed the Millennium Development Goals (MDGs) declaration to guide development cooperation from 2000 to 2015. This declaration included 8 goals, 16 targets and 48 indicators.  In 2012, the UN conference on sustainable development (or RIO +20) took place in Rio De Janeiro, Brazil from the 20th-22nd June and the UN Commissions on Sustainable Development (UNCSD) established an open working group on the post 2015 agenda. This resulted in the adoption of 17 SDGs by the UN General Assembly on the 25th of September 2015. The SDGs will serve as the Global Development Benchmark up to 2030. The 17 SGDs are listed below as follows:


Kenya’s vision 2030
Vision 2030 is the country’s development blueprint covering the period 2008-2030. It aims to “transform Kenya into a newly industrializing middle income country providing a high quality life to all its citizens by 2030.” The vision is based on three pillars:
·         Economic- Aims to improve the prosperity of Kenyans through an economic development programme covering all regions in the country and aiming to maintain a sustained economic growth of 10% p.a starting in 2012.
·         Social- Seeks to build a just and cohesive society with social equity in a just and secure environment.
·         Political- An issue based, people centred, result-oriented and accountable political system.

Linking SDGs to the vision 2030 pillars
The SDGs are linked to the three vision 2030 pillars as shown below:


Economic Pillar
Goal 1: End poverty
Goal 2: Zero Hunger
Goal 8: Decent work and economic growth
Goal 10: Reduced Inequality
Social Pillar
Goal 3: Good Health and Well-being
Goal 4: Quality Education
Goal 5: Gender Equality
Goal 6: Clean water and Sanitation
Goal 7: Affordable and clean energy
Goal 9: Industry, Innovation and Infrastructure
Goal 11: Sustainable cities and communities
Goal 12: Responsible consumption and production
Goal 13: Climate Action
Goal 14: Life below water
Goal 15: Life on Land
Political
Goal 16: Peace and justice strong institutions
Goal 17: Partnerships to achieve the goal

References
United Nations Website
Kenya Vision 2030 publication

Youth in Mental Health Series


  • Mental health is the leading cause of disability worldwide?
  • Every 40 seconds someone in the world takes their own life?
  • Over 75% of mental health conditions manifest themselves by the age of 24?
  • Cities have the highest prevalence rates of mental illness?
  •  By 2030 depression alone will become the largest cause of disability worldwide?          



The above facts may be surprising to many, if not most; many of us do not really comprehend the magnitude of the mental health burden in society. This is attributable to the fact that there’s still a lot of stigma surrounding mental health and as is expected, information on this topic is limited. The new UN sustainable development goals (SDGs) have put young people at the centre of the Agenda; In this series, I will explore the youth mental health burden in Sub Saharan Africa. I will also simplify some of the available information including an introduction to the SDGs ( in the local context) and their relation to mental health as well as other mental health policy documents in a 'youth-friendly' manner. This series also seeks to highlight the different efforts put in place to address youth mental health in various contexts.

Friday, 25 August 2017

Adolescent Nutrition and Mental Health

Our brain is always “on.” It takes care of our thoughts and movements, our breathing and heartbeat, our senses; it works hard 24/7, even while we’re asleep. Our brains therefore require a constant supply of fuel. This “fuel” comes from the foods we eat.

Many of us already know that when we make healthy food choices we tend to feel better, and when we eat heavy, sugary foods we can feel tired or sluggish. Therefore, it should come as no surprise that there is considerable evidence to suggest that nutrition can have an impact on mental health as well as physical health. What you eat directly affects the structure and function of your brain and ultimately, your mood.  This is especially true for young people.

Eating high-quality foods that contain lots of vitamins, minerals, and antioxidants nourishes the brain and protects it from oxidative stress (cell damage caused by free radicals produced when your body uses oxygen). Diets high in refined sugars, for example, are harmful to the brain. In addition to worsening your body’s regulation of insulin, they also promote inflammation and oxidative stress. Multiple studies have found a correlation between a diet high in refined sugars and impaired brain function, and even a worsening of symptoms of mood disorders, such as depression.

Certain foods and dietary supplements, such as fish, fruits and vegetables, and over-the-counter vitamins and supplements can have a positive impact on young people’s mental health. For example, Omega-3 fatty acids, which are found in fish and fish oil, are beneficial to neural functioning.Vitamin D is another supplement that can positively affect mental well-being. Multiple studies have linked vitamin D deficiency to cognitive impairment, depression, bipolar disorder, and schizophrenia. Therefore, many mental health professionals and physicians recommend regular vitamin D intake.

Youth Dietary Practices
Nutrition is especially important during adolescence due to rapid growth and development. The onset of many psychiatric illnesses which coincide with adolescence may be diminished by recommended dietary habits. Additionally, behaviour patterns (such as eating habits) acquired during this time are likely to influence long-term behaviours. However, getting young people to eat healthier is not always easy.

“In a study of 141 adolescents in 7th and 10th grade from two schools in St. Paul, Minnesota, researchers found that the factors that most influence teens’ eating habits were: hunger or cravings; appeal or taste; time available to them; their parents’ eating habits and schedules; and convenience. Time considerations appeared to strongly influence participants’ food choices. Some additional barriers to eating well as reported by participants were: healthy food, such as fruit and vegetables available at school were bruised or “nasty”; healthier food choices were less convenient because some fruits and vegetables require extra preparation time (e.g. peeling, cooking); healthy foods were typically not served at fast-food restaurants; participants also viewed fast-food as less expensive than healthier foods”.

Dietary modifications that increase nutrition can be introduced quickly with minimal to no health risks and could offer significant improvements in physical health, self-esteem, and quality of life. Although getting young people to eat healthy can sometimes be challenging, putting in the effort to help young people eat better can improve their physical and mental well-being. Parents and caregivers can help young people make healthy food choices by keeping fruits and vegetables stocked at home while limiting access to high-fat and sugary foods.

Changing one’s diet to include healthier food choices can be challenging, especially for young people. It can take months or even years. Encouraging, celebrating and modelling these behaviours as well as teaching adolescents how to make quick, tasty, healthy foods can be very beneficial especially as they transition into adulthood. Putting in the effort to encourage adolescents to make smart food choices can help them build healthy habits that could have a positive impact on their physical and mental health.

References
Walsh, R. (2011). Lifestyle and mental health. American Psychologist, 66, 579-592.
Amminger, P. G., Schafer, M. R., Papageorgiou, K., Klier, C. M., Cotton, S. M., Harrigan, S. M.,. . . Berger, G. E. (2010). Long-chain ω-3 fatty acids for indicated prevention of psychotic disorders. Archives of general Psychiatry, 67(2), 146-154
Backman, D. R., Haddad, E. H., Lee, J. W., Johnson, P. K., & Hodgkin, G. E. (2002). Psychosocial predictors of healthful dietary heavier in adolescents. Journal of Nutritional Education and Behavior, 34, 184-193.

Neumark-Sztainer, D., Story, M., Perry, C., & Casey, M. A. (1999). Factors influencing food choices of adolescents: Findings from focus-group discussions with adolescents. Journal of the American Dietetic Association, 99, 929-937.

Thursday, 24 August 2017

HEPATITIS

The 28th of August is internationally recognized as World Hepatitis day.  In commemoration of the day and its activities, here's a brief introduction to the Hepatitis virus and a highlight of some of the key messages the World Health Organization will share on the day. 

Hepatitis is a condition characteristic of inflammation of the liver. The condition can be self-limiting or can progress to fibrosis (scarring), cirrhosis or liver cancer. Hepatitis viruses are the most common cause of hepatitis in the world however other infections, toxic substances (e.g. alcohol, certain drugs), and autoimmune diseases can also cause hepatitis.
There are 5 main hepatitis viruses, referred to as types A, B, C, D and E. These 5 types are of greatest concern because of the burden of illness and death they cause and the potential for outbreaks and epidemic spread.  Hepatitis A and E are typically caused by ingestion of contaminated food or water. Hepatitis B, C and D usually occur as a result of intramuscular/intravenal (parenteral) contact with infected body fluids. Types B and C have the highest burden of illness and death as they lead to chronic disease in hundreds of millions of people and, together, are the most common cause of liver cirrhosis and cancer. Acute infection may occur with limited or no symptoms, or may include symptoms such as jaundice (yellowing of the skin and eyes), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.

 Transmission
 Common modes of transmission for these viruses include:
·         receipt of contaminated blood or blood products
·         invasive medical procedures using contaminated equipment and
·         transmission from mother to baby at birth, from family member to child, and also by sexual contact (Hepatitis B)

Treatment
Getting vaccinated is the best way of preventing hepatitis B infection. More than one billion doses of the hepatitis B vaccine have been used since the early 1980s and it has been shown to be effective in approximately 95% of cases. There is currently no vaccine for hepatitis C.

Key messages for world Hepatitis day 2017
Viral hepatitis is a major global health problem and needs an urgent response.
There were approximately 325 million people living with chronic hepatitis at the end of 2015.
Globally, an estimated 257 million people were living with hepatitis B (HBV) infection, and 71 million people were living with hepatitis C (HCV) infection in 2015.

Very few of those infected accessed testing and treatment, especially in low- and middle-income countries.
By the end of 2015, only 9% of HBV-infected people and 20% of HCV-infected people had been tested and diagnosed. Of those diagnosed with HBV infection, 8% (or 1.7 million people) were on treatment, while 7% of those diagnosed with HCV infection (or 1.1 million people) had started treatment in 2015.

Viral hepatitis caused 1.34 million deaths in 2015 - comparable with TB deaths and exceeding deaths from HIV. Hepatitis deaths are increasing.

New hepatitis infections continue to occur, mostly hepatitis C.
The number of children under five living with chronic HBV infection was reduced to 1.3% in 2015 (from 4.7% before vaccines were introduced).
Hepatitis B vaccine is preventing approximately 4.5 million infections per year in children.
However, 1.75 million adults were newly infected with HCV in 2015, largely due to injecting drug use and due to unsafe injections in health care settings in certain countries.

Achieving the 2030 elimination goal is not overly ambitious
WHO's Global Health Sector Strategy on viral hepatitis aims to test 90% and treat 80% of people with HBV and HCV by 2030. WHO will share progress reports from 28 countries tackling HBV and HCV as evidence to this. 

Friday, 18 August 2017

citiesRISE Youth Symposium

citiesRISE in collaboration with Basic Needs UK in Kenya held a symposium at the Multimedia University, Nairobi on 1/8/2017 targeting youth leaders in Kenya in the realm of mental health. Organizations represented at the symposium included:
  • Amazing minds Africa Amazing minds Africa
  • Beyond Sciences Initiatives
  • Napo care
  •  Nzumari Africa
  •  Pacific Arts and Training
  •  SOWED
  •  Mental health awareness centre
  •  The Mental Health organization
  •  USP-Kenya
  • Youth on the move
  • Zwara Arts and Theatre consultancy
  • Beautiful Minds

The workshop had two main objectives:
  • ·         To identify the main mental health challenges young people face in Nairobi
  • ·         Discuss the major barriers and opportunities to responding to these challenges

Introduction to citiesRISE
“citiesRISE is a global platform committed to transforming the state of mental health policy and practice in cities and beyond to meet the mental health needs of populations across the world, especially the youth. citiesRISE believes that cities have a central role to play in rapidly changing the current trajectory of mental health policy, practice and other related systems. It therefore exists to tackle the urgent need to improve mental health through collective action in major cities that will catalyse systemic change across sectors”. This platform is unique in that it targets critical system changes through bringing together the various strengths and expertise of diverse leaders and institutions to model and build collaborative projects that will meaningfully address mental health.

The citiesRISE youth platform was created to support the youth to become agents of change in mental health by focusing on practical effort on the ground and local collective action. citiesRISE seeks to focus on young people and youth leadership to “create awareness of mental health and mobilize other youth leaders in the field to address wide-scale stigma and prevent mental health challenges before they become chronic or disabling.

citiesRISE has three key areas of focus:
  • ·         Research on the social determinants of youth mental health
  • ·         Networking capacity for youth-led organizations
  • ·         Mobilize funding and resources for youth-led initiatives


In terms of impact, citiesRISE focuses on four key areas:
  • ·         Closing data gaps
  • ·         Increasing access to mental health
  • ·         Safe and effective use of technology
  • ·         Eliminating stigma around mental health

Mental health challenges youth in Nairobi face
The main challenges the youth in Nairobi face with regards to mental health include:
  • ·         Negative/harmful cultural beliefs – witch craft is a cause of mental illness; cultural silence around mental health  and drug/substance abuse
  • ·         Lack of knowledge and information on mental health care and available services
  • ·         Economic constraints affecting the day-to-day activities of the youth
  • ·         Lack of data on mental health; there are no measurable parameters on mental health matters
  • ·         Lack of accountability on who is supposed to address adolescent and youth mental wellbeing- is it parents or teachers and other institutions?
  • ·         System failure- educational , religious and administrative institutions are shifting blame instead of directly addressing the issues around mental health presented to them
  • ·         Negative approach to mental health illness and disorders


The identified challenges were grouped under four main thematic areas: Data, Access to services, Technology and Stigma. Discussions were held around the major barriers and opportunities to responding to the issues identified under the four key areas and how activities can be incorporated into the citiesRISE strategic framework in line with the ministry of health mental health priorities.

Youth leaders identified the skills they thought they would need in order to contribute to improving people’s mental health. Some of the identified skills are listed below:
  • ·         Public speaking skills
  • ·         Facilitation skills
  • ·         Problem solving and program implementation skills
  • ·         Marketing and branding skills
  • ·         Proposal and report writing skills
  • ·         Monitoring and evaluation skills
  • ·         Effectively using social media to create mental health awareness
  • ·         Entrepreneurial skills
  • ·         Good communication and interpersonal skills
  • ·         Pitching skills

Moving forward, citiesRISE will work with youth leaders and offer support through:
  • ·         Creating exposure to other youth leaders working on mental health elsewhere to allow for cross coordinating of ideas possibly through an online convening’s
  • ·         Creating shared commitments- a global voice of young people together.
  • ·         Providing technical and leadership support to youth-led initiatives
  • ·         Organizing skills development workshops for youth leaders
  • ·         Profiling to ensure that all youth leaders are aware of what other youth-led organizations are doing

N/B: The citiesRISE Nairobi youth platform was created to allow like-minded youth leaders stay connected, collectively work towards tackling stigma associated with mental health and create awareness in the country. Youth leaders also use the platform to organize monthly convening’s and other activities addressing mental health.


Written by: Cynthia Buku, Basic Needs UK in Kenya Youth Fellow

Thursday, 17 August 2017

Training on CorStone's Emotional Resilience Curriculum: My Experience

“Resilience is the ability to achieve positive life outcomes despite significant stress, challenge, or adversity”. The youth face adversity in many aspects of their lives, such as threats to their emotional, physical, educational, financial, or career-related well-being. “Resilience in emotions, thoughts and behaviours, which is referred to as ‘emotional resilience’ has been proven to be integral in fostering resilience for adolescents across all other domains and they may able to overcome or successfully ‘bounce back’ from such challenges.” This training thus focused on building emotional resilience among the youth so as to enable them to not only cope, but thrive when faced with difficult or stressful situations.
The training was an introduction to the CorStone’s emotional resilience curriculum and sought to equip myself and other participants with the facilitation skills necessary to train and support program implementers. 

The following topics were covered:
  • ·         Listening skills
  • ·         Character strengths
  • ·         Goal setting
  • ·         Identifying feelings
  • ·         Benefit finding
  • ·         Managing difficult emotions
  • ·         Assertive communication
  • ·         Managing conflict with restorative practices
  • ·         Problem solving
  • ·         Identifying and opposing violence
  • ·         Forgiveness


Three techniques were used to ensure that I gained the practical knowledge and skills necessary to enable me to facilitate sessions:
·         Interactive sessions- This helped me contextualize emotional resilience to my current situation
·         Role play and case scenarios – This enabled me to demonstrate how I would put into practice the newly learnt skills when responding to specific situations.
·         Personal activities, group discussions and presentations- This exposed me to different views and opinions on issues related to the training topics covered and broadened my knowledge on some of the challenges the youth face on a day to day basis.

Highlights of the three day training activity
Day 1: I was introduced to the CorStone’s resilience curriculum where the significance of an opening and closing circle at the beginning and end of every session was explained; ‘just as a circle has no beginning nor end, everyone is linked and connected to each other thus symbolizing equality’ This stressed the fact that everyone’s views and opinions should be respected and  made me feel comfortable and accepted from the get go.  By the end of day 1, I was familiar with the 6 core concepts of attitudinal healing and the 4 pillars and skills of facilitation.

Day 2: I learnt about positive psychology and had a chance to go through the 24 character strengths. By the end of the session, I was familiar with the concept of benefit finding and how to use the problem-solving tool to help students choose suitable solutions to their problems.

Day 3: I was introduced to the concept of Active constructive responding. By the end of the session I was familiar with the four different types of responses and the effect they have on one’s thoughts, feelings and attitudes. 

Impact of the training
Through this training, I developed new facilitative skills and was also able to strengthen existing ones as I was presented with numerous opportunities for me to practice the new skills being taught openly during discussions, and through role plays and group exercises.  I am now more aware of my thoughts and emotions because I now know that they are directly linked to my practices. Moving forward, I intend to incorporate the facilitative knowledge and skills learnt from this training into practice when facilitating the same sessions for program implementers and any other facilitative sessions in future. I also intend to use the knowledge learnt to implement a similar project focusing on the youth in church in the near future.


Conclusion
A closing circle concluded the three day training with an exercise asking participants to state what they appreciate about each other after the three days of interaction. This left me and other participants feeling important and appreciated and goes to show how the activities included in the emotional resilience curriculum really do have an effect on an individual.





Written by: Cynthia Buku, Basic Needs UK in Kenya Youth Fellow

Wednesday, 16 August 2017

The Power Of A Morning Routine

By Laura Greenstein 
 
It’s Early. You Don’t Want To Move, Let Alone Get Up And Start The Day. You Feel Drained. You’re Cozy, All Wrapped Up In Blankets. Thoughts About All That You Should Accomplish Today Floods Your Mind. You Feel Overwhelmed, So You Hit “SNOOZE” One More Time.
Uh Oh, Now You’ve Overslept. You’re Running Late. Time To Get Up And Rush Into The Day.
Sound Familiar? Mornings Are Hard, Right? Actually, Mornings Aren’t Definitively Hard—They Can Be Made Easier. 
The Key To An Easier Morning Is To Keep Your First Waking Hour As Consistent As Possible Throughout The Weeks. The More We Struggle To Make Decisions, The More Energy We Deplete. When First Starting The Day, It’s Important To Avoid “Decision Fatigue” By Having A Set Morning Routine.
Having A Morning Routine Can Increase Your Energy, Productivity And Positivity. It Also Generates Momentum, Building Up To The Brain’s Peak Time For Cognitive Work (Late Morning). Here Are A Few Suggestions To Include In Your Morning Routine.
Ease Into The Day

It’s Easier To Lull Yourself Out Of Sleep When You’re Not Rushing Into The Day. You Feel More Motivated To Open Your Eyes And Let Your Body Properly Wake Up When You Have A Little Bit Of Time To Lounge In Bed Without Jumping Up. After A Few Minutes Of Lounging, Follow These Steps:
  1. Open Your Curtains And Let The Natural Light Energize You. Exposing Yourself To Sunlight In The Morning Can Improve Your Alertness And Energy During The Day.
  2. Put Some Upbeat Tunes On—Music Lights Up The Entire Brain.
  3. Do Some Light Stretching To Get Your Blood Flowing.
These Small Things Can Help You Start The Day In A Positive Mood, Rather Than Feeling Stressed To Get Up And Out The Door.
Eat Breakfast
Research Shows That Those Who Eat Breakfast Have More Energy Than Those Who Wait Until Lunch To Eat. While Coffee Will Help Jolt You Awake, Your Body Will Eventually Crash Without Food. You Don’t Need To Feast First Thing In The Morning—A Healthy Snack And Lots Of Water Is All That’s Needed To Start The Day Off Right.
Read
There Are Many Ways To Stimulate Your Brain, But One Of The Most Recommended Methods Is Reading. Reading A Book In The Morning Can Start Your Day In A Richly Detailed Story, “How-To” Or Narrative, As Opposed To A Stressful, Overflowing To-Do List.
Reading Is Considered A “Mental Break,” Because The Brain Is Only Focusing On One Thing Rather Than The Usual Eight Things. You Can’t Multitask While Reading A Book, And What You’re Focusing On Causes You To Think, Use Imagination And Create Your Own Visual Imagery. It’s This Type Of Focus That Gets Our Minds More Nimble And Creative. As The Saying Goes: “Reading Is To The Mind What Exercise Is To The Body.”
Stimulate Your Body
Speaking Of, You Should Also Exercise In The Morning. Exercise Increases Production Of The Neurotransmitters Serotonin And Norepinephrine, Which Enhances The Body’s Ability To Deal With Stressors And Creates A Post-Workout Feeling Of Bliss. Research Shows That You Are More Creative And Productive For The Two Hours Following Exercise. It Also Shows That People Who Exercise Regularly Are Less Stressed At Work And More Able To Maintain Work-Life Balance.
Begin Work With A Proactive Mindset
Psychologist Ron Friedman Explains In An Interview With Harvard Business Review That Our Usual Start To The Work Day—Checking Email, Answering Questions Or Listening To Voicemails—Is, As He Says, “Cognitively Expensive.” Starting The Day This Way Puts You Into A “Reactive” Mindset, And While Switching From A Proactive Mindset To A Reactive Mindset Is Easy, The Reverse Is Much More Challenging. Instead, He Suggests Starting The Workday With A Brief Planning Session: Strategize First, Execute Second.
Using These Tips, Here’s An Example Of What A Healthy Morning Routine Could Look Like:
6:55-7:00 – Slowly Wake Up, And Open Your Eyes.
7:00-7:15 – Open The Curtains, Put On Energizing Music And Do Some Light Stretching.
7:15-7:30 – Eat Some Fruit And Almonds For Breakfast.
7:30-8:00 – Read And Drink Tea Or Water To Get The Mind Stimulated And The Body Hydrated.
8:00-8:30 – Shower (Don’t Forget To Sing!) And Get Ready For Work.
8:30-9:00 – Walk To Work To Get In Some Moderate Exercise.
9:00-9:15 – Begin Work With A Planning Session To Strategize Your Day.
As You Can See, This Routine Takes Two Hours From The Time You Wake Up Until You Get To Work. While It May Be Difficult To Find The Extra Time, You Will Find Yourself Reaping Only Benefits Throughout The Day. Many People Don’t Like Getting Up Early, But This Is The Type Of Routine That Can Help You Actually Enjoy Mornings.