Table 2.

Study themes and key findings.

Theme	Subtheme	Key findings	Studies
HIV and mental health	Depression	High prevalence of depression among people living with HIV (PLWHIV)Predictors of depression in PLWHIV are lower education, higher income, lack of control in sexual decision making and living in a rural area	26–30
	Neurocognitive disorders	High prevalence of cognitive disorders	30,31
	Prevalence	HIV is more prevalent in mentally ill female inpatients	32
	Sexual behaviour	Batswana men had higher scores on a sexual addiction screening test than American men	33
	Psychosocial issues/distress	Issues among children include behavioural problems, family issues and HIV medication adherence	34,35
	Stigma	Mentally ill patients are stereotyped as dangerous and untrustworthy, and discriminated against	36
Substance use	Prevalence and predictors	Alcohol is the most used substance in BotswanaAlcohol use is associated with depression and sleep abnormalitiesHaving drinking friends and alcohol availability are associated with drug useReligiosity protects against drug use Alcohol abuse is a risk factor for developing multidrug-resistant tuberculosisCannabis use disorder is associated with academic stress and an allowance of more than 150 USD per month. Religiosity is protectivePredictors of tobacco smoking include positive attitudes, subjective norms, perceived behavioural control and intention	40–42,45,46,73
	Interventions	A behavioural activation/problem solving intervention for smoking cessation was found to be feasible and acceptable	47
	Sexual behaviour	Alcohol use and psychological distress contribute to risky sexual behaviour among adolescents	33,43
	Gender-based violence	Alcohol abuse increases the risk of gender-based violence	44
Stress-related disorders	Trauma	PTSD symptoms were high in spouses of patients recently discharged from intensive care units	37
	Stress	Availability of social relationships is associated with better physical and mental health and independence levelStudents are likely to use problem-solving strategies to cope with stressCortisol provides an adaptive boost to meet daily demands	38,39,74
Depression	Depression	Stressful life events predict depression in university studentsA high rate of depression is associated with parental/childhood drug use, physical assault, failed urban migration and psychological aggressionLocus of control is associated with depression	48–51,53
	Childhood trauma	Sexual abuse is the most experienced childhood trauma and predicts depression in adulthood	52
Work-related factors	Stress	There is no association between performance appraisal and perceived stressOccupational stress is associated with psychosomatic complaints	56,57
	Trauma	PTSD is high among mental health workersHigh neuroticism and exposure to violence in the past 12 months are associated with PTSD	58
	Physical violence	There is a high rate of patient violence toward mental health workersNurses experience more physical violence than other mental health staff	54
	Burnout	A high degree of burnout was found in registrars and this was related to insufficient salary and limited medical resources	55
Tools	Validation	The psychometric properties of the GHQ-28 and PHQ-9 were good to excellent among the primary healthcare population in BotswanaThe Setswana version of the PSC had maximal sensitivity and specificity at a cutoff score of 20	62–64
	Tool development	A computerized brief cognitive screening battery was found to be feasible for use in Botswana	75
Child and adolescent mental health	Pharmacological treatment	Psychotropic side effects and comorbidity are associated with polypharmacy	59,76,77
	Abuse	Children with disabilities are exposed to high rates of abuse by their teachers	60
	Behavioural problems	Aggressive and antisocial behaviours are associated with poor parent–child relationships and low parental supervision	61
	Cognition	Urban children are more cognitively advanced than children from other environments	22
	Prevalence	ADHD is the most common disorder among younger children, and depression and psychosis are more common among older children and teenagers	77
Gender-based violence	Mental health effects	Anxiety and depression are associated with gender-based violence	66,78
	Sexual abuse	Sexual abuse is associated with a lower sense of belonging to the community, drug use problems and mental distress	67
	Intervention	Adapted play therapy was found to be useful in managing sexual abuse	69
	Intimate partner violence	Most intimate partner violence was physical, followed by emotionalSuicidal ideation was high among intimate partner violence victims	68
Others	Training	Psychological research is very important in developing training programmes	70
	Service provision	Deficits in service provision in Botswana are shortage of professionals and lack of a comprehensive approach to diagnosis and treatment of disorders	21,23,25
	Caregiver mental health	Psychosocial effects experienced by grandmothers as primary caregivers include loneliness, financial hardship and depression	65,71
	Schizophrenia	According to the ICD-9, the prevalence of schizophrenia in Botswana is 4.9 per 1000 persons	21,24
	Family and mental health	Single parents and multiple family types predict mental health problems in young adults	72

PTSD, post-traumatic stress disorder; GHQ-28, General Health Questionnaire-28; PHQ-9, Patient Health Questionnaire-9; PSC, Pediatric Symptom Checklist; ADHD, attention-deficit hyperactivity disorder; ICD-9, International Classification of Diseases, Ninth Revision.