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  1. Home
  2. Books
  3. Essentials of Global Mental Health
  • Cited by 16
  • Edited by Samuel O. Okpaku, Center for Health, Culture, and Society, Nashville
Publisher:
Cambridge University Press
Online publication date:
March 2014
Print publication year:
2014
Online ISBN:
9781139136341
DOI:
https://doi.org/10.1017/CBO9781139136341
Subjects:
Epidemiology Public Health and Medical Statistics, Psychiatry and Clinical Psychology, Medicine, Psychiatry
Information

Book description

Mental illness accounts directly for 14% of the global burden of disease and significantly more indirectly, and recent reports recognise the need to expand and improve mental health delivery on a global basis, especially in low and middle income countries. This text defines an approach to mental healthcare focused on the provision of evidence-based, cost-effective treatments, founded on the principles of sharing the best information about common problems and achieving international equity in coverage, options and outcomes. The coverage spans a diverse range of topics and defines five priority areas for the field. These embrace the domains of global advocacy, systems of development, research progress, capacity building, and monitoring. The book concludes by defining the steps to achieving equality of care globally. This is essential reading for policy makers, administrators, economists and mental health care professionals, and those from the allied professions of sociology, anthropology, international politics and foreign policy.

Reviews

'Encyclopedic, diverse, and thoughtful … Essentials of Global Mental Health is a volume that practitioners, researchers, educators, and policy makers will find themselves turning to often. It offers an incredibly wide array of international voices.'

Source: PsycCRITIQUES

'Global mental health means more than a trendy change from the term international mental health. It means a new approach to delivering mental health services around the world, reflected by shared values of human rights and respect for diversity. Essentials of Global Mental Health, edited by Samuel Okpaku, is an excellent guide to this challenging new world.'

Howard H. Goldman Source: Journal of Clinical Psychiatry

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Contents

Page 2 of 3

Contents
  • Chapter 18 - Poverty and perinatal morbidity as risk factors for mental illness
    pp 163-172
  • View abstract

    Summary

    Despite the often uphill human rights battle that lies before individuals with mental illness, pioneering individuals and groups have been inspired to act, organizing grassroots movements of affected individuals in a wide variety of contexts. The mental health movement in Ghana has grown dramatically from its inception at the grassroots level. The Mental Health Society of Ghana (MEHSOG) is made up of representatives from the district associations and some community groups. The main aim of Pan African Network of People with Psychosocial Disabilities (PANUSP) was to work with groups across Africa to establish more organized branches in different countries. Grassroots movements are most powerful when led by the vulnerable groups directly affected by the injustices these movements seek to change. Grassroots movements in mental health are fueled by the tireless efforts of passionate individuals who often have overcome great personal injustices to advocate for change for themselves and others.
  • Chapter 20 - Screening for developmental disabilities in epidemiologic studies in low- and middle-income countries
    pp 187-194
  • View abstract

    Summary

    This chapter reviews stigma in epilepsy and HIV/AIDS in terms of its origins and consequences, as well as stigma-reduction efforts in these conditions, focusing on literature from low- and middle-income countries. The consequences of stigma for people with epilepsy include depression, anxiety, impaired physical health, somatic symptoms, reduced self-esteem, and poor quality of life. The chapter presents the common features among the initiatives that have been used to address stigma and discrimination in these disorders (as well as in mental illness). The Global Campaign Against Epilepsy was launched in 1997. This is a partnership between the International League Against Epilepsy, the International Bureau for Epilepsy, and the World Health Organization (WHO). Most of the literature reviewing the effectiveness of stigma-reduction interventions highlights the lack of proper planning and evaluation of interventions. Finally, the chapter reviews the general principles in addressing stigma in epilepsy and HIV.
  • Chapter 21 - Children’s services
    pp 195-203
  • View abstract

    Summary

    Several studies conducted in many low- and middle-income countries (LMICs) have contributed to the body of knowledge on the root causes of poor availability of the mental health workforce. The emigration of mental health professionals from countries of low and middle income, along with rural-to- urban migration, constrains development of human resources for mental health. Current interventions to improve mental health education among health workers include training primary healthcare workers. Newer models of mental health care involve delegating tasks to existing or new cadres with either less training or narrowly focused training to increase access to lower-cost services. Non-governmental organizations (NGOs) have been instrumental in mental health research and program development. One of the most critical processes in improvement and restructuring of a mental health workforce is strategy development. The strategies should be formulated to address the different needs of specific population groups.
  • Chapter 23 - Child soldiers
    pp 213-221
  • View abstract

    Summary

    The management and treatment of mental disorders in primary care is a fundamental step which enables the largest number of people to get easier and faster access to services. Primary health care systems are increasingly relied upon to deliver a myriad of health services, especially in situations of scarcity. In low- and middle- income countries, where poverty and sickness are high, and access to health care is low, health professionals and policy makers have emphasized approaches that integrate the diverse roles of health care and social systems. For HIV programs, integration has enabled shared use of space and staffing through training of healthcare workers and standardizing procedures, increasing the number of people who have receive care. Integration to primary care was one of the World Health Organization's (WHO's) 10 recommendations in the World Health Report 2001 on mental health.
  • Chapter 24 - Mental health and intellectual disability: implications for global mental health
    pp 222-230
  • View abstract

    Summary

    Management of the mental health patient is a concept that has gradually evolved in many countries and cultures. Traditional mental health care is critical in providing support to societies and communities that would otherwise have no one to attend to the coexisting physical and mental illnesses. Over the past few years there have been moves to facilitate collaboration between traditional practitioners and Western practitioners. The collaboration has taken place in countries such as South Africa and India, where national health policies have been amended to try and recognize the role of traditional practitioners. The complexity of mental health systems in some countries may be increased by the parallel operation of traditional healers and Western-style practitioners. One of the main obstacles hindering collaboration between Western-style practitioners and traditional practitioners concerns human rights abuses that can occur in prayer camps and traditional shrines.
  • Chapter 25 - Adolescent alcohol and substance abuse
    pp 231-242
  • View abstract

    Summary

    This chapter summarizes the principles of mental health services organization. It describes the different types of mental health services, and discusses the main issues related to the development of integrated mental health systems. Mental health services are the means by which effective interventions for mental health are delivered, and are vital in reducing some of the burden of mental disorders. In the module Organization of services for mental health, the World Health Organization (WHO) broadly describes the way mental health services are organized around the world. The various components of mental health services are categorized as mental health services integrated into the general health system (in primary care and in general hospitals), community mental health services, and institutional mental health services (specialist institutional services and mental hospitals). The integration of mental health services into general health services is the most viable strategy for extending mental health services to underserved populations.
  • Chapter 26 - Women’s mental health
    pp 243-250
  • View abstract

    Summary

    This chapter presents the Cuban integrative health/mental health system as a widely recognized model grounded in local community and primary care, within a national health system emphasizing free universal health care. Cuba's mental health system, offering community-based mental health care grounded in integrative primary care, incorporates the full spectrum of health promotion, problem prevention, curative treatments, rehabilitation, and social integration. The chapter draws on recent overviews and evaluations of Cuba's mental health systems of care, published research conducted by both Cuban and global sources, and Cuban practice accounts and experiences. Cuba's in-patient services include psychiatric hospitals housing both acute-care patients for short-term stays and longer-term patients, and local and regional general hospitals housing emergency and short-term care. One critical area in which Cuba's integrative health approach offers internationally recognized expertise is in minimizing adverse health/mental health impacts of disasters.
  • Chapter 27 - Violence against women
    pp 251-263
  • View abstract

    Summary

    Mental illness is prevalent in the USA and worldwide. This chapter focuses on poverty and perinatal morbidity as risk factors for mental illness, specifically the association of poverty experience in adolescence and low birth weight with depression in young adulthood. A report by Australia's National Health and Medical Research Council describes the full spectrum of perinatal morbidity, which includes frequent events such as maternal/infant separation due to admission to a special care facility, common conditions such as prematurity, low birth weight, and intrauterine growth restriction, and sentinel events such as major neurological or physical disability. Two depression measures are examined: the Center for Epidemiological Studies Depression (CES-D) scale of depressive symptoms and self-reported clinically diagnosed depression. Mental health is an important facet of overall health in adulthood, yet relatively little research has taken a life-course approach to understanding how illnesses such as depression develop.
  • Chapter 29 - Trafficking in persons
    pp 282-288
  • View abstract

    Summary

    This briefly reviews the literature on common perinatal mental disorders (CPMD) and describes the activities of the Perinatal Mental Health Project (PMHP) based at the University of Cape Town (UCT), South Africa. It summarizes the key lessons learnt over the 10 years regarding the integration of maternal mental health care within primary care settings. The aim of the PMHP training program is to prepare the service delivery environment to integrate maternal mental health care into routine practice. The PMHP's advocacy and communication program focuses on raising awareness among health officials, policy makers, and the public concerning the prevalence and impact of CPMDs, and on maternal mental health as a cross-cutting solution to several key health and development priorities. Maternal mental health interventions require screening, which is undertaken by maternity staff during routine antenatal care. Institutional stigma is, however, a major challenge to providing mental health services in the public sector.
  • Chapter 30 - Capacity building
    pp 289-296
  • View abstract

    Summary

    Developmental disabilities include limitations in function and activities resulting from disorders of the developing nervous system in conjunction with unaccommodating environments or absence of assistive technologies. This chapter discusses key principles and considerations in designing and implementing screening programs and epidemiologic studies of developmental disabilities. The epidemiologic studies in low- and middle-income countries were frequently conducted by foreign researchers and sometimes characterized as "helicopter epidemiology". One of the challenges of epidemiologic studies of disability is that case status is often based on information obtained from questionnaires or cognitive tests that are designed and validated for use in one language and culture, and may not be applicable for or capable of generating comparable data across cultures. It is likely that for the majority of the world's children with developmental disabilities, obtaining an accurate diagnosis, though an important step, comes with no guarantee that coordinated services and appropriate services will be available.
  • Chapter 31 - Child mental health services in Liberia: human resources implications
    pp 297-306
  • View abstract

    Summary

    Today's youth face unprecedented global challenges to their well-being and cognitive development. Many live in poverty without access to proper nutrition, health care, or education. This chapter describes challenges associated with the assessment of children's mental health and functioning, and identifies risk and protective factors, best practices for prevention, and promising interventions that can be utilized in resource-poor settings. The development of mental health disorders in youth is multifactorial; risk and protective factors for mental health cross biological, psychological, and social domains. Substantive research and resources have been dedicated to understanding and ameliorating mental health service provision among children and adolescents in high-income countries, and thus effective evidence-based treatments for most mental health disorders exist. The tenets of the interventions framework of SAFE (Safety and security, Access to health care, Family and others support, and Education) have useful application to all children facing adverse and difficult life situations.
  • Chapter 32 - Mental health and illness outcomes in civilian populations exposed to armed conflict and war
    pp 307-315
  • View abstract

    Summary

    Child abuse is an issue of major concern for the whole of society. It is a global mental health problem of epidemic proportion affecting children of all ages and races, and from all economic and cultural backgrounds. Child trafficking is a major risk factor for child abuse and child prostitution. It is a global problem and a heinous crime against children. An important specific form of child abuse relates to an increasing use of children in armed conflicts as soldiers recruited by a number of official and other agencies. The consequences of child abuse are multifaceted, varying from ongoing trauma to personality changes and even death. Child abuse is linked to long-term deleterious effects on health and well-being, but separating the effects of child maltreatment from other often concomitant childhood adversities, such as poverty, has been challenging.
  • Chapter 33 - Implications of disasters for global mental health
    pp 316-325
  • View abstract

    Summary

    The phenomena of child soldiers can be found manifesting in situations of horizontal inequalities between groups with clearly defined cultural or ethnic identities. In war and violent conflict, children are traumatized by such common experiences as frequent shelling, bombing, helicopter strafing, round-ups, cordon-off and search operations, deaths, injury, destruction, mass arrests, detention, shootings, grenade explosions, and landmines. The impact of war on their growing minds, and the resulting traumatization and brutalization, is decisive in making them more likely to become child soldiers. Apart from death and injury, the recruitment of children becomes even more abhorrent when one sees the psychological consequences. Reintegration of the former child soldiers can be challenging. Some children have no families; either they have fled the country or they have been killed in the war. Child soldiers often face psychological and social problems.
  • Chapter 34 - International response to natural and manmade disasters
    pp 326-335
  • View abstract

    Summary

    This chapter highlights various issues related to mental health in intellectual disability (ID), and the kind of solutions that may be provided to meet the challenges in global mental health. The predominant view is that ID is associated with considerable burden because it presents special challenges not only to the individual but also to the family. Quality of life (QoL) provides an alternative to the traditional medical approach in that it emphasizes understanding, respecting, and providing what is important to and valued by each individual, and what aspects of life or the environment contribute positively to life quality. There is abundant literature on both individual and family QoL in ID, but there is no empirical evidence to suggest that the relationship between them is robust. Rather, the relationship is influenced by the level of disability and behavioral problems in the individual.
  • Chapter 35 - Global health governance, international law, and mental health
    pp 336-345
  • View abstract

    Summary

    This chapter outlines the literature on the prevalence of adolescent substance use worldwide and describes empirically supported treatments for adolescent substance abuse. The largest literature on the prevalence of adolescent substance use is drawn from nationally representative data collected in the United States, Europe, and Australia. Evidence from the Monitoring the Future (MTF) report illustrates similar declines in tobacco use in the United States over recent years. Efforts to establish estimates of adolescent substance use levels in developing countries have increased in recent years through partnerships between multinational organizations, such as the World Health Organization (WHO), and community-level agencies. Interventions for adolescent substance use disorders (SUDs) are organized around the target of intervention, including individual-level, family-level, and community-level approaches. Most of this work has taken place within the USA, although recent research suggests that many of these interventions are adaptable to other regions.
  • Chapter 36 - The role of non-governmental organizations
    pp 346-355
  • View abstract

    Summary

    Women's mental health as an intersectoral matter has drawn the attention of major international organizations such as the United Nations (UN) and its agencies, the International Monetary Fund (IMF), the World Bank, non-governmental organizations (NGOs), and major foundations. This chapter describes various psychosocial issues, specific risks, and diagnostic and service biases that relate to women. It makes some reference to the role of education, family planning availability, and economic opportunities, as illustrated by experience from microfinancial strategies. A variety of factors have been identified as likely to impinge on the mental health of women and girls. These factors include financial and economic stressors, poverty, socioeconomic status, violence, education, and family of origin, as well as refugee, immigration, and minority status. The chapter re-examines the traditional beliefs about sex/gender in psychopathology and diagnosis.
  • Chapter 38 - Suicide and depression
    pp 367-373
  • View abstract

    Summary

    Violence against women is recognized as a significant global problem, a major public health concern, and widespread violations of human rights. Unicef focused on domestic violence (DV) as one of the most prevalent and yet hidden and ignored forms of violence against women and girls globally, and defined this as comprising violence by an intimate partner or other family members, including violence occurring beyond the confines of the home, and across all ages from pregnancy to old age. The World Health Organization (WHO) distinguished intimate-partner violence (IPV) and sexual violence (SV), while recognizing significant overlap between these. This chapter shows that higher rates tend to occur in lower-income countries. A higher risk of violence is found in societies with traditional gender norms and roles, unequal distribution of power and resources between men and women, a normative use of violence to resolve conflicts, and cultural approval of violence against women.
  • Chapter 39 - Violence as a public health problem
    pp 374-383
  • View abstract

    Summary

    This chapter takes an anthropological approach to the study of global mental health among women. It explores the cultural, economic, and political determinants of women's mental health in an effort to identify directions for future research on pathways to improve women's well-being, emphasizing the role of empowerment. The chapter elaborates upon the World Health Organization (WHO) analyses, utilizing the 2009 updates on the disability-adjusted life years (DALYS) and global burden of disease to consider comparisons between women and men in the context of selected countries. It presents global trends as well as a comparison across the world's populous countries and diverse predominantly Muslim countries of high, medium, and low income, three of which have been highly affected by war. Future research on global mental health of women should be grounded in the lived experience of mental illness in an inexorably entangled nexus of relations of culture, power, gender, and meaning.
  • Chapter 40 - The war on drugs in the USA, Mexico, and Central America: Plan Colombia and the Mérida Initiative
    pp 384-390
  • View abstract

    Summary

    This chapter reviews the definitions and backgrounds of human trafficking and sex work, and their relationship with mental health and psychological well-being, and concludes with a discussion on the way forward. The trafficking is the exploitation of human beings by means of sexual exploitation, forms of forced labour, slavery, servitude, or the removal of human organs through threat or use of force, coercion, abduction, fraud, deception, abuse of positions of power or vulnerability. Trafficking into sex work is a profound human rights violation that demands effective and comprehensive international action. Issues related to trafficking and sex work are the biggest priorities of the current world in terms of health, including sexual and reproductive health and HIV prevention, and the promotion of human rights and gender equality. Mainstreaming mental health and psychological well-being is the key to addressing the devastating human rights violations of human trafficking and sex work.
  • Chapter 41 - Medical education and global mental health
    pp 391-398
  • View abstract

    Summary

    Capacity building needs to enable integration of mental health into general health policy and its inclusion in the essential healthcare services; expansion of economic research on resource use, costs, and effectiveness of essential mental health care services in different countries; better identification and use of levers and entry points for improved care delivery and policy development; greater participation in health sector reforms; strengthening of links between mental health and public health; and more effective resource mobilization. A sector-wide approach (SWAp) to reforms was adopted in many countries and often included a form of decentralization, along with development of a framework for policy and planning that emphasized a limited set of cost-effective prioritized health interventions and the integration of a number of vertical programs within mainstream health system functions. Mental disorders generally respond to psychological and social interventions and medications.
  • Chapter 43 - Research infrastructure
    pp 407-415
  • View abstract

    Summary

    This chapter discusses the challenges and opportunities associated with building a practice for child mental health services in Liberia. For children and youth in post-conflict settings such as Liberia, mental health services are almost non-existent, despite the greater need. The chapter focuses on the research on child and adolescent mental health prevalence and the treatment gap for children and youth. The 2009 National Mental Health Policy provided a framework for children's mental health policy and practice. John F. Kennedy Medical Center (JFKMC) is the only tertiary care referral hospital in Liberia. The chapter outlines how services for children are currently organized at Grant Hospital, with outpatient services at JFKMC. A second source of specialty mental health in the JFKMC system is housed in its main ambulatory service. In conjunction with partners, JFKMC launched a child and maternal mental health consultation service in early 2012.

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