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A comprehensive public mental health programme in Guinea-Bissau: a useful model for African, Asian and Latin-American countries

Published online by Cambridge University Press:  09 July 2009

Joop T. V. M. De Jong
Joop T. V. M. De Jong*
Affiliation:
University of Limburg, International Institutional Institute for Psychosocial and Socio-Ecological Research-Amsterdam and the Free University Amsterdam, The Netherlands
*
1Address for correspondence: Professor Joop T. V. M. de Jong, Ipser-Amsterdam, Kerkstraat 219–(219), 1017 GK Amsterdam, The Netherlands.
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Synopsis

From 1983–1994 a community mental health programme was set up in Guinea-Bissau. The first part of the programme concentrated on epidemiological aspects: rural and urban study areas were selected on socio-economic level and participation in the liberation war. A two-stage design was used to screen 351 adult consecutive general health care attenders and 100 children in a rural and an urban area for mental disorder. Psychiatric disorders have a morbidity of 12% among adults seen in Primary Health Care. Disorders were mainly neuroses (74%), but more psychoses were found than in other countries. No statistically significant difference in morbidity was found between rural-urban areas or between previous war and non-war zones. The diagnostic sensitivity of the Primary Health Care workers was 31%, their diagnostic specificity 88%. Thirteen per cent of the children showed neuropsychiatric disturbances. There were no sociocultural impediments to this public mental health approach. During the following intervention programme 850 Primary Health Care workers were trained and supervised nationwide. The diagnostic sensitivity of major mental disorders and epilepsy increased from 31% to an average of 85%. Before the training, their knowledge of the treatment of these disorders was nil whereas after training 82% of the patients received appropriate treatment. Moreover, this model programme shows a profitable cost/benefit ratio and a high sustainability over the last 10 years.

Type
Original Articles
Information
Psychological Medicine , Volume 26 , Issue 1 , January 1996 , pp. 97 - 108
Copyright
Copyright © Cambridge University Press 1996

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References

REFERENCES

Bass, C. & Benjamin, S. (1993). The management of chronic somatization. British Journal of Psychiatry 162, 472–480.CrossRefGoogle Scholar
Carreira, A. (1971). O infanticídio ritual em Africa. Boletim Cultural da Guiné Portuguesa 26, 101, 126, 101, 149–217 and 102, 321–377.Google Scholar
Essex, B. & Gosling, H. (1982). Programme for Identification and Management of Mental Health Problems. Churchill Livingstone: Essex.Google Scholar
Jong de, J. T. V. M. (1982). Déscription du Projet du Centre de Réhabilition Menial à Brá. Publicações do Ministério da Saúde Pública e Assuntos Sociais: Bissau.Google Scholar
Jong de, J. T. V. M. (1983 a). Tarefas Potenciais da Saúde Mental no Domínio da Saúde Pública. Relatório para o Ministério da Saúde Pública e Assuntos Sociais: Bissau.Google Scholar
Jong de, J. T. V. M. (1983 b). Proposition d'un Programme de la Santé Mentale dans le Cadre du Plan Quadriennal 1983–1987. Publicações do Ministério da Saúde Pública e Assuntos Sociais: Bissau.Google Scholar
Jong de, J. T. V. M. (1987 a). Jangue Jangue in Guinee Bissau: een cultuurgebonden syndroom onder Balanta vrouwen. Tijdschrift voor Psychiatric 2, 58–86.Google Scholar
Jong de, J. T. V. M. (1987 b). A Descent into African Psychiatry. Royal Tropical Institute: Amsterdam.Google Scholar
Jong de, J. T. V. M. (1989). Sociale psychiatrie vanuit trancultureel perspectief. Tijdschrift voor Psychiatre 4, 253–267.Google Scholar
Jong de, J. T. V. M. (1991). Investigação dos distúrbios mentais encontrados nas crianças atendidas pelas instituções da saúde na Guiné-Bissau. Journal Brasileiro de Psiquiatria 40, 137–143.Google Scholar
Jong de, J. T. V. M. & Clarke, L. (eds.) (1992). Mental Health of Refugees. WHO/UNHCR: Geneva.Google Scholar
Jong de, J. T. V. M. & Oostrom van, B. O. (1991). Avaliação de um programa básico de saúde mental na Guiné-Bissau. Journal Brasileiro de Psiquiatria 40, 31–34.Google Scholar
Jong de, J. T. V. M., Klein de, G. A. J. & Horn ten, G. H. M. M. (1986). A base line study on mental disorders in Guinea-Bissau. British Journal of Psychiatry 148, 27–32.CrossRefGoogle Scholar
Jong de, J. T. V. M., Klein de, G. A. J. & Horn ten, G. H. M. M. (1991). Estudo sobre perturbações mentais na Guiné-Bissau. Journal Brasileiro de Pisquiatria 40, 79–88.Google Scholar
Kleinman, A. M. (1980). Patients and Healers in the Context of Culture. University of California Press: Berkeley.CrossRefGoogle Scholar
Korten, D. (1980). Community organization and rural development: a learning process approach. Public Administration Review 6, 480–511.CrossRefGoogle Scholar
Lévy-Bruhl, L. (1921). La Mentalité primitive. Librairie Felix Alcan: Paris.Google Scholar
Maassen van de Brink, M. E., Jong de, J. T. V. M. & Horn ten, G. H. M. M. (1986). De geestelijke gezondheidszorg in Guinee Bissau: een vergelijking tussen stad en platteland. Tijdschrift voor Psychiatrie 28, 524–538.Google Scholar
Mechanic, D. (1991). Strategies for integrating public mental health services. Hospital and Community Psychiatry 42, 797–801.Google ScholarPubMed
Ndetei, D. M. & Muhangi, J. (1979). The prevalence and clinical presentation of psychiatric illness in a rural setting in Kenya. British Journal of Psychiatry 135, 269–272.CrossRefGoogle Scholar
Sartorius, N. & Harding, T. W. (1983). The WHO collaborative study on strategies for extending mental health care. I. the genesis of the study. American Journal of Psychiatry 140, 1470–1473.Google Scholar
Sell, H. L., Srinivasa Murthy, R., Seshadri, S., Kumar, K. & Srinivasan, K. (1990). Recognition and management of patients with functional complaints. A training package for the Primary-Care Physician. In Psychological Disorders in Medical Settings (ed. Sartorius, et al. ), Hogrefe & Huber/WHO: Toronto.Google Scholar
Shepherd, M., Cooper, B., Brown, A. C. & Kalton, C. (1966). Psychiatric Illness in General Practices. Oxford University Press: Oxford.Google Scholar
WHO (1975). Expert Committee on Mental Health. Organization of Mental Health Services in Developing Countries. Technical Report Series 564. WHO: Geneva.Google Scholar
WHO (1981). Report from the WHO Collaborative Study on Strategies for Extending Mental Health Care. WHO: Geneva.Google Scholar
WHO (1990). The Introduction of a Mental Health Component into Primary Health Care. WHO: Geneva.Google Scholar