Innovative Mental Health Programs In Latin America And The Caribbean

"Each experience described here has its own history, as can be seen in each one of the chapters. Yet, all of them are part of a single reform process with shared historical roots and influences ... As proved by the experiences included in this book, a great deal can be learned from mental health reforms in Latin America and the Caribbean. On the one hand, each initiative developed truly original and innovative solutions for some of the problems usually encountered in the reform processes. Obviously, many of the innovative solutions can be applied in those countries that are at a similar stage of development as the Latin American and Caribbean countries where the reported experiences took place. However, many of these innovations also can be useful to any country interested in reforming its mental health services, regardless of the country's degree of development. I also believe that the reform of mental health services in Latin America and the Caribbean--given specific aspects such as the dynamic following the Caracas Declaration and the impact of international cooperation--help us to better understand the real importance of some factors, such as social and political aspects and international cooperation, in implementing mental health service reforms."--p. iv.

There are wide inconsistencies between, and even within, countries in how community-orientated care is defined and interpreted. The analysis presented in this book take as a starting point an evidence-based balanced care model in which services are provided in community settings close to the populations served, with hospital stays being reduced as far as possible, usually located in acute wards in general hospitals. The surprising conclusion from the research is that the same problems arise in all countries, regardless of resource status, and thus the recommendations of this book apply to mental health provision everywhere. This book reviews the implementation of community-orientated care using the balanced care model. It summarizes the steps, obstacles and mistakes that have been encountered in the implementation of community mental health care worldwide and presents guidelines on how to avoid them. It proposes realistic and achievable recommendations for the development and implementation of community-orientated mental health care over the next ten years. These guidelines will be of practical use to psychiatrists and other mental health and public health practitioners at all levels worldwide, including policy makers, commissioners, funders, non-governmental organisations, service users and carers. A core message of the book is that the mental health sector will more powerfully advocate for better services in future through strong and unified alliances, especially with powerful representation from consumer/service user and carer groups. Community-orientated care draws on a wide range of practitioners, providers, care and support systems (both professional and non-professional), though particular components may play a larger or lesser role in different settings depending on the local context and the available resources, especially trained staff. Research by a WPA task force has demonstrated that most of the challenges are common and global, but with local variations. The book is therefore relevant to psychiatrists and mental health workers in developed countries who are trying to deliver better health care on reduced budgets and for those in the developing economies who are in the position to modernise their mental health care. It provides clear, concise guidance on policy and practice decisions, learning from what has and has not worked in regions in the world. The book contains many tables documenting the evidence, supported by an essential reference list, and a Key Points summary for each chapter. Highly Commended in the Psychiatry section of the 2012 BMA Book Awards.

Over the course of the last decade, political and mental entities at large have embraced global mental health: the idea that psychiatric health is vital to improved quality of life. Physicians globally have implemented guidelines recommended by the National Institute of Mental Health (NIMH) in 2007, thereby breaking down barriers to care and improving quality of life in areas where these practices have been implemented. Programs for training and education have expanded as a result. Clinicians benefit more from both local resources in some regions as well as in international collaboration and technological advancements. Even amidst all of these positive outcomes, clinicians still face some stumbling blocks. With worldwide statistics estimating that 450 million people struggle with mental, neuropsychiatric, and neurological disorders—25 percent of the world’s non-communicable disease burden—rising to these challenges prove to be no small feat, even in wealthy Western nations. Various articles and books have been published on global mental health, but few of them thoroughly cover the clinical, research, innovative, and social implications as they pertain to psychiatry; often, only one of these aspects is covered. A comprehensive text that can keep pace with the rapidly evolving literature grows more and more valuable each day as clinicians struggle to piece together the changes around the world that leave open the possibility for improved outcomes in care. This book seeks to boldly rectify this situation by identifying innovative models of service delivery, training, education, research funding, and payment systems that have proven to be exemplary in implementation and scalability or have potential for scalability. Chapters describe specific barriers and challenges, illuminating effective strategies for improved outcomes. This text is the first peer-reviewed resource to gather prestigious physicians in global mental health from around the world and disseminate their expertise in the medical community at large in a format that is updateable, making it a truly cutting-edge resource in a world constantly changed by medical, scientific, and technological advances. Innovations in Global Mental Health is the ultimate resource for psychiatrists, psychologists, primary care physicians, hospitalists, policy makers, and all medical professionals at the forefront of global mental health and its implications for the future.

Franco Basaglia (1924-1980) was an Italian psychiatrist and activist who proposed the dismantling of psychiatric hospitals and pioneered new ideas about mental health and its treatment. Basaglia was also one of the principal proponents of Italy's Law 180, which effectively closed down large mental hospitals in Italy. His ideas and his disciples have had a decisive influence in the move away from institutional care in many parts of the world, particularly in continental Europe and South America. However, Basaglia is strikingly absent from the literature in Germanic and Anglophone psychiatry. Most of the literature about Basaglia in the last 40 years has been published by his followers and supporters and has often been largely positive, with little exploration of differing responses or possible limitations of his model. Basaglia's International Legacy: From Asylum to Community provides an overview of current thinking and the international influence of Franco Basaglia. This resource draws on the combined knowledge of clinicians, policy makers, historians, and social scientists, including a handful of Basaglia's collaborators. It provides an in-depth understanding and critical analysis of the various applications of his thinking worldwide. Organised into three broad sections, chapters examine Basaglia's work and influence in Italy; in the 'Basaglian' countries of Europe and South America; and in those countries where his influence has either been rejected or significantly modified. The Editors bring together the contributions and draw out the important messages (both positive and negative) for current clinical practice and development within international mental health services.

The use of coercion is one of the defining issues of mental health care. Since the earliest attempts to contain and treat the mentally ill, power imbalances have been evident and a cause of controversy. There has always been a delicate balance between respecting autonomy and ensuring that those who most need treatment and support are provided with it. Coercion in Community Mental Health Care: International Perspectives is an essential guide to the current coercive practices worldwide, both those founded in law and those 'informal' processes whose coerciveness remains contested. It does so from a variety of perspectives, drawing on diverse disciplines such as history, law, sociology, anthropology and medicine to provide a comprehensive summary of the current debates in the field. Edited by leading researchers in the field, Coercion in Community Mental Health Care: International Perspectives provides a unique discussion of this prominent issue in mental health. Divided into five sections covering origins and extent, evidence, experiences, context and international perspectives this is ideal for mental health practitioners, social scientists, ethicists and legal professionals wishing to expand their knowledge of the subject area.

This book describes clearly how legislation can be used to advance the rights and entitlements of people with mental health problems. Straightforward and practical, it provides useful information on how to address disabilities so these people may enjoy full citizenship. It presents the key issues succinctly and illustrates these with legislative examples from around the world. This book documents the role that law can play, at all levels, in combating such discrimination and abuse.

This handbook presents a thorough examination of the intricate interplay of race, ethnicity, and culture in mental health – historical origins, subsequent transformations, and the discourses generated from past and present mental health and wellness practices. The text demonstrates how socio-cultural identities including race, gender, class, sexual orientation, disability, religion, and age intersect with clinical work in a range of settings. Case vignettes and recommendations for best practice help ground each in a clinical focus, guiding practitioners and educators to actively increase their understanding of non-Western and indigenous healing techniques, as well as their awareness of contemporary mental health theories as a product of Western culture with a particular historical and cultural perspective. The international contributors also discuss ways in which global mental health practices transcend racial, cultural, ethnic, linguistic, and political boundaries. The Routledge International Handbook of Race, Culture and Mental Health is an essential resource for students, researchers, and professionals alike as it addresses the complexity of mental health issues from a critical, global perspective.

Defines an approach to mental healthcare focused on achieving international equity in coverage, options and outcomes.