The Culture Of Mental Illness And Psychiatric Practice In Africa

In many African countries, mental health issues, including the burden of serious mental illness and trauma, have not been adequately addressed. These essays shed light on the treatment of common and chronic mental disorders, including mental illness and treatment in the current climate of economic and political instability, access to health care, access to medicines, and the impact of HIV-AIDS and other chronic illness on mental health. While problems are rampant and carry real and devastating consequences, this volume promotes an understanding of the African mental health landscape in service of reform.

The influence of culture on mental illness has been the subject of considerable academic investigation and debate in recent years. This debate has provoked concerns about the validity and reliability of older methodologies which emphasised either universal characteristics of disorders which were heavily biased towards Euro-American systems, or the culturally relativist approach which saw psychological disorders as products largely of their own culture. The "new" cross-cultural psychiatry proposed that the integration of ethnographic and epidemiological techniques be required to enable a culture sensitive psychiatric model to emerge. This monograph describes a series of research studies conducted in primary care in Harare, Zimbabwe, focusing on the most frequent of all psychological disorders, Common Mental Disorders (CMD). The four consecutive studies are unique in several respects, most notably, the involvement of both biomedical and traditional health care providers at all stages, the development of an indigenous measure of CMD for use in epidemiological investigations, the examination of the relationship between local and biomedical models of psychological disorder and the sociodemographic and economic risk factors for CMD. The experiences and findings of these studies provide new directions in our understanding of the contribution of culture to the presentation, assessment, classification and risk factors for CMD in primary care in an urban African setting. The methodology used also sets out a model for epidemiological research in other areas of mental health in different cultural settings.

As psychiatry has developed it has proved to be susceptible to the influence of contemporary social and political mores. With its origins in nineteenth-century Europe, psychiatry evolved as an ethnocentric body of knowledge, the vehicle of implicit and overt racism. Originally published in 1988 this author, however, saw no reason why the contemporary psychiatrist should not challenge this ethnocentrism. He provides a critical account of the development of psychiatry in relation to its cultural context and then examined contemporary practice of the time in the light of this development. Throughout, the book is informed by an awareness of issues of race and culture and of their difficult interactions, the author emphasising both the frequency of racist attitudes and the very real cultural distinctions in our society, distinctions that can be used to mask what are actually racist sentiments. What emerges is not just a plea for an anti-racist, culture sensitive psychiatry, but a blueprint for how this can be brought about. He argued that the shift towards community work and social psychiatry could reorientate the profession by confronting it with its social setting and responsibilities. This book represented a significant contribution to this literature for all mental health professionals and social scientists with an interest in this field at the time; the author has gone on to write many more.

Seventy percent of the global burden of mental disorders is located in low and middle income countries (LMIC),including sub-Saharan Africa (SSA). However, in Africa,only 0.62% of the national health budget is allocated to mental health compared to a global median of 2.8% and 5% in Europe. The government is the source of funding in 62%of patients with severe mental disorder in the World Health Organisation (WHO), Africa Region, the lowest of all the WHO regions, and lower compared to a global median of 79%. This is compounded by poor resources, with mental health outpatient facilities in WHO Africa Region being less that 10% of the global median. To address these problems, the WHO launched its Mental Health Action Gap Programme (mhGAP) in 2008, to scale-up mental health services in low and middle income countries (LMIC). The book is directed to all policy makers in sub-Saharan Africa to aid decision making about the urgent need for sustainable and relevant mental health care strategies, and the important areas that need priority. The book should be helpful to local and international researchers in formulating research questions relevant to the African continent and it will be of interest to medical practitioners and students in the region as adjunct to standard text books.

A thought-provoking handbook for practitioners, students and trainers in the mental health field. Addresses controversial issues and offers revealing insights and intelligent suggestions for all those involved with mental health.

This is the definitive textbook on global mental health, an emerging priority discipline within global health, which places priority on improving mental health and achieving equity in mental health for all people worldwide.

This book introduces key issues in understanding social and cultural factors as they relate to mental health and illness, and to a southern African understanding and construction of these categories. It lays out central international and local debates in the field of mental health in an accessible way, making use of extensive research and case studies. Central theoretical debates (such as those between relativism and universalism, and between hermeneutical and critical approaches) are presented early in the text, and referred to throughout the more applied chapters. The aim is to equip the reader to assess the strengths and weaknesses of different approaches to understanding specific aspects of mental health and illness. Stressed throughout is the role of the mental health professional in the construction of ideas of mental health and illness.

"USEFUL TO THOSE SEEKING TO INITIATE RESEARCH, AS WELL AS THOSE INVOLVED IN ETHNOPSYCHIATRIC RESEARCH."--CHOICE. Do Africans experience the same mental illnesses as people in the Western world? What attitudes do Africans have toward the mentally ill? What part do sorcery & spirit possession play in traditional African psychiatry? These are among the questions addressed by this annotated bibliography of more than 900 books & articles published since the groundbreaking 1960 work, SEARCH FOR SECURITY: AN ETHNOPSYCHIATRIC STUDY OF RURAL GHANA. This volume tracks the rise of psychiatry as a science in Africa & the myriad ways in which indigenous & modern medicine are combined. A glossary of terms, & two indexes--one by geographic & ethnic group & one by subject-- make this an easy to use & rewarding guide to transcultural psychiatry.