Book contents
- Frontmatter
- Contents
- List of figures, tables and boxes
- List of contributors
- Preface
- Part I Conceptual basis and overarching themes
- 1 What is primary care mental health?
- 2 Mental health and primary healthcare: an international policy perspective
- 3 The epidemiology of mental illness
- 4 A sociological view of mental health and illness
- 5 The service user perspective
- 6 Low- and middle-income countries
- 7 Diagnosis and classification of mental illness: a view from primary care
- Part II Clinical issues
- Part III Policy and practice
- Part IV Reflective practice
- Epilogue: Racing pigeons and rolling rocks: reflections on complex problems in primary care
- Index
6 - Low- and middle-income countries
from Part I - Conceptual basis and overarching themes
Published online by Cambridge University Press: 02 January 2018
- Frontmatter
- Contents
- List of figures, tables and boxes
- List of contributors
- Preface
- Part I Conceptual basis and overarching themes
- 1 What is primary care mental health?
- 2 Mental health and primary healthcare: an international policy perspective
- 3 The epidemiology of mental illness
- 4 A sociological view of mental health and illness
- 5 The service user perspective
- 6 Low- and middle-income countries
- 7 Diagnosis and classification of mental illness: a view from primary care
- Part II Clinical issues
- Part III Policy and practice
- Part IV Reflective practice
- Epilogue: Racing pigeons and rolling rocks: reflections on complex problems in primary care
- Index
Summary
In the early 1970s, comprehensive and authoritative reviews of psychiatric disorders in low- and middle-income (LAMI) countries in Latin America, sub-Saharan Africa and South-East Asia showed that all types of mental disorders were widely prevalent. The reviews highlighted the gross neglect of mental disorders in these countries for a variety of reasons, which included pervasive stigma, widespread misconceptions, grossly inadequate budgets and acute shortages of trained personnel. It was pointed out that, in these countries, basic mental healthcare should be decentralised and integrated with the existing system of general health services (German, 1972; Leon, 1972; Carstairs, 1973; Neki, 1973). The strategy of integrating mental health into primary care services was endorsed by a Mental Health Expert Committee of the World Health Organization (WHO) in 1974 (WHO, 1975). More than 25 years later, in 2001, the WHO devoted its World Health Report to mental health, focusing on the importance of integrating mental health into primary care (WHO, 2001a). Several other influential international reports have recommended the strengthening of existing systems of primary care services in LAMI countries to provide services for persons with mental disorders (Institute of Medicine, 2001; Hyman et al, 2006). More recently, the Lancet series ‘Global Mental Health’ unequivocally recommended that mental health be recognised as an integral component of primary and secondary general healthcare, particularly in LAMI countries (Chisholm et al, 2007a; Gureje et al, 2007).
Better recognition of the societal burden of mental disorders, availability of effective interventions and high-profile recommendations often do not result in improved provision of mental healthcare in LAMI countries. This chapter reviews the widely varying nature of LAMI countries, their health policies, health systems, health personnel and barriers to better healthcare delivery in the context of the integration of mental health into primary healthcare.
‘Developing countries’
More than 80% of the world's population of over 6 billion live in countries that are referred to as ‘developing’, a euphemism for poor countries. These countries are situated mostly in Africa, Latin America, Asia and some parts of eastern Europe.
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- Chapter
- Information
- Primary Care Mental Health , pp. 72 - 87Publisher: Royal College of PsychiatristsPrint publication year: 2009