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  • Cited by 15
  • Edited by Samuel O. Okpaku, Center for Health, Culture, and Society, Nashville
Cambridge University Press
Online publication date:
March 2014
Print publication year:
Online ISBN:

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.


'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.'


'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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Page 1 of 3

  • Chapter 7 - Internalized stigma
    pp 72-77
  • View abstract


    This chapter traces the origin and background of modern global mental health and sketches its domain. A primary objective of global health and mental health is the eradication of disparities in terms of access to care, quality of life, and well-being worldwide. Dorothea Dix and Clifford Beers contributed immensely to global mental health and had experiences of mental illness, making their contribution more instructive. Currently, membership in the World Federation for Mental Health (WFMH) is open to individuals, users and survivors, and mental health and disability societies. The World Health Organization (WHO) played a vital role in several aspects of mental health worldwide. The future of global health and mental health is likely to be influenced by a variety of driving factors. One of these is activism. The concerns of global mental health focus on the most needy communities, in the low- and middle-income countries, but the vision is worldwide.
  • Chapter 9 - Stigmatization and exclusion
    pp 85-92
  • View abstract


    This chapter discusses the results of the World Mental Health (WMH) surveys regarding the burden of mental disorders. The mental disorders were assessed with Composite International Diagnostic Interview (CIDI), a fully structured lay-administered interview designed to generate research diagnoses of commonly occurring mental disorders according to the definitions and criteria of both the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and International Classification of Diseases (ICD-10) Diagnostic Criteria for Research (DCR) diagnostic systems. Generalized linear modeling (GLM) was used to assess the effects of mental disorders on continuous outcome variables with skewed distributions. The CIDI included retrospective disorder age-of-onset (AOO) reports based on a special question sequence that has been shown experimentally to improve recall accuracy. Mental disorders are important causes of productivity loss and low perceived health. They are among the most important disorders at both individual and societal levels.
  • Chapter 10 - Grassroots movements in mental health
    pp 93-102
  • View abstract


    The prevention, care, and rehabilitation of mental disorders are a growing public health problem globally. Addressing the increasing public health burden of mental disorders worldwide requires an understanding of the prevalence, associated disability, and treatment gap associated with these disorders. Community-based psychiatric epidemiological studies provide insights into the magnitude of the burden. Estimates of the prevalence of specific mental disorders in numerous countries globally have been established using either structured or semi-structured interview schedules linked to current diagnostic criteria that have improved the reliability and validity of psychiatric diagnoses. The World Mental Health (WMH) surveys and the International Consortium of Psychiatric Epidemiology are cross-national initiatives that have demonstrated that mental disorders are highly prevalent throughout the world. Neuropsychiatric conditions account for a disproportionate amount of burden of disease, although they result in few direct deaths.
  • Chapter 11 - The rise of consumerism and local advocacy
    pp 103-109
  • View abstract


    This chapter reviews some definitions of global health and mental health diplomacy. It explores heuristic instances where global health drives foreign policy and vice versa, bearing in mind that these two processes frequently overlap and sometimes intersect. The cornerstone of Norwegian policy is to promote and respect fundamental human rights. The principle of equal access to health services based on comprehensive, robust health systems serves as a guideline. The Helsinki Accord emphasized "Respect for human rights and fundamental freedoms, including the freedom of thought, conscience, religion, or belief". The future of global health and mental health depends at least to some extent on the fate of globalization. Bearing in mind that political and economic serendipities can occur at any time, it is hazardous to predict the future with a great deal of confidence.
  • Chapter 12 - Programs to reduce stigma in epilepsy and HIV/AIDS
    pp 110-116
  • View abstract


    This chapter focuses on the United Nations (UN), and its work related to mental health and psychological well-being, so that the mental health community can strengthen partnership with the UN as a key stakeholder in global mental health. In 2006, the UN General Assembly adopted the Convention on the Rights of Persons with Disabilities (CRPD) by consensus. The Convention on the Rights of the Child (CRC) recognizes the rights of children with regard to mental health. The convention states that child must have a standard of living adequate for the child's physical, mental, spiritual, moral, and social development. The Platform for Action (PFA) reaffirms that women have the right to enjoy the highest attainable standard of physical and mental health. An interagency mechanism on mental health and psychosocial well-being should be established to support integration of mental health into existing and emerging priorities of the UN policies and programs.
  • Chapter 13 - The challenges of human resources in low- and middle-income countries
    pp 117-125
  • View abstract


    The user/survivor movement emerged in the early 1970s and became formalized in 2001 when it was launched at its founding conference in Vancouver, Canada. This chapter draws upon significant milestones in this discourse from within the user/survivor movement, starting with the paper written in 1999 by Mary O'Hagan, the founder and one of the first co-chairs of the World Federation of Psychiatric Users (WFPU), called "A call to open the door", which was a plain-language parable on human rights for people with psychiatric disabilities. The Convention on the Rights of Persons with Disabilities (CRPD) and its Optional Protocol was adopted on December 13, 2006. The CRPD recognizes disability rights as human rights. Its advocacy concern has been to end forced or coercive treatments, and help distressed receive the appropriate care they need, to be free from stigma, exclusion, and other abuses of their human rights.
  • Chapter 15 - Collaboration between traditional and Western practitioners
    pp 135-143
  • View abstract


    One of the most perplexing and elusive phenomena in the HIV epidemic is the concept of internalized stigma. The phenomenon of stigma is well understood and lavishly described in the AIDS literature. Internal stigma is the individual's internal appropriation of the fear, rejection, and condemnation with which many react to AIDS. The non-description, or mis-description, of internalized stigma in the literature of AIDS is the more puzzling because the phenomenon is well-known in other settings. The "self-hating Jew" and the "self-loathing gay man" are readily recognizable constructs of the psychological and other literature. In South Africa's vile past of racial hatred, Steven Bantu Biko recognized that the stigma of racial subordination had an internal impact that had to be eradicated first, if notions of white superiority and black subordination were to be effectively overcome. Internalized stigma is deadly because it incapacitates health-seeking choices.
  • Chapter 16 - Setting up integrated mental health systems
    pp 144-151
  • View abstract


    This chapter reviews the origins and nature of stigma. It traces a shift from considering stigma from the perspective of those stigmatized, viewing them as indelibly marked, to a broader social determinants framework that considers stigma from the perspective of the stigmatizing groups, as a form of social oppression. Significant contributions to the field of stigma research have been made by sociologists, social psychologists, geographers, psychiatrists, and more recently epidemiologists and public health professionals. Self-stigma is a form of self-fulfilling prophesy. It occurs when members of a stigmatized group internalize negative stereotypes and adopt a stigmatized illness identity. Self-stigma has its origins in cultural conceptions of mental illness that begin in childhood and become crystalized throughout adulthood. The UN Convention on the Rights of Persons with Disabilities (CRPD) has provided an important rallying point for legislative and social reform.
  • Chapter 17 - Integrated mental health systems: the Cuban experience
    pp 152-162
  • View abstract


    This chapter focuses on the relationship to stigma from a cultural perspective across the globe. Stigma is also seen to affect the families of persons with mental illness. For persons with mental illnesses, social contexts such as marriage, divorce, or relationships are perhaps the most affected by stigma. The social, psychological, and cultural concomitance of being mentally ill and divorced/separated is particularly severe in the Indian culture. In addition to the stress of mental illness, hostility from family members, and rejection from society in general, women in particular are ridiculed and ostracized for their divorced/separated status. Work is a major determinant of mental health and a socially integrating force. To be excluded from the workforce creates material deprivation, erodes self-confidence, creates a sense of isolation and marginalization, and is a key risk factor for mental disability.

Page 1 of 3


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