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Page 1 of 2

Essentials of Global Mental Health
  • Edited by Samuel O. Okpaku
  • Published online:
    05 March 2014
    Print publication:
    27 February 2014
  • 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.

  • Chapter 4 - Global health and mental health as diplomacy

  • from Section 1 - History and background of global mental health
  • Edited by Samuel O. Okpaku
  • Book:
    Essentials of Global Mental Health
    Published online:
    05 March 2014
    Print publication:
    27 February 2014, pp 39-51

  • Summary

    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 40 - The war on drugs in the USA, Mexico, and Central America: Plan Colombia and the Mérida Initiative

  • from Section 7 - Depression, suicide, and violence
  • Edited by Samuel O. Okpaku
  • Book:
    Essentials of Global Mental Health
    Published online:
    05 March 2014
    Print publication:
    27 February 2014, pp 384-390

  • Summary

    This chapter reviews the definitions and backgrounds of human trafficking and sex work, and their relationship with mental health and psychological well-being, and concludes with a discussion on the way forward. The trafficking is the exploitation of human beings by means of sexual exploitation, forms of forced labour, slavery, servitude, or the removal of human organs through threat or use of force, coercion, abduction, fraud, deception, abuse of positions of power or vulnerability. Trafficking into sex work is a profound human rights violation that demands effective and comprehensive international action. Issues related to trafficking and sex work are the biggest priorities of the current world in terms of health, including sexual and reproductive health and HIV prevention, and the promotion of human rights and gender equality. Mainstreaming mental health and psychological well-being is the key to addressing the devastating human rights violations of human trafficking and sex work.

  • Section 8 - Research and monitoring the progress of countries

  • Edited by Samuel O. Okpaku
  • Book:
    Essentials of Global Mental Health
    Published online:
    05 March 2014
    Print publication:
    27 February 2014, pp 391-424

  • Summary

    This chapter discusses two educational partnerships that illustrate how high-income countries (HICs), were able to collaborate with a low-income country (LIC), Ethiopia, addressing training needs and access to PhD training. These partnerships addressed the gap in Ethiopia, between mental health services and care delivery personnel and systems. The chapter emphasizes five impacts of the educational partnerships that were set up between Addis Ababa University (AAU) and the University of Toronto, and between AAU and Umeå University: the increase in research capacity and academic productivity; development of local psychiatric training capacity; progress that has been made in Ethiopia in the integration of mental health into the health system at all levels; regionalization of access and training for mental health in community systems; and task-sharing. The chapter concludes that partnerships between HICs and LICs in mental health education act to foster research into, and development of, culturally appropriate models of education.

  • Section 5 - Gender and equality

  • Edited by Samuel O. Okpaku
  • Book:
    Essentials of Global Mental Health
    Published online:
    05 March 2014
    Print publication:
    27 February 2014, pp 243-288

  • Summary

    Women's mental health as an intersectoral matter has drawn the attention of major international organizations such as the United Nations (UN) and its agencies, the International Monetary Fund (IMF), the World Bank, non-governmental organizations (NGOs), and major foundations. This chapter describes various psychosocial issues, specific risks, and diagnostic and service biases that relate to women. It makes some reference to the role of education, family planning availability, and economic opportunities, as illustrated by experience from microfinancial strategies. A variety of factors have been identified as likely to impinge on the mental health of women and girls. These factors include financial and economic stressors, poverty, socioeconomic status, violence, education, and family of origin, as well as refugee, immigration, and minority status. The chapter re-examines the traditional beliefs about sex/gender in psychopathology and diagnosis.

  • Section 4 - Systems of development for special populations

  • Edited by Samuel O. Okpaku
  • Book:
    Essentials of Global Mental Health
    Published online:
    05 March 2014
    Print publication:
    27 February 2014, pp 163-242

  • Summary

    Mental illness is prevalent in the USA and worldwide. This chapter focuses on poverty and perinatal morbidity as risk factors for mental illness, specifically the association of poverty experience in adolescence and low birth weight with depression in young adulthood. A report by Australia's National Health and Medical Research Council describes the full spectrum of perinatal morbidity, which includes frequent events such as maternal/infant separation due to admission to a special care facility, common conditions such as prematurity, low birth weight, and intrauterine growth restriction, and sentinel events such as major neurological or physical disability. Two depression measures are examined: the Center for Epidemiological Studies Depression (CES-D) scale of depressive symptoms and self-reported clinically diagnosed depression. Mental health is an important facet of overall health in adulthood, yet relatively little research has taken a life-course approach to understanding how illnesses such as depression develop.

  • Chapter 26 - Women’s mental health

  • from Section 5 - Gender and equality
  • Edited by Samuel O. Okpaku
  • Book:
    Essentials of Global Mental Health
    Published online:
    05 March 2014
    Print publication:
    27 February 2014, pp 243-250

  • Summary

    This chapter presents the Cuban integrative health/mental health system as a widely recognized model grounded in local community and primary care, within a national health system emphasizing free universal health care. Cuba's mental health system, offering community-based mental health care grounded in integrative primary care, incorporates the full spectrum of health promotion, problem prevention, curative treatments, rehabilitation, and social integration. The chapter draws on recent overviews and evaluations of Cuba's mental health systems of care, published research conducted by both Cuban and global sources, and Cuban practice accounts and experiences. Cuba's in-patient services include psychiatric hospitals housing both acute-care patients for short-term stays and longer-term patients, and local and regional general hospitals housing emergency and short-term care. One critical area in which Cuba's integrative health approach offers internationally recognized expertise is in minimizing adverse health/mental health impacts of disasters.

  • Section 6 - Human resources and capacity building

  • Edited by Samuel O. Okpaku
  • Book:
    Essentials of Global Mental Health
    Published online:
    05 March 2014
    Print publication:
    27 February 2014, pp 289-366

  • Summary

    Capacity building needs to enable integration of mental health into general health policy and its inclusion in the essential healthcare services; expansion of economic research on resource use, costs, and effectiveness of essential mental health care services in different countries; better identification and use of levers and entry points for improved care delivery and policy development; greater participation in health sector reforms; strengthening of links between mental health and public health; and more effective resource mobilization. A sector-wide approach (SWAp) to reforms was adopted in many countries and often included a form of decentralization, along with development of a framework for policy and planning that emphasized a limited set of cost-effective prioritized health interventions and the integration of a number of vertical programs within mainstream health system functions. Mental disorders generally respond to psychological and social interventions and medications.

  • Section 1 - History and background of global mental health

  • Edited by Samuel O. Okpaku
  • Book:
    Essentials of Global Mental Health
    Published online:
    05 March 2014
    Print publication:
    27 February 2014, pp 1-62

  • Summary

    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 1 - History of global mental health

  • from Section 1 - History and background of global mental health
  • Edited by Samuel O. Okpaku
  • Book:
    Essentials of Global Mental Health
    Published online:
    05 March 2014
    Print publication:
    27 February 2014, pp 1-10

  • Summary

    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.

  • Section 7 - Depression, suicide, and violence

  • Edited by Samuel O. Okpaku
  • Book:
    Essentials of Global Mental Health
    Published online:
    05 March 2014
    Print publication:
    27 February 2014, pp 367-390

  • Summary

    This chapter reports on the epidemiology of suicidal behaviors in each type of mood disorder, discusses the boundaries between sadness and depressive disorders in relation to suicide, and highlights possible prevention strategies for suicide in patients with mood disorders. Mood disorders are a leading public health problem worldwide. They are not only enormously detrimental to society and the economy and have negative consequences on personal and interpersonal circumstances, but are also related to the fatal outcome of suicide. Unipolar disorders primarily include major depressive disorder and dysthymic disorder. Bipolar disorder is characterized by alternating episodes of mania and depression over the course of life. While suicidal behaviors are convincingly predicted by clinical depression, their association with normal sadness has been neglected and never properly examined. This is likely the result of the confusion between normal sadness and depressive disorders among contemporary psychiatrists and researchers.

Page 1 of 2