Pub Date : 2015-10-22DOI: 10.1176/appi.focus.130406
D. Bhugra, Susham Gupta, K. Bhui, T. Craig, N. Dogra, J. Ingleby, J. Kirkbride, D. Moussaoui, J. Nazroo, Adil Qureshi, T. Stompe, R. Tribe
The purpose of this guidance is to review currently available evidence on mental health problems in migrants and to present advice to clinicians and policy makers on how to provide migrants with appropriate and accessible mental health services. The three phases of the process of migration and the relevant implications for mental health are outlined, as well as the specific problems of groups such as women, children and adolescents, the elderly, refugees and asylum seekers, and lesbian, gay, bisexual and transgender individuals. The concepts of cultural bereavement, cultural identity and cultural congruity are discussed. The epidemiology of mental disorders in migrants is described. A series of recommendations to policy makers, service providers and clinicians aimed to improve mental health care in migrants are provided, covering the special needs of migrants concerning pharmacotherapies and psychotherapies.
{"title":"WPA guidance on mental health and mental health care in migrants.","authors":"D. Bhugra, Susham Gupta, K. Bhui, T. Craig, N. Dogra, J. Ingleby, J. Kirkbride, D. Moussaoui, J. Nazroo, Adil Qureshi, T. Stompe, R. Tribe","doi":"10.1176/appi.focus.130406","DOIUrl":"https://doi.org/10.1176/appi.focus.130406","url":null,"abstract":"The purpose of this guidance is to review currently available evidence on mental health problems in migrants and to present advice to clinicians and policy makers on how to provide migrants with appropriate and accessible mental health services. The three phases of the process of migration and the relevant implications for mental health are outlined, as well as the specific problems of groups such as women, children and adolescents, the elderly, refugees and asylum seekers, and lesbian, gay, bisexual and transgender individuals. The concepts of cultural bereavement, cultural identity and cultural congruity are discussed. The epidemiology of mental disorders in migrants is described. A series of recommendations to policy makers, service providers and clinicians aimed to improve mental health care in migrants are provided, covering the special needs of migrants concerning pharmacotherapies and psychotherapies.","PeriodicalId":209484,"journal":{"name":"World psychiatry : official journal of the World Psychiatric Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128833012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A postal survey of a representative sample of UK adults was conducted. Subjects were asked "What do you understand by the term 'schizophrenia'?".Four hundred four completed questionnaires were received (81% response rate). Forty-two percent of respondents mentionedat least one first rank symptom of schizophrenia or gave a description that reasonably approximated to any diagnostic feature as stated inICD-10. Forty percent mentioned "split" or "multiple" personality. Thirty-eight percent described auditory hallucinations or "hearing voices".Fifteen percent mentioned "delusions" or described passivity experiences. Only 6% of subjects mentioned violence in their descriptions.
{"title":"Understanding of the term \"schizophrenia\"by the British public.","authors":"J. Luty, D. Fekadu, Arun Dhandayudham","doi":"10.1192/PB.30.11.435","DOIUrl":"https://doi.org/10.1192/PB.30.11.435","url":null,"abstract":"A postal survey of a representative sample of UK adults was conducted. Subjects were asked \"What do you understand by the term 'schizophrenia'?\".Four hundred four completed questionnaires were received (81% response rate). Forty-two percent of respondents mentionedat least one first rank symptom of schizophrenia or gave a description that reasonably approximated to any diagnostic feature as stated inICD-10. Forty percent mentioned \"split\" or \"multiple\" personality. Thirty-eight percent described auditory hallucinations or \"hearing voices\".Fifteen percent mentioned \"delusions\" or described passivity experiences. Only 6% of subjects mentioned violence in their descriptions.","PeriodicalId":209484,"journal":{"name":"World psychiatry : official journal of the World Psychiatric Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129669699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2003-02-01DOI: 10.1108/13619322200500008
Rachel Jenkins
It is important to support governments to adopt mental health policies and to integrate mental health policy into public health policy and general social policy (1), because mental disorder causes a heavy burden for societies (2), impedes the development of other health and development targets, contributes to poverty and differentially affects the poor (3,4) and, last but not least, because mental health itself is of intrinsic value as is physical health. In developing mental health policy, it is important to include consideration of stigma about mental health issues and mental illness. In a previous issue of this journal, the impact of stigma on people with mental illness was discussed (5). Stigma results in a lack of attention from ministers and the public, which then results in a lack of resource and morale, decaying institutions, lack of leadership, inadequate information systems, and inadequate legislation. By resulting in social exclusion of people with mental illness, stigma is detrimental not just to people with mental illness, but also to the health of society as a whole. All too often our services are departure points for exclusion when they should be stepping stones for social inclusion. In 2001, the World Health Organization (WHO) devoted both its annual health day and its annual health report to mental health, which called on countries to develop mental health policies (6-8). In the same year, the Institute of Medicine in Washington launched a scientific report on neurological, psychiatric and developmental disorders in low income countries, which called for immediate strategic action to reduce the burden of brain disorders (3). The European Commission plays an important role both in Europe and elsewhere and has recently produced a public health framework for mental health (9). At national level, various governments, national non-governmental organizations (NGOs), professional bodies and the media have played important roles in prioritising mental health in their countries (10-12).
{"title":"Supporting governments to adopt mental health policies.","authors":"Rachel Jenkins","doi":"10.1108/13619322200500008","DOIUrl":"https://doi.org/10.1108/13619322200500008","url":null,"abstract":"It is important to support governments to adopt mental health policies and to integrate mental health policy into public health policy and general social policy (1), because mental disorder causes a heavy burden for societies (2), impedes the development of other health and development targets, contributes to poverty and differentially affects the poor (3,4) and, last but not least, because mental health itself is of intrinsic value as is physical health. \u0000 \u0000In developing mental health policy, it is important to include consideration of stigma about mental health issues and mental illness. In a previous issue of this journal, the impact of stigma on people with mental illness was discussed (5). Stigma results in a lack of attention from ministers and the public, which then results in a lack of resource and morale, decaying institutions, lack of leadership, inadequate information systems, and inadequate legislation. By resulting in social exclusion of people with mental illness, stigma is detrimental not just to people with mental illness, but also to the health of society as a whole. All too often our services are departure points for exclusion when they should be stepping stones for social inclusion. \u0000 \u0000In 2001, the World Health Organization (WHO) devoted both its annual health day and its annual health report to mental health, which called on countries to develop mental health policies (6-8). In the same year, the Institute of Medicine in Washington launched a scientific report on neurological, psychiatric and developmental disorders in low income countries, which called for immediate strategic action to reduce the burden of brain disorders (3). The European Commission plays an important role both in Europe and elsewhere and has recently produced a public health framework for mental health (9). At national level, various governments, national non-governmental organizations (NGOs), professional bodies and the media have played important roles in prioritising mental health in their countries (10-12).","PeriodicalId":209484,"journal":{"name":"World psychiatry : official journal of the World Psychiatric Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124500692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The quality of health care for schizophrenia and other psychoses around the world remains unacceptably poor (1-3). Serious under-resourcing of mental health care is a major factor in most countries, but even when this is less of a problem (e.g., parts of Western Europe), there is still a large gap between efficacy (what can be achieved under optimal conditions) and effectiveness (what can be achieved under routine conditions). Typically, Falloon recognised this in conceiving the optimal treatment project (OTP) for schizophrenia (4). Many factors are responsible for this efficacy-effectiveness gap, including community-wide stigma and pessimistic beliefs about outcome, the low status of psychiatry in the health care system with consequent underfunding and poor workforce quality, the failure in the developed world to fully implement, resource and sustain the reforms associated with deinstitutionalisation, and the lack of translation of genuine advances in treatment into clinical settings (5). In fact, reform and the evidence base actually are not as closely related as might be expected, and while the former tends to lag well behind the latter, sometimes the opposite occurs based on fashion or enthusiasm alone. In psychiatry, given our fragile position in the health care system and a legacy of errors and scandal, this rightly concerns us. Hence our desire to get it right. We remain unclear as to how much evidence is required before reform is justified, and even what kind of evidence is necessary. There is also the key practical issue that to produce evidence, a certain amount of reform needs to be carried out anyway.
{"title":"The recognition and optimal management of early psychosis: an evidence-based reform.","authors":"P. McGorry","doi":"10.1159/000078973","DOIUrl":"https://doi.org/10.1159/000078973","url":null,"abstract":"The quality of health care for schizophrenia and other psychoses around the world remains unacceptably poor (1-3). Serious under-resourcing of mental health care is a major factor in most countries, but even when this is less of a problem (e.g., parts of Western Europe), there is still a large gap between efficacy (what can be achieved under optimal conditions) and effectiveness (what can be achieved under routine conditions). Typically, Falloon recognised this in conceiving the optimal treatment project (OTP) for schizophrenia (4). Many factors are responsible for this efficacy-effectiveness gap, including community-wide stigma and pessimistic beliefs about outcome, the low status of psychiatry in the health care system with consequent underfunding and poor workforce quality, the failure in the developed world to fully implement, resource and sustain the reforms associated with deinstitutionalisation, and the lack of translation of genuine advances in treatment into clinical settings (5). In fact, reform and the evidence base actually are not as closely related as might be expected, and while the former tends to lag well behind the latter, sometimes the opposite occurs based on fashion or enthusiasm alone. In psychiatry, given our fragile position in the health care system and a legacy of errors and scandal, this rightly concerns us. Hence our desire to get it right. We remain unclear as to how much evidence is required before reform is justified, and even what kind of evidence is necessary. There is also the key practical issue that to produce evidence, a certain amount of reform needs to be carried out anyway.","PeriodicalId":209484,"journal":{"name":"World psychiatry : official journal of the World Psychiatric Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2002-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116214861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A new beginning.","authors":"J. Mezzich","doi":"10.2307/j.ctv1xz0cq.16","DOIUrl":"https://doi.org/10.2307/j.ctv1xz0cq.16","url":null,"abstract":"","PeriodicalId":209484,"journal":{"name":"World psychiatry : official journal of the World Psychiatric Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122398537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.1016/b978-0-12-050350-6.50001-2
Thomas A Widiger
{"title":"Personality and psychopathology.","authors":"Thomas A Widiger","doi":"10.1016/b978-0-12-050350-6.50001-2","DOIUrl":"https://doi.org/10.1016/b978-0-12-050350-6.50001-2","url":null,"abstract":"","PeriodicalId":209484,"journal":{"name":"World psychiatry : official journal of the World Psychiatric Association","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128149536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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