Book Review: Still Down: What to Do When Antidepressants Fail

The authors present a broad overview of issues related to mental health in Canada. They offer evidence from physical sciences, clinical practice, and social sciences, thus examining mental health issues from a wide variety of perspectives. They have developed a good text for students, from the level of senior high school to postgraduate, who want to develop their understanding of mental health and its many issues. This book could also be useful for many professionals to remind them of the broader issues beyond their particular profession. Residents in family medicine or psychiatry could benefit since it is likely to open their eyes beyond any possible narrow professional view to more of a population health focus. To give some idea of the scope of the book, chapters include discussion of what is mental health, biological foundations, insights from social sciences, substance use, diagnostic systems and their problems, stigma, workplace mental health, children and youth, gender and sexuality, culture, mental health crises, treatment of mental disorders, and a description of services in Canada. This very broad spectrum is a major strength of this book. The book is written in an easy to read style, avoiding unnecessary jargon. This is perhaps the essence of good scientific writing, that complex scientific issues are made easily comprehensible to a general readership. This well-written, easy to read style makes this book easily accessible to those with no special knowledge of mental health. The 3 authors are to be congratulated on having managed to achieve a consistent style throughout the book. They have also managed to keep the book very up-to-date. The format of the book is unusual and interesting. Each chapter ends with a conclusion, followed by a helpful glossary of terms, a number of critical thinking questions that really focus on the main content of the chapter, and a short list of recommended readings and recommended websites, followed by a full reference list for that chapter. There are also numerous vignettes throughout the book. This format makes the book ideal for learning purposes, whether for the individual reader, a group or small seminar (perhaps the most useful format for study), or a larger class. This reviewer does not know of any other text that so comprehensively brings such a wide variety of mental health issues into clear focus and that is also very readable and entertaining. My only criticism is of some of the illustrations. There are numerous illustrations throughout the book, none in colour, and the black and white rendering is frequently not very attractive. In addition, in some instances, it is difficult to see the relevance of the illustration to the topic under discussion. This should not detract from the overall quality and relevance of this publication.