Unmet Need in Psychiatry: Problems, Resources, Responses

by Edited by Gavin Andrews , Scott Henderson

• ISBN13: 9780521662291
• ISBN10: 052166229X
• Format: Hardcover
• Copyright: 2000-02-13
• Publisher: Cambridge University Press

Summary

This innovative book considers ways to resolve the imbalance between the demand and supply of mental health services. Treatment services in most countries reach only a minority of people identified as suffering from a mental disorder. Few countries can provide adequate health services for all the mentally ill, yet none has developed a rational system to decide who should be treated. The questions are clear. Could we develop a staged treatment process to reach all in need? If not, how do we decide who to treat? What should the criteria be for deployment of scarce treatment resources? How do we determine such criteria? What are the ethical implications of applying such criteria? In this pioneering work, an international team of eminent psychiatrists, epidemiologists, health administrators, economists and health planners examine these questions. The result will inform and encourage all concerned with the equitable provision of mental health care.

Table of Contents

List of contributors	ix
Preface	xv
Part I Unmet need: defining the problem
Assessing needs for psychiatric services	3	(5)
Norman Sartorius
Unmet need: a challenge for governments	8	(3)
Harvey Whiteford
Meeting the unmet need with disease management	11	(30)
Gavin Andrews
Part II Unmet need: general problems and solutions
Introduction	39	(2)
Gavin Andrews
The epidemiology of mental disorder treatment need: community estimates of `medical necessity'	41	(18)
Darrel A. Regier
William E. Narrow
Agnes Rupp
Donald S. Rae
Charles T. Kaelber
Some considerations in making resource allocation decisions for the treatment of psychiatric disorders	59	(26)
Ronald C. Kessler
The need for psychiatric treatment in the general population	85	(12)
Paul Bebbington
Comparing data on mental health service use between countries	97	(22)
Margarita Alegria
Ronald C. Kessler
Rob Bijl
Elizabeth Lin
Steven G. Heeringa
David T. Takeuchi
Bodhan Kolody
The challenges of meeting the unmet need for treatment: economic perspectives	119	(13)
Agnes Rupp
Helen Lapsley
Unmet need for prevention	132	(14)
Beverley Raphael
Meeting unmet needs: can evidence-based approaches help?	146	(11)
Harold Alan Pincus
Deborah A. Zarin
Unmet need for management of mental disorders in primary care	157	(15)
T. Bedirhan Ustun
Is complementary medicine filling needs that could be met by orthodox medicine?	172	(25)
John E. Cooper
Part III Unmet need: people with specific disorders
Introduction	195	(2)
Gavin Andrews
The unmet needs of people suffering from schizophrenia	197	(21)
Graham Thornicroft
Sonia Johnson
Morven Leese
Mike Slade
The early course of schizophrenia: new concepts for early intervention	218	(15)
Heinz Hafner
Kurt Maurer
Unmet need in depression: varying perspectives on need	233	(12)
Kay Wilhelm
Elizabeth Lin
Unmet need following serious suicide attempt: follow-up of 302 individuals for 30 months	245	(11)
Annette Beautrais
Peter Joyce
Roger Mulder
Met and unmet need for interventions in community cases with anxiety disorders	256	(21)
Hans-Ulrich Wittchen
The unmet need for treatment in panic disorder and social phobia	277	(13)
Caroline Hunt
Alcohol-use disorders: who should be treated and how?	290	(12)
Wayne Hall
Maree Teesson
Putting epidemiology and public health in needs assessment: drug dependence and beyond	302	(7)
James C. Anthony
Why are somatoform disorders so poorly recognized and treated?	309	(21)
Ian Hickie
Rene G. Pols
Annette Koschera
Tracey Davenport
Part IV Unmet need: specific issues
Introduction	327	(3)
Scott Henderson
Unmet need in mental health service delivery: children and adolescents	330	(15)
Michael Sawyer
George Patton
Assessing psychopathology among children aged four to eight	345	(11)
Linda Cottler
Wendy Reich
Kathy Rourke
Renee M. Cunningham-Williams
Wilson M. Compton
Unmet need in Indigenous mental health: where to start?	356	(7)
Ernest Hunter
Health systems research: a pragmatic model for meeting mental health needs in low-income countries	363	(15)
Vikram Patel
Disablement associated with chronic psychosis as seen by two groups of key informants: patients and mental health professionals	378	(12)
Charles B. Pull
Arnaud Sztantics
Steve Muller
Jean Marc Cloos
Jean Reggers
The assessment of perceived need	390	(9)
Graham Meadows
Ellie Fossey
Carol Harvey
Philip Burgess
Public knowledge of and attitudes to mental disorders: a limiting factor in the optimal use of treatment services	399	(18)
Anthony F. Jorm
Mattias Angermeyer
Heinz Katschnig
Part V Unmet need: conclusion
A personal overview	417	(5)
John R.M. Copeland
Conclusion: the central issues	422	(7)
Scott Henderson
Index	429