Community Mental Health Putting Policy Into Practice Globally

by Thornicroft, Graham; Alem, Atalay; Drake, Robert E.; Ito, Hiroto; Mari, Jair; McGeorge, Peter; Tara, R.; Semrau, Maya

• ISBN13: 9781119998655
• ISBN10: 1119998654
• Edition: 1st
• Format: Paperback
• Copyright: 2012-01-24
• Publisher: Wiley-Blackwell

Summary

There are wide inconsistencies between, and even within, countries in how community-orientated care is defined and interpreted. The analysis presented in this book take as a starting point an evidence-based balanced care model in which services are provided in community settings close to the populations served, with hospital stays being reduced as far as possible, usually located in acute wards in general hospitals. The surprising conclusion from the research is that the same problems arise in all countries, regardless of resource status, and thus the recommendations of this book apply to mental health provision everywhere. This book reviews the implementation of community-orientated care using the balanced care model. It summarizes the steps, obstacles and mistakes that have been encountered in the implementation of community mental health care worldwide and presents guidelines on how to avoid them. It proposes realistic and achievable recommendations for the development and implementation of community-orientated mental health care over the next ten years. These guidelines will be of practical use to psychiatrists and other mental health and public health practitioners at all levels worldwide, including policy makers, commissioners, funders, non-governmental organisations, service users and carers. A core message of the book is that the mental health sector will more powerfully advocate for better services in future through strong and unified alliances, especially with powerful representation from consumer/service user and carer groups. Community-orientated care draws on a wide range of practitioners, providers, care and support systems (both professional and non-professional), though particular components may play a larger or lesser role in different settings depending on the local context and the available resources, especially trained staff. Research by a WPA task force has demonstrated that most of the challenges are common and global, but with local variations. The book is therefore relevant to psychiatrists and mental health workers in developed countries who are trying to deliver better health care on reduced budgets and for those in the developing economies who are in the position to modernise their mental health care. It provides clear, concise guidance on policy and practice decisions, learning from what has and has not worked in regions in the world. The book contains many tables documenting the evidence, supported by an essential reference list, and a Key Points summary for each chapter.

Author Biography

Graham Thornicroft and Maya Semrau, Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK

Atalay Alem, Department of Psychiatry, Faculty of Medicine, Addis Ababa University, Ethiopia

Robert E. Drake, Dartmouth Psychiatric Research Center, NH, USA

Hiroto Ito, National Institute of Mental Health, National Centre of Neurology and Psychiatry, Tokyo, Japan

Jair Mari, Department of Psychiatry, Universidade Federal de São Paulo, Brazil

Peter McGeorge, New Zealand Mental Health Commission, Wellington, New Zealand

R. Thara, Schizophrenia Research Foundation (SCARF), Chennai, India

Table of Contents

List of Contributors	p. viii
Foreword	p. xi
Acknowledgements	p. xiii
Introduction	p. 1
Global mental health: the context	p. 3 ]
Description of the world regions	p. 14
Overview of mental health policies worldwide	p. 23
Implementation of community mental health services	p. 37
The current provision of community mental health services	p. 39
Policies, plans, and programs	p. 90
Scaling up services for whole populations	p. 97
Stigma, discrimination, and community awareness about mental illnesses	p. 119
Developing a consensus for engagement	p. 135
Human and financial resources	p. 140
Development, organization, and evaluation of services	p. 151
Recommendations	p. 167
Lessons learned and recommendations for the future	p. 169
Terminologies	p. 213
Questions from a survey conducted with regional experts in the Africa region	p. 221
Internet resources	p. 223
Index	p. 227
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