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Essentials of Global Mental Health.

Essentials of Global Mental Health

edited by Samuel O. Okpaku, MD PhD

Cambridge University Press, New York, NY

2014; 446 pages; $135.00

Mental illness directly accounts for about 14 % of the global burden of disease. In human terms, over 450 million people--many of them mothers and infants--suffer from mental or behavioral disorders. While there is widespread suffering related to mental illness in developed and undeveloped countries, some of the poorest nations have fewer than ten psychiatrists. Growing awareness of the significant worldwide incidence of mental illness and the inequitable distribution of mental health services--particularly in low and middle income countries--led to the formation of the global mental health movement. It has emphasized research, study, improved practice, and greater equity in mental health services and well being. The major objective of Essentials of Global Mental Health is to better describe the domain of global mental health and to define the boundaries of the field. Professor Okpaku and his co-authors provide an invaluable text on global mental health and offer an original vision of the discipline which is to make cost-effective, evidence-based treatment services globally available, especially to potentially ill persons in low and middle income countries.

Excellent, well written, and data based chapters are included on the following topics: history and background of global mental health; advocacy and reduction of stigma; integration of mental health with modern systems of primary care and traditional healthcare; gender and equality; human resources and capacity building; depression, suicide and violence; research, and monitoring the progress of countries. The organization of the book follows five priorities of the global mental health movement--global advocacy, systems of development, research programs, capacity building, and program monitoring--and the barriers and challenges that must be overcome to complete these essential tasks.

With the proclamation of the Millennium Development goals, increasing global attention has been paid to the health and mental health of mothers and infants. Professor Okpaku and his co-authors have several chapters dedicated to maternal and child mental problems that are very informative for childbirth educators. In "Poverty and Perinatal Morbidity as Risk Factors for Mental Illness," we learn that household poverty and low birth weight have been linked with higher levels of depression (and other mental disorders) in later life. These are implications for rising levels of inequality in the United States where 40 percent of births are now out of wedlock, in many cases to poor single women living on welfare.

The chapter on "Child Abuse as a Global Mental Health Problem" reports that child maltreatment of various kinds in the U.S. occurs to 10 percent of children and is much higher (over 50 percent) in many African countries. This data raises serious questions regarding the cause and management of abusive parental behavior in the home and institutional environment. Further, in immigrant families where physical punishment of children and their mothers is the norm, serious issues in cross-cultural communication and interpretation arise for the pediatric nurse and childbirth educator.

A third noteworthy essay, "Children's Services," discusses the importance of early identification of childhood mental health disorders. The authors report that in Western developed countries approximately 1 in 5 children are affected by mental problems, but few receive any professional treatment for them. They argue for more accessible mental health screening of young children so that problems can be addressed with treatment prior to the development of serious mental illness which is associated with suicide, substance abuse, academic failure, teenage pregnancy, and criminal behavior. Further, they note that in the absence of valid and reliable instruments for the assessment of psychopathology in many low and middle-income countries is a major obstacle to providing effective treatment of them.

Essentials of Global Mental Health is a path-breaking work of scholarship. It differs significantly from the typical textbook. The topic authors are experienced international researchers and/or clinicians. Many have academic appointments at outstanding universities in the U.S., Latin America, Europe, Asia or Africa. Each chapter is written like a journal research or review article. Key issues and problems in important sub-fields of Global Mental Health, e.g., maternal and child mental health, gender and equality, and child abuse are identified and presented with recent epidemiological data. This is followed with presentations of current interventions and documented mental health outcomes. The reference lists include citations from a wide array of prestigious international journals, government, and nonprofit reports. For each topic area, they cite the most important recent studies as well as classic articles and publications. To benefit the instructor and the student, the book concludes with action items for attaining greater equality of care globally. Finally, the time is right for EEssentials of Global Mental Health because in 2013 almost 200 countries approved the WHO Mental Health Action Plan. This document calls for the global upgrading and expansion of mental health services by 2020.

Essentials of Global Mental Health should be in the library of all healthcare researchers, policy makers, and clinicians. It will serve as an important resource for childbirth educators.

It should be on the required reading list of instructors for introductory courses in global health. Students who read it will learn the most important issues and findings in the field.

reviewed by James G. Linn, PhD and Thabo T Fako, PhD

James G. Linn, PhD is past President of Research Committee No.49 (Mental Health and Illness) of the International Sociological Association. As a Peace Corps volunteer, he worked in community and cooperative development in urban barrios and rural villages of the Dominican Republic and for over 25 years he has studied the behavioral and mental health dimensions of HIV/AIDS as they relate to public health initiatives in Africa and Latin America.

Thabo T. Fako, PhD is Vice Chancellor and Professor of Sociology at the University of Botswana. He has conducted research on family structure and the spread of HIV/AIDS in Botswana.
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Author:Linn, James G.; Fako, Thabo T.
Publication:International Journal of Childbirth Education
Article Type:Book review
Date:Apr 1, 2016
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