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Mental, neurological, and substance use disorders are common, highly disabling, and associated with significant premature mortality. The impact of these disorders on the social and economic well-being of individuals, families, and societies is large, growing, and underestimated. Despite this burden, these disorders have been systematically neglected, particularly in low- and middle-income countries, with pitifully small contributions to scaling up cost-effective prevention and treatment strategies. Systematically compiling the substantial existing knowledge to address this inequity is the central goal of this volume. This evidence-base can help policy makers in resource-constrained settings as they prioritize programs and interventions to address these disorders.
Current data and trends in morbidity and mortality for the sub-Saharan Region as presented in this new edition reflect the heavy toll that HIV/AIDS has had on health indicators, leading to either a stalling or reversal of the gains made, not just for communicable disorders, but for cancers, as well as mental and neurological disorders.
Seventy percent of the global burden of mental disorders is located in low and middle income countries (LMIC),including sub-Saharan Africa (SSA). However, in Africa,only 0.62% of the national health budget is allocated to mental health compared to a global median of 2.8% and 5% in Europe. The government is the source of funding in 62%of patients with severe mental disorder in the World Health Organisation (WHO), Africa Region, the lowest of all the WHO regions, and lower compared to a global median of 79%. This is compounded by poor resources, with mental health outpatient facilities in WHO Africa Region being less that 10% of the global median. To address these problems, the WHO launched its Mental Health Action Gap Programme (mhGAP) in 2008, to scale-up mental health services in low and middle income countries (LMIC). The book is directed to all policy makers in sub-Saharan Africa to aid decision making about the urgent need for sustainable and relevant mental health care strategies, and the important areas that need priority. The book should be helpful to local and international researchers in formulating research questions relevant to the African continent and it will be of interest to medical practitioners and students in the region as adjunct to standard text books.
Millions of people in sub-Saharan Africa suffer from mental, neurological, and substance use (MNS) disorders, and most do not have the resources to obtain treatment. The Uganda National Academy of Sciences and the Institute of Medicine hosted a workshop to discuss the state of care for MNS disorders in sub-Saharan Africa.
About four out of five people in low- and middle-income countries who need services for mental, neurological and substance-use conditions do not receive them. Even when available, the interventions often are neither evidence-based nor of high quality. WHO recently launched the mental health Gap Action Programme (mhGAP) for low- and middle-income countries with the objective of scaling up care for mental, neurological and substance-use disorders. This mhGAP Intervention Guide has been developed to facilitate mhGAP-related delivery of evidence-based interventions in non-specialised health-care settings. The Intervention Guide is brief so as to facilitate interventions by busy non-specialists in low- and middle-income countries. It describes in detail what to do but does not go into descriptions of how to do. It is important that the non-specialist health-care providers are trained in using the mhGAP Intervention Guide in assessing and managing people with mental, neurological and substance-use disorders.
The mhGAP Intervention Guide (IG) is a clinical guide on mental neurological and substance use disorders for general health care workers who work in non-specialized health care settings particularly in low- and middle-income countries. These health care workers include general physicians family physicians nurses and clinical officers. The mhGAP programme provides a range of tools to support the work of health care providers as well as health policy makers and planners The proposed guide is an adaptation of the mhGAP Intervention Guide to be used in humanitarian settings. These settings include a broad range of acute and chronic emergency situations arising from armed conflicts natural disasters and industrial disasters and may include mass displacement of populations (eg refugees and/or internally displaced people).
This publication highlights key issues and principles to be considered in the drafting, adoption and implementation of mental health legislation and best practice in mental health services. It contains examples of diverse experiences and practices, as well as extracts of laws and other legal documents from a range of different countries, and a checklist of key policy components. Three main elements of effective mental health legislation are identified, relating to context, content and process.
Prevention of mental illness and mental health promotion have often been ignored in the past, both in undergraduate and postgraduate curricula. Recently, however, there has been a clear shift towards public mental health, as a result of increasing scientific evidence that both these actions have a serious potential to reduce the onset of illness and subsequent burden as a result of mental illness and related social, economic and political costs. A clear distinction between prevention of mental illness and mental health promotion is critical. Selective prevention, both at societal and individual level, is an important way forward. The Oxford Textbook of Public Mental Health brings together the increasing interest in public mental health and the growing emphasis on the prevention of mental ill health and promotion of well-being into a single comprehensive textbook. Comprising international experiences of mental health promotion and mental well-being, chapters are supplemented with practical examples and illustrations to provide the most relevant information succinctly. This book will serve as an essential resource for mental and public health professionals, as well as for commissioners of services, nurses and community health visitors.
Although epilepsy is one of the nation's most common neurological disorders, public understanding of it is limited. Many people do not know the causes of epilepsy or what they should do if they see someone having a seizure. Epilepsy is a complex spectrum of disorders that affects an estimated 2.2 million Americans in a variety of ways, and is characterized by unpredictable seizures that differ in type, cause, and severity. Yet living with epilepsy is about much more than just seizures; the disorder is often defined in practical terms, such as challenges in school, uncertainties about social situations and employment, limitations on driving, and questions about independent living. The Institute of Medicine was asked to examine the public health dimensions of the epilepsies, focusing on public health surveillance and data collection; population and public health research; health policy, health care, and human services; and education for people with the disorder and their families, health care providers, and the public. In Epilepsy Across the Spectrum, the IOM makes recommendations ranging from the expansion of collaborative epilepsy surveillance efforts, to the coordination of public awareness efforts, to the engagement of people with epilepsy and their families in education, dissemination, and advocacy for improved care and services. Taking action across multiple dimensions will improve the lives of people with epilepsy and their families. The realistic, feasible, and action-oriented recommendations in this report can help enable short- and long-term improvements for people with epilepsy. For all epilepsy organizations and advocates, local, state, and federal agencies, researchers, health care professionals, people with epilepsy, as well as the public, Epilepsy Across the Spectrum is an essential resource.
Even though mental illnesses are common and cause great suffering in every part of the world, many health workers have a limited understanding about mental health and are less comfortable dealing with mental illness. This book is a practical manual for mental health care for the community health worker, the primary care nurse, the social worker and the primary care doctor, particularly in developing countries. After giving the reader a basic understanding of mental illness, the book goes on to describe more than 30 clinical problems associated with mental illness and uses a problem-solving approach to guide the reader through their assessment and management. Mental health issues as they arise in specific health care contexts are described, for example in a refugee camp, a school health programme or with people suffering from AIDS, as well as in mental health promotion. The final section combines quick reference information for common problems and it also includes chapters for the reader to personalise the manual for a particular location, for example, by entering local information on voluntary agencies, the names and costs of medicines and words in the local language for emotional symptoms.