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The 1960s was a period of reform and innovation in the provision of care for people with mental health problems. The most important development was the move away from residential institutions and the development of community services based on district general hospitals.

The influence of the ’new cross-cultural psychiatry’ is demonstrated with reference to a Japanese culture-bound syndrome, the interpretation of anorexia nervosa as a culture-reactive syndrome, and in the deconstruction of ’mass hysteria’. The validity of cross-cultural interviewing is examined in a number of papers which deal with the problems of interpretation and translation. New instruments have been developed to explore how people from different cultures explain mental distress, and to assess the psychological impact of the experience of being a refugee. The study of supplicants at a healing temple provides valuable anthropological insights into the phenomenon of spirit possession. A study of Chinese immigrants elucidates explanatory models and help-seeking behaviour in a hypothetical case of depression.

This review looks at attempts to improve the cultural and religious sensitivity of nosological systems and of clinical interview schedules. Cross-cultural psychotherapy and those culture-bound syndromes which involve men as the principal actor are also reviewed.

Cultural explanations of psychopathology in the West have rarely employed models derived by anthropologists for small-scale non-literate communities. Some general features of those ritual patterns usually classed as ‘culture-bound syndromes’ are applicable to Western neurosis. Such reactions articulate both personal predicament and public concerns. usually core structural oppositions between age groups or the sexes. They gain their power. by relying on certain unquestionable assumptions which. although beyond everyday jural relationships, articulate such relationships. In the case of Western reactions, such ‘mystical sanction’ is provided by biomedicine. Theoretical paradigms emphasize either the individual pragmatic or expressive aspects, or social homeostasis.