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Since 1989, the major professional organization of psychiatrists has expressed concern for the human rights of people with mental disorders: "Involuntary intervention is a great infringement of the human rights and the fundamental freedom of a patient. Therefore, specific, and carefully defined criteria and safeguards are needed for such intervention. Hospitalization or treatment against the will of a patient should not be conducted unless the patient suffers from serious mental illness. Involuntary intervention must be conducted in accordance with the least restrictive principle. [ABSTRACT FROM AUTHOR]

The current crisis of Italian psychiatry probably depends on a diminished drive for innovation in the field mental health, on a political climate that gives voice to conservative and pseudo-progressive psychiatry, and on a certain laziness of anti-institutional psychiatry to look to the future rather than the past, producing new theoretical reflections and further innovations in liberation practices. All these factors determine the strengthening of psychiatry in its most conservative, dehumanizing and institutional forms. But how much all this is to be attributed exclusively to a crisis of psychiatry, including the anti-institutional one, or, and more generally, to the dramatic absence of collective thought and practices of liberation and justice, is a question that needs to be studied. [ABSTRACT FROM AUTHOR]

Mental health care programmes during and after acute emergencies in resource-poor countries have been considered controversial. There is no agreement on the public health value of the post-traumatic stress disorder concept and no agreement on the appropriateness of vertical (separate) trauma-focused services. A range of social and mental health intervention strategies and principles seem, however, to have the broad support of expert opinion. Despite continuing debate, there is emerging agreement on what entails good public health practice in respect of mental health. In terms of early interventions, this agreement is exemplified by the recent inclusion of a "mental and social aspects of health" standard in the Sphere handbook's revision on minimal standards in disaster response. This affirmation of emerging agreement is important and should give clear messages to health planners.

Mental health research is needed in African countries in order to improve quality of care at local levels. This paper presents the results of a study conducted in 2018 among one hundred care givers in two peripheral primary health care facilities in rural Kenya. Opened interviews were performed, with the aim of eliciting relevant issues. The body of knowledge generated by the Global Mental Health (GMH) movement was used as the theoretical frame of reference. Five broad topics emerged as particularly significant in the specific context of this study: a. a globally negative perception of mental illness; b. a lack of trained professionals associated with limited opportunities for task-sharing or task-shifting; c. an intense stigmatization of affected individuals; d. the importance of strengthening the collaboration between the formal health sector and traditional healers, and, e. the necessary efforts to be made in order to reach patients living in remote areas. Our study highlights the importance of actively detecting mental disorders, promoting initiatives to reduce stigma and adapting western designed tools for specific settings in low and middle income countries (LMICs). [ABSTRACT FROM AUTHOR]

The treatment gap for mental disorders remains a challenge worldwide. Identifying reasons for nontreatment may contribute to reducing this gap. To evaluate sociodemographic and clinical factors associated with use and barriers to treatment in Portugal. Data from the 2009 National Mental Health Survey were used. Participants reported 12-month treatment and reasons for nontreatment. Logistic regression models analysed the association between sociodemographic (education; employment; income; marital status) and clinical variables (mental disorder diagnosis; disability) with treatment and type of barriers (low perceived need; structural; attitudinal). The majority of participants with a mental disorder was not treated. Treatment was more common among participants with mood disorders (OR = 4.19; 95% CI: 2.72–6.46), and disability (OR = 2.43; 95% CI: 1.33–4.46), and less common among single participants (OR = 0.38; 95% CI: 0.20–0.70) and those with basic/secondary education (OR = 0.42; 95% CI: 0.24–0.73). Attitudinal barriers were more likely among participants with none/primary (OR = 2.90; 95% CI: 1.42–5.90) and basic/secondary education (OR = 1.70; 95% CI: 1.01–2.85), and less likely among those with substance use disorders (OR = 0.27; 95% CI: 0.10–0.70). Low perceived need was higher among single people (OR = 1.77; 95% CI: 1.01–3.08), and lower among those with anxiety (OR = 0.50; 95% CI: 0.28–0.90) and mood disorders (OR = 0.16; 95% CI: 0.09–0.30). Unemployed participants had higher odds of reporting structural barriers (OR = 3.76; 95% CI: 1.29–10.92). This study identifies factors associated with nontreatment, providing useful evidence to develop policies and effective interventions. [ABSTRACT FROM AUTHOR]

Increasingly, social scientists interested in mental and social health conduct qualitative research to chronicle the experiences of and humanitarian responses to disaster We reviewed the qualitative social science research literature in relation to a significant policy document, the Sphere Handbook, which includes a minimum standard in disaster response addressing 'mental and social aspects of health', involving 12 interventions indicators. The reviewed literature in general supports the relevance of the Sphere social health intervention indicators. However, social scientists' chronicles of the diversity and complexity of communities and responses to disaster illustrate that these social interventions cannot be assumed helpful in all settings and times. With respect to Sphere mental health intervention indicators, the research largely ignores the existence and well-being of persons with pre-existing, severe mental disorders in disasters, whose well-being is addressed by the relevant Sphere standard. Instead, many social scientists focus on and question the relevance of posttraumatic stress disorder-focused interventions, which are common after some disasters and which are not specifically covered by the Sphere standard. Overall, social scientists appear to call for a social response that more actively engages the political, social, and economic causes of suffering, and that recognizes the social complexities and flux that accompany disaster. By relating social science research to the Sphere standard for mental and social health, this review informs and illustrates the standard and identifies areas of needed research. Keywords: Mental health; Disaster; Sphere; Policy; Anthropology; Qualitative methods

Mental disorders are highly prevalent and cause considerable suffering and disease burden. To compound this public health problem, many individuals with psychiatric disorders remain untreated although effective treatments exist. We examine the extent of this treatment gap. We reviewed community-based psychiatric epidemiology studies that used standardized diagnostic instruments and included data on the percentage of individuals receiving care for schizophrenia and other non-affective psychotic disorders, major depression, dysthymia, bipolar disorder, generalized anxiety disorder (GAD), panic disorder, obsessive-compulsive disorder (OCD), and alcohol abuse or dependence. The median rates of untreated cases of these disorders were calculated across the studies. Examples of the estimation of the treatment gap for WHO regions are also presented. Thirty-seven studies had information on service utilization. The median treatment gap for schizophrenia, including other non-affective psychosis, was 32.2%. For other disorders the gap was: depression, 56.3%; dysthymia, 56.0%; bipolar disorder, 50.2%; panic disorder, 55.9%; GAD, 57.5%; and OCD, 57.3%. Alcohol abuse and dependence had the widest treatment gap at 78.1%. The treatment gap for mental disorders is universally large, though it varies across regions. It is likely that the gap reported here is an underestimate due to the unavailability of community-based data from developing countries where services are scarcer. To address this major public health challenge, WHO has adopted in 2002 a global action programme that has been endorsed by the Member States. Keywords Mental health services/utilization; Health services accessibility; Schizophrenia/therapy; Anxiety disorders/therapy; Mood disorders/therapy; Compulsive personality disorder/therapy; Alcoholism/therapy; Epidemiologic studies; Cost of illness; Americas; Europe (source: MESH, NLM). Mots cles Service sante mentale/utilisation; Accessibilite service sante; Schizophrenie/therapeutique; Etat anxiete/therapeutique; Troubles humeur/therapeutique; Personnalite compulsive/therapeutique;Alcoolisme/therapeutique; Etude analytique (Epidemiologie); Cout maladies Amerique; Europe (source: MeSH, INSERM). Palabras clave Servicios de salud mental/utilizacion; Accesibilidad a los servicios de salud; Esquizofrenia/terapia; Trastornos de ansiedad/terapia; Trastornos del humor/terapia; Trastorno de personalidad compulsiva/terapia; Alcoholismo/terapia; Estudios epidemiotogicos; Costo de la enfermedad; Americas; Europa (fuente: DeCS, BIREME). [TEXT NOT REPRODUCIBLE IN ASCII], Resume Le defaut de traitement en sante mentale Les troubles mentaux ont une prevalence elevee et representent une charge considerable en termes de souffrance et de maladie. De plus, de [...]