Attitudes towards mental disorders have been studied in rural areas of Sudan and Northern India and an urban area of the Philippines using standardized interviews with key informants. On average each informant knew by name 3.6 individuals who corresponded to descriptions provided of common mental disorders. The conditions most frequently identified were mental retardation (in all three areas), alcohol and drug related problems (in the Sudanese and Philippines areas) and acute psychosis (in the Indian area). In the Philippines area, the majority of informants indicated traditional healers as the primary source of help for psychological symptoms; in all areas people were judged to be more likely to seek help for psychological than for physical symptoms from traditional healers. Perceptions of mental illness and their consequences have been presented in graphic form through “attitude profiles”. These reveal differences in responses to the seven mental disorders presented to the key informants through vignettes. More negative and pessimistic attitudes were found in the Indian area than in the other two areas. The study has been carried out within a programme to introduce community based mental health care as part of primary health care in developing countries. The results have already been used in selecting priorities and designing interventions to promote community involvement. Their eventual use in evaluating the effectiveness of new forms of mental health care is also described.

Teams in seven developing countries under sponsorship of the World Health Organization have been carrying out collaborative operational research on providing mental health care through primary health care services. New techniques of identifying mental disorders in children and adults have been developed and tested. Methods of assessing the skills and attitudes of health workers toward mental health work and of gauging community attitudes toward mental illness have also been developed. Results have been directly applied in planning better mental health care. The authors conclude that cross-cultural collaborative research is effective in improving mental health care for those in greatest need.

It is possible to carry out high quality epidemiological research in developing countries. Such research has provided new insights into the distribution, causation, course and outcome of mental disorders. There is need for greater attention to the development of epidemiological assessment tools to suit local conditions. Specific centers/institutions developing long-term research interests on specific subjects would be valuable for future efforts. There is also need to widen the conditions to be studied.

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