Community psychiatry in developing countries – a misnomer?

Farooq, Saeed; Minhas, Fareed Aslam

doi:10.1192/pb.25.6.226

Cited by 15 publications

(10 citation statements)

References 14 publications

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“…Culture, social class, and ethnicity make a major difference along the pathway to depression care, influencing diagnosis, treatments prescribed, and treatment utilization. Depressed individuals from White, middle class backgrounds are more likely than working class and ethnic minorities to be treated for depression (Bristow & Patten, 2002; Gillam, Jarman, White, & Law, 1989; Farooq & Minhas, 2001). While problems of access to treatment play a role, evidence to date suggests that these disparities in rates of treatment may also be related to differences in attitudes and preferences regarding treatment (Burroughs et al, 2006; Givens et al, 2006; Sleath et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Conceptual Models of Depression in Primary Care Patients

Karasz

Garcia

Ferri

2009

Journal of Cross-Cultural Psychology

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Conventional psychiatric treatment models are based on a biopsychiatric model of depression. A plausible explanation for low rates of depression treatment utilization among ethnic minorities and the poor is that members of these communities do not share the cultural assumptions underlying the biopsychiatric model. The study examined conceptual models of depression among depressed patients from various ethnic groups, focusing on the degree to which patients’ conceptual models ‘matched’ a biopsychiatric model of depression. The sample included 74 primary care patients from three ethnic groups screening positive for depression. We administered qualitative interviews assessing patients’ conceptual representations of depression. The analysis proceeded in two phases. The first phase involved a strategy called ‘quantitizing’ the qualitative data. A rating scheme was developed and applied to the data by a rater blind to study hypotheses. The data was subjected to statistical analyses. The second phase of the analysis involved the analysis of thematic data using standard qualitative techniques. Study hypotheses were largely supported. The qualitative analysis provided a detailed picture of primary care patients’ conceptual models of depression and suggested interesting directions for future research.

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Section: Introductionmentioning

confidence: 99%

Conceptual Models of Depression in Primary Care Patients

Karasz

Garcia

Ferri

2009

Journal of Cross-Cultural Psychology

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“…Policy-makers must be made aware of the inefficiencies in clinic service provision so that the meagre funds available for health care services can be utilised optimally. Farooq & Minhas (2001) have stressed that community psychiatry as practised in the developed world context is not the answer to the mental health problem in developing countries but 'primary care psychiatry' is, as proposed by the World Health Organization (1975). In several developing countries there are small pockets of models integrating mental health into primary health care but these models are never implemented on a national scale.…”

Section: Discussionmentioning

confidence: 99%

Reasons for consultation in the psychiatric out-patient clinic of a university teaching hospital in Nigeria: is this optimal use of psychiatrists' time and expertise?

Omigbodun

Esan

2003

Psychiatr. bull.

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Aims and MethodTo identify activities that can be modified in the psychiatry out-patient clinic in order to improve the quality of services rendered. Consulting doctors obtained information on the reason for consultation and time spent by each patient over a one-month period.ResultsHalf of all the patients (50.5%) came for a repeat prescription, and 19.3% came for a repeat prescription and counselling. The mean times spent on these two activities were 5.13 (s.d.=2.5) and 7.81 (s.d.=7.51) minutes, respectively. The time spent on these activities by doctors was 47% of the total clinic time.Clinical ImplicationsClinic services should be reorganised so that doctors can use their skills in more efficient and creative ways.

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“…This necessitates conceptualising, directing and conducting mental health research as well as dissemination of research output, in which psychiatrists are expected to play a crucial role as well (Farooq & Minhas, 2001). Further, as part of capacity building and mentoring, psychiatrists must inculcate a research oriented approach/culture at all levels of service delivery; sharing out challenges, solutions and new discoveries.…”

Section: The Role Of Psychiatristsmentioning

confidence: 99%

“…The psychiatrist will for the foreseeable future remain an expert clinician for service delivery both at primary and tertiary levels, with key roles of clinical assessment, diagnosing and treating persons with mental illness; training fellow mental health professionals as well as developing and disseminating guidelines for fellow professionals (Farooq & Minhas, 2001;Patel, 2009). This should be in addition to other key roles with multiplier effects such as influencing resource mobilisation, generating demand for service utilisation and contributing to the provision of an enabling professional environment for scaling up mental health services.…”

Section: The Role Of Psychiatristsmentioning

confidence: 99%

The multiplier role of psychiatrists in low income settings

Kigozi

Ssebunnya

2014

Epidemiol Psychiatr Sci

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Mental health care is receiving increased attention in low-income countries with the availability of a wide range of effective evidence-based treatments for acute and chronic mental disorders amidst scarce resources. Availability of these treatments and competent human resources enables the use of a variety of interventions at several levels of care for persons with mental illness and makes it feasible to ensure observance of quality in the treatment approaches that go beyond institutionalisation. However, unlike developed countries which are endowed with many and relatively well-paid mental health specialists, low-income countries face a dire shortage of highly trained mental health professionals in addition to several other challenges. In light of this, there is need to re-assess the role of the few available psychiatrists, with a shift to new core tasks such as designing mental health care programmes that can be delivered by non-specialists, building their health system's capacity for delivering care, including supporting front-line health workers through support supervision, raising awareness on mental health and patients’ rights in addition to promoting essential research. This requires a fundamental paradigm shift from the current training for mental health specialists to a public health oriented approach and providing incentives for community engagement.

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Community psychiatry in developing countries – a misnomer?

Cited by 15 publications

References 14 publications

Conceptual Models of Depression in Primary Care Patients

Conceptual Models of Depression in Primary Care Patients

Reasons for consultation in the psychiatric out-patient clinic of a university teaching hospital in Nigeria: is this optimal use of psychiatrists' time and expertise?

The multiplier role of psychiatrists in low income settings

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