Unmet Need in Psychiatry: Problems, Resources, Responses

Cambridge University Press
Edition: Illustrated, 1/6/2000
EAN 9780521662291, ISBN10: 052166229X

Hardcover, 462 pages, 22.9 x 15.2 x 2.5 cm
Language: English

This book considers ways to resolve the imbalance between the demand and supply of mental health services. Treatment services in most countries reach only a minority of people identified as suffering from a mental disorder. Few countries can provide adequate health services for all the mentally ill, yet none has developed a rational system to decide who should be treated. The questions are clear. Could we develop a staged treatment process to reach all in need? If not, how do we decide who to treat? What should the criteria be for deployment of scarce treatment resources? How do we determine such criteria? What are the ethical implications of applying such criteria? In this pioneering work, an international team of eminent psychiatrists, epidemiologists, health administrators, economists and health planners examine these questions. The result will inform and encourage all concerned with the equitable provision of mental health care.

List of contributors
Preface
Part I. Unmet Need
Defining the Problem
1. Assessing needs for psychiatric services Norman Sartorius
2. Unmet need
a challenge for governments Harvey Whiteford
3. Meeting the unmet need with disease management Gavin Andrews
Part II. Unmet Need
General Problems and Solutions
Introduction Gavin Andrews
4. The epidemiology of mental disorder treatment need
community estimates of 'medical necessity' Darrel A. Regier, William E. Narrow, Agnes Rupp, Donald S. Rae and Charles T. Kaelber
5. Some considerations in making resource allocation decisions for the treatment of psychiatric disorders Ronald C. Kessler
6. The need for psychiatric treatment in the general population Paul Bebbington
7. Comparing data on mental health service use between countries Margarita Alegría, Ronald C. Kessler, Rob Bijl, Elizabeth Lin, Steven G. Heeringa, David T. Takeuchi and Bodhan Kolody
8. The challenges of meeting the unmet need for treatment
economic perspectives Agnes Rupp and Helen Lapsley
9. Unmet need for prevention Beverley Raphael
10. Meeting unmet needs
can evidence-based approaches help? Harold Alan Pincus and Deborah A. Zarin
11. Unmet need for management of mental disorders in primary care T. Bedirhan Üstün
12. Is complementary medicine filling needs that could be met by orthodox medicine? John E. Cooper
Part III. Unmet Need
People with Specific Disorders
Introduction Gavin Andrews
13. The unmet needs of people suffering from schizophrenia Graham Thornicroft, Sonia Johnson, Morven Leese and Mike Slade
14. The early course of schizophrenia
new concepts for intervention Heinz Häfner and Kurt Maurer
15. Unmet need in depression
varying perspectives on need Kay Wilhelm and Elizabeth Lin
16. Unmet need following serious suicide attempt
follow-up of 302 individuals for 30 months Annette Beautrais, Peter Joyce and Roger Mulder
17. Met and unmet need for interventions in community cases with anxiety disorders Hans-Ulrich Wittchen
18. The unmet need for treatment in panic disorder and social phobia Caroline Hunt
19. Alcohol-use disorders
who should be treated and how? Wayne Hall and Maree Teesson
20. Putting epidemiology and public health in needs assessment
drug dependence and beyond James C. Anthony
21. Why are somatoform disorders so poorly recognized and treated? Ian Hickie, Rene G. Pols, Annette Koschera and Tracey Davenport
Part IV. Unmet Need
Specific Issues
Introduction Scott Henderson
22. Unmet need in mental health service delivery
children and adolescents Michael Sawyer and George Patton
23. Assessing psychopathology among children aged four to eight Linda Cottler, Wendy Reich, Kathy Rourke, Renee M. Cunningham-Williams and Wilson M. Compton
24. Unmet need in indigenous mental health
where to start? Ernest Hunter
25. Health systems research
a pragmatic model for meeting mental health needs in low-income countries Vikram Patel
26. Disablement associated with chronic psychosis as seen by two groups of key informants
patients and mental health professionals Charles B. Pull, Arnaud Sztantics, Steve Muller, Jean Marc Cloos and Jean Reggers
27. The assessment of perceived need Graham Meadows, Ellie Fossey, Carol Harvey and Philip Burgess
28. Public knowledge of and attitudes to mental disorders
a limiting factor in the optimal use of treatment services Anthony F. Jorm, Mattias Angermeyer and Heinz Katschnig
Part V. Unmet Need
Conclusion
29. A personal overview John R. M. Copeland
30. Conclusion
the central issues Scott Henderson
Index.