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An introduction to the journal is presented in which the authors discuss several reports focusing on the mental health of people living in the South Asian region which is comprised of the countries India, Pakistan, Nepal, Sri Lanka and Bangladesh as well as Iran, Afghanistan and the Maldives.

The unprecedented changes in our society because of COVID-19 and the fourth industrial revolution (4IR) shows that our healthcare system and the medical approach to psychotherapy can no longer meet the mental health needs of society. This paper first described the negative impact of COVID-19 and 4IR on our mental health. Then, following a brief critique of the medical model, this paper proposes that the future of psychotherapy needs to be based on the more inclusive and integrative framework of existential positive psychology (PP 2.0), which emphasizes flourishing through suffering. Finally, the paper emphasizes Viktor Frankl's cure and Wong's integrative meaning therapy. It concludes that integrative meaning therapy represents the future of psychotherapy, because it is situated in the area of interactions of at least three traditions: Clinical psychology, existential psychology, and positive psychology. This integrative model is holistic, recognising humans as bio-psycho-social-spiritual beings and considers several theoretical perspectives in both diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Research in mental health is a complex phenomenon that requires the use of more than one technique. It is extremely crucial to study and understand people's perceptions, beliefs, healing practices and coping strategies related to mental health. Stipulating only one between the medical/biomedical and medical anthropology perspectives may not be adequate to understand the dynamics of mental health research. The number of variables and components associated with the respondents and their social environments give diverse results. Research on mental health is very crucial and different from other kinds of health-related researches. Thus, while conducting mental health research, it is important that the researchers be careful in choosing and applying appropriate methodology. It is a very critical field of research, requiring Interdisciplinary research methodological approaches. An eclectic strategy is required to give an innate understanding of the phenomenon of mental health. Studies should follow both anthropological and epidemiological notions to understand human behaviour, for better management and planning of the mental health services. The proposed paper discusses 'cultural epidemiology' as a methodology and explores its contribution to the contemporary mental health research. [ABSTRACT FROM AUTHOR]

This paper shows how the community of Latin-American and Spanish psychiatry represents a solid platform for the so-called 'continental thought' to meet the analytical Anglo-Saxon thought. It reviews what both Latin America and the Spanish and Portuguese languages represent in the American continent; the relation between Spanish psychiatry and Spanish-speaking psychiatry in America during the twentieth century; the reality of psychiatric research and profession in Latin America; the evolution of Spanish psychiatry in the twentieth century from the post civil war diaspora to the beginning of the twenty-first century, and research on mental health in Spain and the foreseeable future. [ABSTRACT FROM AUTHOR]

Mental health disorders cause a large burden on global public health, with many patients living years with the disability. However, many doctors are ill-equipped to treat mental health disorders given inadequate training during their undergraduate years. In some countries, psychiatry is even considered an elective course rather than a core module. There is, therefore, a pressing need to improve the training of medical students in managing mental health disorders. Measures need to be implemented to attract students to choose psychiatry as their career. Given the developments in the fields and the challenges currently faced by trainees and early career psychiatrists, changes may also be made to the training programme in the postgraduate stage to unify the variations across the world in terms of the training duration and format. This paper will describe the ways that undergraduate and postgraduate psychiatry training may be ameliorated to improve the delivery of mental healthcare around the world and to equip doctors to face challenges in the future. [ABSTRACT FROM AUTHOR]

Films featuring psychiatrists, psychiatry and the mentally ill abound, for better or for worse. The use of cinema in postgradute psychiatry training has been gaining increasing acceptability, but its potential for use in undergraduate psychiatry has received little attention in the literature. This paper reports on the rationale behind, and medical students' responses to a special study module for third year medical students at King's College London, which utilized movies to highlight the significance of the social, cultural and historical context in shaping representations of mental illness, psychiatry, and psychiatrists. Medical students were very receptive to the use of film as an educational tool and able to understand both the benefits and limitations. They found the module enjoyable, and subjectively rated their knowledge of psychiatric topics and the history of psychiatry as significantly improved. The results presented are course feedback from medical students (n = 8) who completed the module. Although our findings provide provisional support for the use of film as an educational tool in undergraduate psychiatry, more systematic research is needed to delineate the potential role of cinema in undergraduate psychiatric education. [ABSTRACT FROM AUTHOR]

Psychopathology is usually recognized as an important clinical and research tool in psychiatric textbooks. However, in the era of operationalized psychiatric diagnosis, therapeutic guidelines and strong neuroscientific impact on the self-understanding of psychiatry, its role became somewhat insecure in recent decades. And it has even been argued that psychopathology will sooner or later be fully replaced by neuroscientific concepts. This paper elucidates the theoretical (and, partly, historical) framework of this debate and argues for a modern understanding of psychopathology. This understanding will, on the one hand, be compatible with neurobiological and social sciences appoaches to mental illness, and, on the other hand, will not abandon psychopathology's demand to be an indispensable foundation of psychiatry. [ABSTRACT FROM AUTHOR]

This paper is based on the Bruce Burns Memorial Trust Lecture, Terrorism and Mental Health, presented in October 2005, in Birmingham. In addition to written sources, it is informed by the author's experience and contact with military and police experts in this arena over 28 years as a member of the British Army. The diagnosis and treatment of post traumatic mental disorders are not addressed in this paper. The author explores the general phenomenon of terrorism, in an endeavour to inform understanding of terrorist acts. He stresses the need for contextualisation of acts of terror, their perpetrators, their effects on populations and individuals, and attention to the psychology of groups. The author aims to invite and inform further thought and debate on the subject by raising a wide range of issues which do not sit comfortably within a strict psychiatric, research-based paradigm. The author covers a brief history of terrorism; organisational requirements of terror groups and the process of recruiting personnel to them; the means, motives and opportunities terrorists exploit in their work; the need for communication with terror groups; sacrificial death; governmental responses to terrorist acts and fear and mental health. The author proposes that terrorist organisations perform some of the functions of a family; that acts of terror are 'propaganda by deed'; that terrorism, or more precisely the media's treatment of it, breeds 'formless fears' which may directly lead to the development of fear-based symptoms and illness within societies. He notes that terrorism is an enterprise from which many players ('experts', media, politicians, etc.) benefit; that terrorism has its shadow in counter-terrorism, which may range from benign to malignant and that psychiatry could, in this context, acknowledge its bias towards individual psychologies and rectify its lack of understanding of groups and the behaviours of individuals within them. [ABSTRACT FROM AUTHOR]

The objectives of this paper are to develop insights into the mind of the terrorist, to conduct a review of health impacts on the health of populations, especially from the point of view of mental health impacts caused by terrorist attacks and to discern the role to be played by forensic psychiatry in emergencies caused by terrorist actions. These objectives are developed at the population level and at the individual level from the point of view of a description of the terrorist and of victim's need for forensic intervention and representation. On entrance, the paper starts with a general frame of definitions and a historical overview of terrorism as an ancient, purposeful, political tool used to change a situation objectionable to the terrorist group via intimidation of a captive population. People are used as expendable pawns and become psychologically captive to the aims of the terrorist group. As well, the paper reviews the new reality of bioterrorism and the use of improved technologies to inflict expensive damage to national infrastructures and massive loss of life. [ABSTRACT FROM AUTHOR]

Mental ill health is a universal phenomenon: that is, it is seen across all cultures and societies, even though the presentation may be culture-specific and affected by cultural norms and more. Governments have a moral and ethical duty to develop mental health services which are accessible, appropriate, and non-discriminatory. Equity in funding mental health services is critical. As globally services and their quality vary dramatically, one should be proposing and agreeing on minimum standards of care. In this paper the basic components and minimum standards of care are described. It is imperative that services are non-discriminatory. It is important that governments work with psychiatrists, other mental health professionals, and individuals with mental illness, their families, and carers to plan, develop, and deliver services with adequate funding. Employers and psychological first aid must also be remembered. Services must be geographically accessible. In this endeavour primary care services have a major role to play. Training and clinical decision-making must be part of the change in service delivery. It is imperative that every effort is made to keep the population mentally as well as physically healthy, and people who develop mental illness must have access to evidence-based treatment at the earliest possible opportunity. [ABSTRACT FROM PUBLISHER]

Psychiatry is a topic that has long fascinated the film industry. Psychiatric illnesses provide a unique base for directors to create characters and surroundings that capture the imagination of the audience. However, there is the risk that inaccurate portrayals can lead to biased and unfair views in those with no direct experience of them. In this paper two portrayals are compared. [ABSTRACT FROM AUTHOR]

The article discusses various papers published within the issue including a paper by Enrique Baca et al. on the role of Spain and Portugal in the psychiatry and mental health fields of Latin America, another by Jorge J. Rodriguez on the psychiatric and mental health systems across Latin America and the Caribbean, and another by Renato D. Alarcon and colleagues examining the role of identity with respect to personality development.

This paper summarizes a series of events that were historical milestones in Latin America and the Caribbean in the long road toward restructuring and setting up psychiatric and mental health services to shift from the old and obsolete psychiatric hospital models to other, community-based models. This has been and largely remains the principal challenge that we face. The burden of mental illness is described in terms of morbidity, mortality, and disability. In 1990, it was estimated that psychiatric and neurological disorders accounted for 8.8% of the disability-adjusted life years in Latin America and the Caribbean; in 2004 that burden had grown to 21%. However, the treatment gap (sick people who remain untreated) exceeds 60%; added to that there is a prevailing gap in funding and resources for the treatment of mental health problems. In response to these problems, the Pan American Health Organization (PAHO/WHO) has continued to strengthen its technical cooperation with the countries. The 49th Directing Council of PAHO/WHO approved the Strategy and Plan of Action on Mental Health for the region of the Americas, which constitutes a major historical landmark; for the first time, the ministries of health in every country in the hemisphere studied and approved a work programme to improve mental health care based on the experiences gained and expressing a technical and political commitment. It is a key priority to continue working to restructure mental health services and strengthen intersectoral initiatives to promote mental health; specific problems, such as care for vulnerable groups, child and adolescent mental health, suicide, alcohol abuse, and violence, also pose a great challenge for mental health programs today. [ABSTRACT FROM AUTHOR]

This paper provides a brief review of the addictions field in Latin America. Epidemiology, legal aspects, dual pathology, treatment, prevention and future directions are discussed. This increasing disease is one of the major contributors for mental health problems in the region. Efforts have been made in treatment and prevention but results and budgets are scarce. Dual pathology, new modalities such as injected heroin in countries such as Colombia, low coverage of programmes, training resources, research and publications are important challenges. The tendency to liberalize legal terms of use would require more effort for prevention and education. Based on relevant literature and a long and current experience in the area, the authors summarize this important theme. [ABSTRACT FROM AUTHOR]

Tamil cinema is a vibrant part of the lives of many in south India. A chequered history and a phenomenal growth have made this medium highly influential not only in Tamil Nadu politics, but also in the social lives of the viewers. This paper provides an overview of the growth of Tamil cinema, and discusses in detail the way mental health has been handled by Tamil films. Cinema can be used very effectively to improve awareness about mental health issues. [ABSTRACT FROM AUTHOR]

Psychoanalysis was developed in nineteenth-century Vienna and led to a major change in thinking about emotions and feelings, and entered common parlance. Psychoanalysis raises notions of individual's growth and development, and defence mechanisms are used to suppress anxiety and stress. Portrayal of psychoanalysis in modern Hindi cinema is rare. In this paper we look at two films released in the late 1960s which dealt directly with psychoanalysis. Using these films we illustrate the relationship between males and females and the interaction between mothers and sons in the Indian context. The role of nurses as nurturing maternal figures and the role of tradition and modernity related to gender and westernization are discussed. These films represent the emergent India and its relationship with modernity and traditional values. [ABSTRACT FROM AUTHOR]

In Asia, like other regions, the circumstances for psychiatric care and rehabilitation impose various limitations on us. However, committed professionals have been creating innovative models of excellence, which are culturally appropriate and clinically effective. In this paper, seven innovative models of psychiatric care and rehabilitation are presented. The Nitte project in India provides a comprehensive free rural psychiatric service, while transforming the 'brain drain' problem to 'brain circulation' cooperation. Through Social Enterprises in Hong Kong recovered clients are trained and employed. Senior Peer Counselling in Singapore emphasizes the relief of emotional distress by psychological methods and the primacy of communication in the healing or therapeutic relationship. Seoul Mental Health 2020, an epoch-making project in Korea, has increased the coverage rate of community mental health centres remarkably. Yuli Psychiatric Rehabilitation Model in Taiwan helps long-term inpatients to get reintegrated into the community. In Japan, models of excellence for community-based psychiatry have been developed at local government, hospital and community/NGO levels. Chinese Psychiatry Online, an excellent website, provides public education, resource searching, self-testing and consultation services for the public along with various contents for professionals. We must disseminate information about models of excellence which provide great benefit to the people who suffer from psychiatric illness without high expenses. [ABSTRACT FROM AUTHOR]

In the past decade, mental health professionals have initiated a number of national and international efforts against the stigma of mental illness. While largely successful in beating stigma and discrimination, these programmes have, in part, been criticized to be largely uninformed by the lived realities of people with mental illness and their families. Some critics claimed that anti-stigma efforts led by mental health professionals were in fact a concealed attempt at de-stigmatizing psychiatry itself as a profession. This paper will attempt to throw light on the various ways in which mental health professionals are 'entangled' in anti-stigma activities. It will outline the complex relationships between stigma and the psychiatric profession, presenting evidence on how its members can simultaneously be stigmatizers, stigma recipients and powerful agents of de-stigmatization. In exploring the role of mental health professionals as targets of stigma, new findings will be presented on the role of stigma as a professional stressor in psychiatry. Conclusions will be drawn on how the pursuit of professional self-interest can be a legitimate goal of anti-stigma programmes. Further, ways in which acknowledging psychiatry's own agenda can contribute to both credibility and success of fighting stigma from within psychiatry will be discussed. [ABSTRACT FROM AUTHOR]

This paper discusses factors associated with low rates of help-seeking and poorer quality of physical healthcare among people with mental illnesses. Evidence is reviewed on the associations between low rates of mental health literacy, negative attitudes towards people with mental illness, and reluctance to seek help by people who consider that they may have a mental disorder. People with mental illness often report encountering negative attitudes among mental health staff about their prognosis, associated in part with 'physician bias'. 'Diagnostic overshadowing' appears to be common in general health care settings, meaning the misattribution of physical illness signs and symptoms to concurrent mental disorders, leading to underdiagnosis and mistreatment of the physical conditions. [ABSTRACT FROM AUTHOR]

Different phases of intervention after any disaster bring with them specific issues that policy-makers as well as healthcare deliverers must take into account. There are some specific issues related to aid with dignity and dead-body identification that need to be taken into account. The human and material resources are important in planning and delivering mental healthcare. In India, with each successive disaster, the immediate response in the rescue and relief phase has improved and the administration is able to mobilize a large amount of resources from different sectors quickly, efficiently and in a co-ordinated manner in the immediate and short-term periods after a disaster. That psychological first aid will reduce psychiatric morbidity is now generally accepted as a key principle in interventions immediately after a disaster. In the recent events, large numbers of community-level volunteers have received short-term training and been able to provide effective psychosocial care and support. The paper presents the author's observations and provides an overview of some of the lessons learnt in mental health and psychosocial support care across the several natural and human-made disasters that have taken place in India. While significant progress has been made with respect to the rescue and relief response, there is still a lot to be achieved in the rehabilitation and rebuilding phases that follow a disaster. Disaster prevention and mitigation need global vision combined with local action. Building capacity through careful planning and training potential workers is an important step. The stakeholders must take into account local cultural and social needs. [ABSTRACT FROM AUTHOR]

The nature of the workplace continues to change as Europe adapts to the challenges of competing in a global marketplace. Across the European Union there is a trend of increasing absenteeism and early retirement due to mental health problems, particularly stress and depression. The social and economic costs of lost productivity in Europe are substantial. Moreover, the sustainability of social protection systems may be challenged further by increases in the levels of disability benefits paid to people who have left work on grounds of poor mental health. Yet despite these significant consequences, at both national and pan-European levels, decision-makers have been slow to recognise the importance of promoting mental health within the workplace, although recently there have been some positive developments. This paper outlines some of the socio-economic arguments for the promotion of good mental well-being in the labour force and identifies how they link with different national and European policy agendas around four key issues: economic growth and development, the promotion of a high level of public health, sustainability of social welfare systems and social inclusion. The role and activities to promote mental well-being in the workplace undertaken by both national and international organizations in Europe are outlined along with important gaps and challenges that need to be addressed. [ABSTRACT FROM AUTHOR]

The development of an excellent mental health system at the national level or even the state or provincial jurisdiction resembles the search for the Holy Grail. We are not there yet, and some stakeholders doubt we will ever get there. The last 20 years has seen an explosion of progressive mental health policy statements in a number of jurisdictions. However, it is difficult to find national mental health systems that are performing well. This paper reviews the status of national mental health policy in Australia, the UK, the USA and New Zealand. It examines the evolution of mental health policy in Ontario, Canada, and provides some commentary on how the Ontario experience is consistent with the experience of other jurisdictions. Finally it explores whether there are lessons to be learned that can be applied in Canada and elsewhere. [ABSTRACT FROM AUTHOR]

This paper draws upon a review of the relevant literature and the results of the recent Mental Health Awareness in Action (MHAA) programme in England to discuss the current evidence base on the active ingredients in effective anti-stigma interventions in mental health. The MHAA Programme delivered educational interventions to 109 police officers, 78 adults from different community groups whose working lives involved supporting people with mental health problems but who had received no mental health training and 472 schools students aged 14–15. Each adult target group received two intervention sessions lasting two hours. The two school lessons were 50 minutes each. Knowledge, attitudes and behavioural intent were assessed at baseline and follow-up. In addition focus groups were held with mental health service users to explore the impact of stigma on their lives and facilitators of educational workshops were interviewed to provide expert opinion on ‘what works' to reduce psychiatric stigma. Personal contact was predictive of positive changes in knowledge and attitudes for the school students but not the police officers or community adult group. The key active ingredient identified by all intervention groups and workshop facilitators were the testimonies of service users. The statements of service users (consumers) about their experience of mental health problems and of their contact with a range of services had the greatest and most lasting impact on the target audiences in terms of reducing mental health stigma. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented in which the editor discusses several reports focusing on the mental health of people living in the South Asian region, best captured by the political grouping of eight nations under the South Asian Association for Regional Cooperation (SAARC).

People with psychosocial disabilities are often discriminated against and experience violations of their human rights. With the QualityRights program, World Health Organisation highlights that one of element founding the quality of services is the respect for users' rights, in the belief that there is no quality of care without respect for human rights and vice versa. To date, studies explored the issue mainly in Europe. In this sense, the purpose of the study is to verify if the perception of respect for patients' rights is a component of organisational well-being for mental health workers in three countries of Latin America (Argentina, Colombia, Peru). A random sample representative of professionals working in three mental healthcare networks in Argentina, Colombia, and Peru was enrolled (n = 310). Each health worker completed a questionnaire on sociodemographic data and the Well-Being at work and respect for human rights (WWRR). The WWRR consists of seven items on satisfaction at work, beliefs about users' satisfaction in received care, the satisfaction of work's organisation, respect of users' and staff's human rights, adequacy of resources, and perceived needs of resources in the mental health service. The principal components analysis of the instrument was carried out with Varimax rotation and Kaiser normalisation (including all components with Eigen value > 1). The total explained variance was 67.2%. Item 6 saturated in one single factor, and the first five items saturated in factor 1 with factor loadings ranging from 0.52 to 0.86. Parallel test suggested a one-factor structure as acceptable. The results show in three countries of Latin America that the more workers perceive that the human rights of users are respected, the more satisfied they are of own work. This article confirms previous observations in Italy, North Macedonia, Tunisia and Palestine. [ABSTRACT FROM AUTHOR]

This paper provides an illustration of problems in making diagnosis based on a single film. American Psycho provides an overview of the personality traits of an individual who may be suffering from a number of potential conditions. These are discussed in relation to diagnostic categories. [ABSTRACT FROM AUTHOR]

This article provides a conceptual overview of the medical model and its application to psychiatry, understanding the medical model in psychiatry as a biopsychosocial model. The article discusses basic concepts relevant to the medical model (illness, disease, disorder, condition, etc.), the nature of medical knowledge and diagnostic construct, medical classifications in psychiatry, and the medical model within multidisciplinary practice. Salient criticisms of the medical model are discussed and addressed at relevant points. It is recognized that concepts such as disease and illness lack uncontested definitions and are not free from value judgements even in general medicine. Diagnostic constructs used in psychiatry are often descriptive heterogenous categories which can nonetheless offer clinical utility. The medical model co-exists with non-medical approaches and perspectives, and psychiatrists work in an interdisciplinary context with other models and professionals. Criticism of the medical model in psychiatry often fail to recognize the continuities between psychiatry and the rest of medicine, and the persistence of these controversies may be a result of fundamental disagreement over values. [ABSTRACT FROM AUTHOR]

This interview with Derek Bolton, PhD, goes into a discussion of his philosophical work on the diagnosis and definition of mental disorder, the basis of the standards or norms by which we judge that a person has a mental disorder, and the validity of the distinction between abnormal and normal mental functioning. Bolton argues that the notion that emerges from a conceptual analysis of psychiatry's diagnostic manuals is not a naturalist notion of disorder, but one that is focussed on harm and suffering, and in which the personal, the social and the biological cannot be clearly distinguished. The implications of this thinking with regards to the relationship between the medical model and the psychological approaches are also discussed. His most recent philosophical work reconceptualizes the biopsychosocial model as a philosophical theory of biopsychosocial causal interactions and he argues that there are causal regulatory functions within the psychological domain, and this is so independent of whether they can be captured by a physicochemical description of brain processes. [ABSTRACT FROM AUTHOR]

Despite the important roles families play in the lives of many individuals with mental illness across cultures, there is a dearth of data worldwide on how family members perceive the process of cultural assessment as well as to how to best include them. This study addresses this gap in our knowledge through analysis of data collected across six countries as part of a DSM-5 Field Trial of the Cultural Formulation Interview (CFI). At clinician discretion, individuals who accompanied patients to the clinic visit (i.e. patient companions) at the time the CFI was conducted were invited to participate in the cultural assessment and answer questions about their experience. The specific aims of this paper are (1) to describe patterns of participation of patient companions in the CFI across the six countries, and (2) to examine the comparative feasibility, acceptability, and clinical utility of the CFI from companion perspectives through analysis of both quantitative and qualitative data. Among the 321 patient interviews, only 86 (at four of 12 sites) included companions, all of whom were family members or other relatives. The utility, feasibility and acceptability of the CFI were rated favourably by relatives, supported by qualitative analyses of debriefing interviews. Cross-site differences in frequency of accompaniment merit further study.

The mental health gap has been a persistent concern globally, especially in low and middle-income countries (LMIC). In an attempt to mitigate resource limitations, the psychiatric practice has been undergoing a paradigm shift into digitalized mental health interventions. One such innovation involves digital gaming utilizing the principles of 'gamification' to incorporate both the playfulness component of online gaming as well as the domain-targeted design of gaming elements. Digital gaming-based interventions have been to deliver psychotherapy, biofeedback, cognitive training and rehabilitation, as well as behavioural modification and social skills training. Research shows their utility in autism spectrum disorders, attention deficit disorders, schizophrenia, depression, anxiety disorders, post-traumatic stress, eating disorders, neurocognitive disorders and also to promote healthy aging. Though promising in scope, these interventions face pragmatic challenges for implementation in developing countries. Even though increased use of technology, internet penetration and growing digital literacy have enhanced their accessibility and feasibility, various factors like socio-cultural diversity, lack of standardization, poor infrastructural support, bandwidth issues and lack of practice can impair their use and acceptability. Keeping this in the background, this commentary critically discusses the scope, applications and challenges of digital gaming in mental healthcare delivery in one of the rapidly globalizing LMIC nations, India. [ABSTRACT FROM AUTHOR]

Recent randomized controlled trials have shown that improving diet quality reduces symptoms in those with depression. The provision of digital health interventions that can support dietary change in those with depression has important benefits with respect to reach, accessibility convenience and cost. The My Food & Mood study used single arm cohort design to test the feasibility of such an intervention. Participants with current depressive symptoms were recruited and enrolled online to use the My Food & Mood m-Health (smartphone delivered) program for 8 weeks. Participants completed depression (PHQ-8) and dietary questionnaires (MEDAS) at baseline, week 4 and week 8. Metrics of use and intensity of use engagement measures were calculated from system logs and data entries. There was a significant change in both MEDAS score (t = 8.147, df = 44, p < 0.001) and PHQ-8 score (t = −7.199, df = 44, p < 0.001) throughout the study. There was a moderate positive association between change in MEDAS score and activities completed, goals and weeks engaged, and a strong inverse association between change in MEDAS score and change in PHQ-8 score. An m-Health program targeting dietary intervention in those with depression was feasible. Dietary change was associated with higher engagement and reduced depressive symptoms. [ABSTRACT FROM AUTHOR]

Multiple surveys have revealed that China has an immense mental health care needs predominantly related to common mental disorders like anxiety and depressive disorders. China has provided different training pathways with an aim of increasing the number of psychiatrists working to address such growing mental health care needs. Although this strategy has successfully doubled the total number of psychiatrists over a couple of years, there remains the problem of harmonising the training standards across different training pathways and across different training units. There is also a pressing need to enhance psychiatric education among other health professionals as it is increasingly recognised that many people with common mental disorders do not have or want to have access to psychiatric care, and need to be taken care of by medical practitioners of other specialties or health professionals. Despite Hong Kong having a different training system from Mainland China, the problems faced with training psychiatrists and other health professionals in Hong Kong are strikingly similar to those encountered by their counterparts in China. Given their different historical origins and subsequent diverse development of training systems, Mainland China and Hong Kong have much to learn from one another. [ABSTRACT FROM AUTHOR]

This World Psychiatric Association (WPA) global survey of its WPA member society presidents using an online self-administered 15-item questionnaire successfully recruited 47 WPA member countries or regions (response rate = 39.8%) to provide responses about training provisions of psychiatric education at undergraduate, postgraduate, and post-qualified levels in their respective countries. There were significantly fewer responses from the low and middle income countries (LMIC) than the high income countries (HIC). At undergraduate level, the median duration of psychiatric education during medical school education was 4.0%. However, the current allocated time for psychiatric education was only around one-third to one-half of the time considered as optimal by the member countries or regions (optimal mean = 8.9%; optimal median = 10%). At the postgraduate level, the duration of training varied widely from 12–72 months, with a mean duration of 48 months. In 31% of the respondent countries, psychiatrists only required 36 or fewer months of post-graduate training. The number of months of training required for training a psychiatrist was significantly fewer in the LMIC than HIC. At post-qualified continuing medical education level, all respondents reported providing post-qualified continuing medical education. With the advent of internet technology, many respondents prefer having online training. [ABSTRACT FROM AUTHOR]

The article discusses some of the controversies over psychedelic drugs in managing a variety of psychiatric disorders. The discovery of lysergic acid diethyamide, or LSD, was said to be a strong contributor to the neuroscientific model that took hold in the 1950s and 1960s. Some investigators in Europe and the U.S. re-initiated human studies with psychedelics during the 1990s. It is noted that the mechanisms underlying psychedelic efficacy might be biological and psychological.

Mentally ill patients are entering the criminal justice system at alarming rates, representing a significant percentage of those incarcerated. Correctional facilities are mandated to provide mental health treatment to inmates. The increasing number of inmate patients has made psychiatry an important part of institutional operations. Psychiatrists are called to provide psychopharmacological interventions to aid in the safe operation of institutions and provide effective treatment to those with mental illness. This article discusses the uniqueness of prescribing within correctional settings and delineates important aspects of correctional psychiatry. It includes information on navigating the rigid structure of correctional environments, providing effective interventions for behaviourally disruptive and manipulative inmates, prescribing within the limits of formulary restrictions, considerations for dispensing medication, preventing medication diversion, involuntarily medication practices, and treatment of aggressive inmates. The article concludes with case illustrations that depict the pitfalls, challenges, and victories of working with inmate patients. [ABSTRACT FROM AUTHOR]

The biological mechanisms underlying the major psychiatric disorders remain mysterious, resulting in a lack of precision in diagnosis and controversies in nosology. This is especially true for the mood disorders. This issue of the International Review of Psychiatry reviews several of these controversies with special attention to syndromic manifestations of affective disorder that are often missing in modern nosological systems. [ABSTRACT FROM AUTHOR]

The history of Mental Health in Latin America is relatively young. It dates back to the mid nineteenth century and widely developed during the twentieth century, with formidable scientific, social, political, and ethical challenges. Latin American psychiatry has contributed in the fields of epidemiology, phenomenology, social psychiatry, psychiatric and epistemological research, and clinical genetics as well. More recent advances can also be seen in clinical psychotherapy and psychopharmacology. Now, there is a formal and informal recognition of various areas of expertise, such as children and adolescents, addictions, anxiety disorders, among others. However, we need to solve the health problems resulting from mental illnesses as well as the disorders related to the social, environmental, political, and economic factors of a continent marked by the precariousness of underdevelopment, which have a high impact on population health. Therefore, considering and trying to minimize the impact of those factors, contributing to the destigmatization of mental illnesses and their consequences, together with the growing number of non-governmental organizations (NGOs), human rights defenders, public figures, etc., and collaborating in building a society that guarantees the right to mental health and adequate treatment and rehabilitation are part of our present challenges in Latin America. [ABSTRACT FROM AUTHOR]

Identity can be defined from different perspectives such as those from philosophy, social sciences and phenomenology. The latter entails sameness, uniqueness, distinctiveness, continuity, diversity, universality and equality connotations to define characteristics of the existence and action of individuals, institutions, entities, organizations and collectivities. In order to elaborate on the identity of Latin American Psychiatry, this chapter deals first with the identity of the Latin American continent, the result of a 'collision of cultures' with mestizaje as its most prominent collective contribution. In turn, the Latin American population (and its 'Hispanic' equivalent in other countries and regions of the world) has been the subject of a pluralistic search, and played a combined role of hope and conflict, advances and setbacks in a fascinating historical process. In such context, Latin American psychiatry offers a mixed identity, resulting from a succession of mythic-religious, moral, phenomenologico-existential, biological and social/community-based routes. Each of them are assessed, and the contributions of two eponymous figures, Honorio Delgado and Gregorio Bermann, are duly delineated. Current realities in Latin American psychiatry and mental health in socio-political, conceptual, professional, ideological, academic and heuristic areas, are examined. The chapter ends with considerations of the future of psychiatry in the continent, the postulation of a 'new synthesis' embracing the essence of contemporary neurobiological knowledge and a new, revitalized humanism in the context of a healthy eclecticism, progressive educational training and didactic programmes, and concrete contributions embodying the promise of well justified expectations. [ABSTRACT FROM AUTHOR]

The practices and systems of mental health in Latin America and the Caribbean are heterogeneous and are connected to dissociation between national macro systems and the complex quotidian that occurs in the daily attention of mental pathologies. The health care experiences in mental health are diverse and go back to the 1960s; these took a boost with the Caracas Declaration of 1990. The Health Care Reform has had several stages, lately focused in the strength that derives from a growing psychiatric epidemiology 'base'. In addition, it notes that the majority of countries have a National Plan of Mental Health, but they do not seem purposely deployed in local developmental plans or in other sectors. It is proposed the existence of a willing to discuss psychiatry, critical and bold; trans and intrasectoral face to the national and communal developments. Governments need to prioritize strategies in mental health as an integral part of another national project with regard for quality of life and productivity of citizens. The communication poses challenges for the next 15 years, with what is complete the first quarter of this century, proposing a series of measures even basic, but valid for this part of the continent. [ABSTRACT FROM AUTHOR]

Working is undoubtedly an important aspect of western life. As well as structuring time, it provides financial security, meaning, identity and social participation, and has a beneficial effect on long-term physical and mental well-being. Despite this, people with mental health conditions have the lowest employment rate of any disabled group, although many of them want to work and work is highly beneficial for their physical and mental health. Existing research on mental health problems and employment outcomes have tended to focus on interventions for people with severe mental illness. Little research exists on the relationship between affective disorders, mainly depression and anxiety, and employment. This review focuses on studies conducted in the UK. Its conclusion is that there is no single rigorous investigation to test the relationship between common mental disorders and vocational outcomes. [ABSTRACT FROM AUTHOR]

The use of films in teaching psychiatry and psychotherapy remains problematic for a number of reasons. The bulk of films are made for commercial reasons, not for educational purposes. Scientific truth is often overshadowed by narrative requirement in films. In most 'mainstream' cinema and 'indie' productions, diagnostic accuracy is still seriously compromised by narrative considerations. Clinical reality continues to be undermined and overridden by the need - as makers see it - to tell a powerful story in aid of huge box office receipts. Therapists in films are also often caricatures and caution must be employed in using cinema in real-time individual therapy. [ABSTRACT FROM AUTHOR]

There is a tradition of using films to teach various aspects of psychiatry and we feel that Malayalam cinema can also be used suitably to teach effectively. These films can be an invaluable resource in cultural competency training as they depict the effects of culture on psychopathology and cultural and regional influences on attitudes to mental illness and stigma. We also note that the portrayal is often far from reality but this is not a barrier for using the films as an effective alternative to traditional and didactic teaching methods. This method of teaching can stimulate interest and discussion and demystify the myths of novice students and others about mental health. [ABSTRACT FROM AUTHOR]

Background: Despite numerous and indispensable advantages, the shift from hospital-based to community mental healthcare has engendered problems. To analyse whether or not the process of de-institutionalization has gone too far, studies are needed that cover general psychiatry, forensic psychiatry, and penitentiaries as interlocked systems, but these are still scarce. Method: We combined epidemiological and service utilization data from three recent European studies that explored the legal frameworks for and the practices with regard to involuntary treatment in general mental healthcare, to the care of mentally disordered offenders in forensic care and to the care of mentally ill inmates in the European prison systems, and used more specific data from one country to illustrate how changes to the legal frameworks in one sector may potentially affect the others. Results: Time series from European Union (EU) member states suggest that civil detention rates remained more or less stable during the 1990s, though on rather different levels internationally. Admissions to forensic psychiatric facilities increased during the same period. Data on the mental state (or changes in rates of psychiatric morbidity) in European prison populations are not available-aside from the prison suicide rate. Data from selected countries are likely to suggest that changes to the legal framework in one sector may considerably affect admission rates in others. Conclusions: National or regional studies are needed to analyse the linkage between sectors and to identify inappropriate patient shifting. National and international data bases need to be implemented or improved. [ABSTRACT FROM AUTHOR]

All healthcare is delivered in relationships between professionals and patients, and this relationship is particularly central to mental healthcare. Although fewer studies have been conducted in community psychiatry than in psychological treatments, there is increasing evidence that the therapeutic relationship predicts outcome across various psychiatric settings. The clinician-patient relationship and communication may indirectly improve outcome, e.g. mediated through better treatment adherence. Yet, evidence suggests that these interpersonal processes also have a direct therapeutic effect. Thus, depending on the conceptual model of therapeutic processes they may be seen as therapy in itself. Clinicians receive little specific instruction and supervision in communication skills, and research on the issue is scarce. Whilst there are conceptual and methodological challenges to such research, the aim should be to identify therapeutically effective elements of relationships and communication that can be tested in experimental studies. Although still rare, interventions to improve clinician-patient communication in routine mental healthcare show favourable results. A further step may be adapting established psychological treatment models, such as cognitive behaviour or solution focused therapy, to make routine clinical interactions more therapeutic and evidence based. This would be in the interest of clinicians, in optimizing their therapeutic potential, and patients alike. [ABSTRACT FROM AUTHOR]

Non-traditional (Eastern/non-conventional) treatments have gained increased interest and recognition recently. The utilization of these treatments in psychiatry challenges mental health professionals to examine the impact of cultural factors and the bi-directional effects of body on mind and mind on body when treating psychiatric illnesses. Professionals in the psychiatric field need to be aware of commonly practised treatments used by people in Asia, the most populous region in the world. There is a wide variety of non-traditional (Eastern) psychiatric treatments in Asia. This article selects only a few commonly practised treatments and describes the clinical application of each treatment. [ABSTRACT FROM AUTHOR]

The article discusses on mass violence and tragedy and its mental health impact across the globe. According to the author, people across the globe are being traumatized by catastrophic event, or by its aftermath, which are being humanized by televisions and media. Various disasters and tragedy had its main impact on public opinion for days and weeks later, in which he asserts that each occurrence has its need for response, for help and for healing.

This article focuses on post-traumatic stress disorder (PTSD) as both one of the most important mental health consequences of mass violence and as the manifestation of a disrupted human attachment system. The implications are many in terms of treatment and prevention. For instance, since the vulnerability to PTSD appears to be transmitted down the generations via the psychobiological manifestations of the parents' attachment system, prevention requires the effective treatment of afflicted communities within a context of strong social support. More specific guidelines for intervention are outlined focusing on the role of psychosocial workers and their need to be carefully selected, trained and supervised. Failure to tackle the effects of mass violence and to prevent further psychological damage through political action has serious implications in terms of the future of mankind. [ABSTRACT FROM AUTHOR]

Mass violence carries with it an enormous impact on health; the psychological impact is well recognized but poorly understood. There is a need for health professionals around the world to learn basic issues about the psychological impact of violence and to have available more specialized training to equip them with skills necessary to work directly with victims of mass violence. Organizing mental health services in conflict and in post-conflict situations requires many skills and complex work across sectors. Understanding mass violence from a public mental health perspective provides a framework for a curriculum that covers treatment for individuals and interventions for populations as well as exploring the mental states and social relationships which promote peace. Training implications are broad and should take account of individual and population needs, but also of a deeper human need to understand and contain that violent side of our nature that threatens us with extinction. [ABSTRACT FROM AUTHOR]

There is growing awareness of the mental health impact of all types of mass violence. The exposure of large population groups, mostly having no mental health problems prior to the exposure, and the subsequent development, in a significant proportion of the population, of a variety of psychiatric symptoms and disorders represent both a challenge and an opportunity for psychiatrists. There is sufficient evidence from the variety of mass violence/conflict situations, that a significant proportion of the exposed population develop different mental disorders. There are vulnerable groups like women, children, widows, orphans, elderly, disabled, those exposed to severe pain and loss of body parts. There is also a consistent finding of the dose-response to the amount of trauma and the prevalence of mental disorders. There is growing recognition that there is need to consider a variety of syndromes, in addition to post-traumatic stress disorder (PTSD) like acute stress disorder (ASD), depression, complicated bereavement reactions, substance use disorders, poor physical health, fear, anxiety, physiological arousal, somatisation, anger control, functional disability and arrest or regression of childhood developmental progression. The challenge is to reach all of the ill persons and provide mental health services. The opportunity provided by this field is to develop a better understanding of issues of resilience, recovery and effectiveness of public health approaches to mental health care. [ABSTRACT FROM AUTHOR]

The authors reflect on anti-stigma-endeavors relative to mental disorders. It is noted that most of the general population in all parts of the world hold negative thoughts towards people with mental illness. On an individual perspective, mentally ill people are perceived as dangerous, unpredictable, and violent. Discrimination against people with mental illness is greatly observed.