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Background: The Italian anti-institutional psychiatric movement is closely associated with the name of F. Basaglia, whom Szasz in his 188-page essay on antipsychiatry labels a 'real phony' (in similar terms to others considered antipsychiatrists such as D. Cooper, R. Laing, E. Goffman and M. Foucault). Specifically, Szasz says of Basaglia and his work in psychiatry that it's a 'prevarication-illusion about the end of asylum psychiatry in Italy'. Aim/objective: The aim of this paper is to determine whether Szasz's assessments were reliably based on scholarly knowledge of Basaglia's psychiatric work, or can better be attributed to Szasz's misrepresentation of his Italian colleague. Methods: In considering this question, the paper is timely but, more importantly, it is also unique in considering Basaglia and Szasz together. It is beyond the scope of this article to examine Basaglia's career in detail, and references to it will be made only to clarify Szasz's assertions regarding Basaglia. Results and conclusions: As I will show here, Szasz misconstrued the Basaglian project for a new kind of psychiatry, and for the transformation and closure of the old asylum system. This erroneous view of Basaglia by Szasz is partly associated with his idea that Basaglia and other antipsychiatrists were supported by the modern socialist-therapeutic State. [ABSTRACT FROM AUTHOR]

Targeted school-based programs seem to be a promising approach to help adolescents in need. Nevertheless, successful implementation and evaluation of such programs is challenging. However, there is limited knowledge about (overcoming) the challenges of implementation and experimental evaluation of school-based programs. The goal of the present paper is, therefore, to improve future research by describing the challenges encountered and lessons learned during two randomized controlled trials (RCTs) to study the effectiveness of two skills-training programs reducing school or social stress. In this way, we aim to inform others who plan to implement and evaluate such programs in schools using an RCT design. Some of the challenges encountered apply to all effectiveness studies, such as the recruitment and retention of participants; others are more "intervention at school" specific, such as scheduling the programs and assessments. Our experiences show that it is possible to effectively implement and evaluate targeted programs promoting adolescent mental health in secondary schools with RCTs, even during a worldwide health pandemic, but that it requires investing sufficient time in keeping close and regular contact as well as clear communication between the involved parties. Moreover, high levels of flexibility are needed in adjusting scheduled meetings for intervention and research while keeping track of the entire process for each school and individual participant. [ABSTRACT FROM AUTHOR]

Background: The Latin American prison population has grown faster than anywhere else globally over the past two decades, reaching a total of 1.7 million people at any given time. However, research on mental health prevention and treatment interventions in Latin American prisons remains scarce. Aims: This study aimed to systematically review and synthesize research on prison mental health interventions conducted in the region. Methods: We used a two-stage scoping review design guided by the JBI Manual for Evidence Synthesis. Searches took place in December 2021 in nine databases using descriptors and synonyms. First, all prison mental health research in Latin America was retained. Secondly, using title and abstract screening, all research possibly related to interventions was retained for full text evaluation. Studies reporting interventions were assessed by country, language, institution, population, intervention type, intervention focus and outcomes. Results: N = 34 studies were included in this review. These were 13 case reports, seven expert consensus papers and 14 quantitative studies (four randomized controlled trials, nine cohort studies, one quasi-experimental study). Fourteen interventions were targeted at promoting prosocial behavior, seven studies each aimed to improve mental health and to treat substance use disorders. Six studies involved the treatment of sexual offending behavior, and 3 focused on reducing criminal recidivism. Psychoeducation (n = 12) and motivational interviewing (n = 5) were the most frequent intervention types studied. Promising data from trials showed that anger management, depression, substance use and reoffending could be successfully addressed through interventions. Conclusions: Implementation and effectiveness research of mental health interventions in Latin American prisons is scarce. Addressing mental health, substance use and prosocial behavior outcomes should be considered in future research. There is a particular dearth of controlled trials describing quantifiable outcomes. [ABSTRACT FROM AUTHOR]

The author comments on the article "Group Psychotherapy with Immigrants from Turkey," by Raymond Battegay and Ali Tarik Yilmaz, published in the June 1, 1997 issue of "Group Analysis: The Journal of Group Analytic Psychotherapy." The authors refer to studies that corroborate the fact that more than a third of Turkish immigrants develop massive depressive and psychosomatic symptoms in the first eighteen months after their arrival in Western Europe. The important factors that were ignored or not fully developed by the authors are discussed.

Psychiatry and anthropology have a long relationship, and it is worth examining aspects of how that relation is carried over into the developing field of Global Mental Health (GMH). One place at which the two disciplines overlap significantly is in addressing religious phenomena and ritual performance in relation to mental health, and one of the greatest challenges for GMH is how productively to take into account forms of indigenous healing based on religion and ritual. In this paper I compare recent texts in GMH written from the standpoint of psychiatry and anthropology, observing that the psychiatric texts emphasize evidence-based determination of treatment efficacy, while the anthropological texts emphasize ethnographic understanding of treatment experience. Reconciling these two emphases constitutes a challenge to the field, attending to contextual variations in treatment events, illness episodes, phenomenological factors both endogenous and intersubjective, and sociopolitical factors both interpersonal and structural. In addressing this challenge, I propose an approach to therapeutic process that on the empirical level can facilitate comparison across the diversity of healing forms, and on the conceptual level can constitute a bridge between efficacy and experience. This approach is predicated on a rhetorical model of therapeutic process including components of disposition, experience of the sacred, elaboration of alternatives, and actualization of change that highlights experiential specificity and incremental change. Deploying this model can help meet the challenge of understanding efficacy and experience in indigenous healing, and prepare the ground for the further challenge of how practitioners of GMH relate to and interact with such forms of healing. [ABSTRACT FROM AUTHOR]

The author comments on the article by Friedhelm Roder and Petar Opalic which was published in the June 1, 1997 issue of "Group Analysis: The Journal of Group Analytic Psychotherapy." The author questions the therapeutic validity of Turkish therapist who runs groups for Turkish immigrants in Great Britain and the issue of cultural differences. The author emphasizes that the boundaries and the deepening communication are the backbone of any therapeutic approach. The author believes that running groups with people from different cultures is a very delicate subject.

The proliferation of digital technology within the lives of children and young people (CYP) provides arguably one of the most significant clinical and ethical paradigm shifts in Child and Adolescent Psychiatry. One can argue that mental health research has taken a myopic approach to understanding the interaction between young people's technology use and their mental health. Mental health clinicians also need a better understanding of the digital lives of CYP and how technology may be supporting or harming their mental health. Within this paper, we argue that greater longitudinal research is required, particularly in vulnerable groups, and that there is an essential need for a standardised digital use assessment (DUA) tool, which assimilates CYP use of technology and their vulnerabilities/resilience to online risks. We subsequently offer a series of questions clinicians can use to explore technology use by CYP. Such an aide memoire may empower clinicians to have wider discussions around digital technology use with CYP, while also helping to develop appropriate safety and management plans. [ABSTRACT FROM AUTHOR]

This paper explores how film-making can assist as part of the development of sensitive and participative methodologies appropriate to accessing the worlds of people with severe and enduring mental health problems. It discusses how the film-making process can also act as a text that holds valuable data about the impact of the arts on mental health, and facilitates a range of mutually beneficial outcomes for those collaborating across usual academic/community divides. This agenda contributes to a consideration of the role of the arts in participative social geographies of mental health, and critically expands recent discussions about uses of video and film in a visual discipline. [ABSTRACT FROM AUTHOR]

Background: In a highly technical civilization like ours, in which the interest in human communication transcends academic barriers and clinical practice, it seems necessary to look back to Ruesch’s work in psychiatry. The main reason of it rests upon the idea that he was one of the few truly outstanding clinicians, researchers, and theoretical in the field of normal and abnormal communication. In fact, he did not only present a wealth of observational and clinical data; more importantly, he used these data to formulate creative hypotheses about the conflict between man and other human beings. Aim/Objective: The main purpose of this article is to pay tribute to Dr. Jurgen Ruesch (1909-1995), distinguished psychiatrist, communications experts and psychotherapist. For that reason, here we want to pay tribute to the enormous value of his work for the promotion of mental health and the clinical assessment of normal and pathological communication behavior. Methods: In working out his theoretical stance toward communication, all Ruesch’s works here have been reviewed. In line with this, the author also mentions similarities between Ruesch and other psychiatric/psychotherapeutic authors. Also similarities have been established between Ruesch and Frank on “non specific factors in psychotherapy”, and tensions within contemporary training of psychiatrists, almost predicted by Ruesch. Results and Conclusions: While some of Ruesch’s ideas about the nature and origins of communication has been discounted, many of his preoccupations are now part of the mainstream, and it is to here that we should look for evidence of his legacy. In fact, he has been the author of rich and fruitful ideas, which are essential to clinical understanding of mental diseases and their treatments. It is not surprising, therefore, that Ruesch’s burning interest in the clinical assessment of normal and pathological communicative behavior finds a significant echo in today’s proliferation of books, papers, and conferences on communication. For all that, we should honor him. [ABSTRACT FROM AUTHOR]

Background: This contribution responds to three articles (we refer to all three as 'editorials') concerning something called 'geopsychiatry'. Aims: To evaluate claims made in these editorials for 'geopsychiatry' as a new field of inquiry at the interface between geography and psychiatry. Method: Close critical reading of two editorials in the International Journal of Social Psychiatry – entitled 'Geographical determinants of mental health' and 'Political determinants of mental health' – and one in the International Review of Psychiatry – entitled 'What is geopsychiatry?' Results: While this geopsychiatry initiative is to be applauded, disquiet can be expressed about the almost complete neglect of a pre-existing domain of inquiry – 'mental health geography' or 'the geography of mental health' – that has long been researched by academic geographers and cognate scholars. Key trajectories in this field can be identified and related to the proposed foci for geopsychiatry. Conclusions: The hope is voiced that future developments in geopsychiatry will proceed in dialogue with the literature and practitioners of mental health geography. [ABSTRACT FROM AUTHOR]

Sadly, much of the world is no stranger to Psychological Trauma, particularly in poorer areas with poor health infrastructure. Western Aid Organisations frequently deploy to such areas bringing with them a western psychiatric tradition of nosology and therapy which may not be appropriate in other cultures. We argue that imposing a western system of diagnosis and treatment may not only undermine local culture but may also be bad for the patient. We discuss this with reference to the WHO's Mental Health Gap initiative (MHGap). [ABSTRACT FROM AUTHOR]

Despite the knowledge that people with mental illness often seek care from multiple healing systems, there is limited collaboration between these systems. Greater collaboration with existing community resources could narrow the treatment gap and reduce fragmentation by encouraging more integrated care. This paper explores the origins, use, and outcomes of a collaborative programme between faith-based and allopathic mental health practitioners in India. We conducted 16 interviews with key stakeholders and examined demographic and clinical characteristics of the user population. Consistent with previous research, we found that collaboration is challenging and requires trust, rapport-building, and open dialogue. The collaboration reached a sizeable population, was reviewed favourably by key stakeholders—particularly on health improvement and livelihood restoration—and perhaps most importantly, views the client holistically, allowing for both belief systems to play a shared role in care and recovery. Results support the idea that, despite differing practices, collaboration between faith-based and allopathic mental health practitioners can be achieved and can benefit clients with otherwise limited access to mental health care. [ABSTRACT FROM AUTHOR]

This paper reconstructs a fragment of psychiatric-psychoanalytical geography, interfacing it with the 'new walking studies', centring on a walk conducted in 1935 by a man experiencing mental health problems in Glasgow, Scotland. This man, a patient of the psychiatrist Thomas Ferguson Rodger, had mobility problems that rendered walking difficult – prone to stumbling, staggering, wavering – but with the likelihood of these problems being psychosomatic in origin. Through analytic sessions enacting a kind of 'make-do' psychoanalysis, the patient reflected on his mobility problems, as when relating his own walking 'experiment'. Explanations advanced for his difficulties mixed psychoanalytic tropes with a gathering self-awareness of how fraught childhood experiences, had created the frame for an adult existence continually shying away from wider encounters and challenges beyond the domestic sphere. Central here was forward momentum being lost, whether walking or advancing through a life-course, with material and metaphoric senses of being stalled or stuck – spatially, environmentally – constantly entraining one another. This case study is deployed to illustrate claims about the 'worlding' of psychoanalysis, and to offer provocations for how such a psychiatric-psychoanalytic geography fragment might be illuminated by work on the cultural geographies of walking. [ABSTRACT FROM AUTHOR]

What does it take to see how autistic people participate in social interactions? And what does it take to support and invite more participation? Western medicine and cognitive science tend to think of autism mainly in terms of social and communicative deficits. But research shows that autistic people can interact with a skill and sophistication that are hard to see when starting from a deficit idea. Research also shows that not only autistic people, but also their non-autistic interaction partners, can have difficulties interacting with each other. To do justice to these findings, we need a different approach to autistic interactions—one that helps everyone see, invite, and support better participation. I introduce such an approach, based on the enactive theory of participatory sense-making and supported by insights from indigenous epistemologies. This approach helps counteract the homogenizing tendencies of the "global mental health" movement, which attempts to erase rather than recognize difference, and often precludes respectful engagements. Based in the lived experiences of people in their socio-cultural-material and interactive contexts, I put forward an engaged—even engag ing —epistemology for understanding how we interact across difference. From this perspective, we see participatory sense-making at work across the scientific, diagnostic, therapeutic, and everyday interactions of autistic and non-autistic people, and how everyone can invite and support more of it. [ABSTRACT FROM AUTHOR]

Cultural psychiatry research in the UK comprises a broad range of diverse methodologies, academic disciplines, and subject areas. Methodologies range from epidemiological to anthropological/ethnographic to health services research; mixed methods research is becoming increasingly popular, as are public health and health promotional topics. After briefly outlining the history of cultural psychiatry in the UK we will discuss contemporary research. Prominent themes include: the epidemiology of schizophrenia among Africans/Afro-Caribbeans, migration and mental health, racism and mental health, cultural identity, pathways to care, explanatory models of mental illness, cultural competence, and the subjective experiences of healthcare provision among specific ethnic groups such as Bangladeshis and Pakistanis. Another strand of research that is attracting increasing academic attention focuses upon the relationship between religion, spirituality, and mental health, in particular, the phenomenology of religious experience and its mental health ramifications, as well as recent work examining the complex links between theology and psychiatry. The paper ends by appraising the contributions of British cultural psychiatrists to the discipline of cultural psychiatry and suggesting promising areas for future research. [ABSTRACT FROM AUTHOR]

The psychological consequences of sexual abuse are generally serious and enduring, particularly when the perpetrator is known and trusted by the survivor. This paper explores the experiences of five contemplative nuns who were sexually abused by priests and the spiritual journeys that followed. In the context of an ethnographic study of contemplative practice, participant observation and in-depth interviews were used to examine the ways that the nuns sought to make sense of their experiences through a long process of solitary introspection. The pursuit of meaning was shaped by religious beliefs relating to forgiveness, sacrifice, and salvation. Thus, trauma was transformed into a symbolic religious narrative that shaped their sense of identity. They were able to restructure core beliefs and to manage their current relationships with priests more securely. They described regaining their spiritual well-being in ways that suggest a form of posttraumatic spiritual growth. We conclude by discussing the findings in the light of the existing literature on the interaction of trauma and spirituality. [ABSTRACT FROM PUBLISHER]

The article discusses some of the key issues that are crucial for developing a culturally responsive global mental health (GMH) research agenda. Some of the key issues include developing a language of global mental health, the etic-emic balance, identifying stakeholders, tying the goals of research to stakeholders, and evaluation of benefit. The use of bidirectional pathways is the only way to help GMH researchers as well as the communities considered in the study.

Background: In this paper we deliberate mental illness stigma in the Israeli context and suggest ways to reduce it, emphasizing the community's role in the rehabilitation of persons with mental illness. Material: A literature review of Israeli and international literature of mental illness stigma. Discussion: Community mental health, in addition to its traditional focus on developing community-based services, should focus also on community-based interventions such as the delivery of anti-stigma interventions. Conclusions: Providing individualized rehabilitation services in the community while addressing stigma-induced social barriers may create a better recovery ground for Israelis with mental illness. [ABSTRACT FROM AUTHOR]

In this paper I consider some of the implications, possibilities and dangers of addressing the experience of 'madness' or 'mental illness' within autobiographical narrative: in particular, I ask how madness can be narrated, or spoken. Engaging with theoretical interventions by, amongst others, Jacques Derrida, Michel Foucault, Shoshana Felman and Maurice Blanchot, and looking at three autobiographies of madness, I suggest that an attentive reading of narrative form, as the outworking and evidence of a way of knowing and thinking about the world, may reveal authorial attempts to manage and stretch the constraints inherent in conventional narrative's tendency toward linearity and resolution. This tendency, I argue, is inimical to the expression of madness. Insinuated in this process of working with form is a particular narrative mode of existence, which has implications for the psychodynamics of living with mental distress. With reference to the work of Sarah Kofman on the representation of trauma, I propose that her conception of a 'writing without power' may be a salutary way in which to address chronic distress, and to reformulate identity in the light of biographical disruption. [ABSTRACT FROM AUTHOR]

This paper focuses on Günter Ammon's concept of dynamic psychiatry and how its practice can aid and enhance group dynamics. This is illustrated by an account of group dynamic therapeutic work in the Hospital Menterschwaige in Munich, demonstrating how this work has its roots in the theoretical concept of dynamic psychiatry. [ABSTRACT FROM AUTHOR]

The paper suggests that just as skin colour plays a significant part in the structuring of society, it also plays a significant role in the structuring of the psyche. The argument is built on the hypothesis that the internal object world is colour-coded. The paper looks at how this might come about and explores its consequences. Therapists need to have worked through this area in their training and therapy, otherwise it will reappear as the therapist's transference to confound the therapy. [ABSTRACT FROM AUTHOR]

Background: Patients with bipolar disorder (BD) had contributed immensely to high health service utilization. Variation in clinical practices that miss to follow the standard guidelines all with the disorder complexity, deepened the management gap. This study aimed to provide an Egyptian epidemiological database of the ongoing clinical practices that framed different diagnostic and management choices in a sample of patients with bipolar disorder. Highlighting challenges and the need for optimized clinical practices. Methods: Over 4 months in 2014, 20 clinicians filled in a designed sheet of their routine healthcare practice with information about; caseload /month, management guidelines knowledge background. Out of 301 patients in acute episode BD, 300 patients aged 20 to 60 years from both sexes, completed their assessment using; (1) a semi-structured interview sheet, (2) Structured Clinical Interview for DSM-IV Axis I (SCID I) for psychiatric diagnoses, (3) Global Assessment of Functioning scale for illness impact. Results: Psychiatrists received 49.5 ± 37.0 (mean ± SD) patient /month. 95% of them reported positive knowledge background on BD diagnostic guidelines and treatment recommendations (G/R), 89.6% of patients had different initial diagnosis than BD.The most commonly given initial diagnosis was major depressive disorder (33%) followed by brief psychotic disorder(20.7%) and others. The median of time taken from the initial to bipolar diagnosis was 12.3 months. Majority of patients had evident functional impairment. Atypical antipsychotics were mostly used. Drug abuse and obesity were high comorbidities. Conclusion: The evident gap in practice and BD complexity have negative impact on clinical outcomes. Physician's continuous medical education programs and individually tailored standard medical care are recommended for optimized practices. [ABSTRACT FROM AUTHOR]

Community treatment orders are a legal mechanism to extend powers of compulsion into outpatient mental health settings in certain circumstances. Previous ethical analyses of these powers have explored a perceived tension between a duty to respect personal freedoms and autonomy and a duty to ensure that patients with the most complex needs are able to receive beneficial care and support that maximises their welfare in the longer-term. This empirical ethics paper presents an analysis of 75 interviews with psychiatrists, patients and family carers to show how these ethical considerations map onto the different ways that community treatment orders are used and experienced in practice. A complex and nuanced account of how the requirements to respect patients’ autonomy, to respect patients’ liberty and to act beneficently should be interpreted in order to make judgements about the ethics of community treatment orders is presented. The article argues that, due to such complexity, no general ethical justification for community treatment orders can be provided, but a justification on the basis of the promotion of patients’ autonomy could provide an ethical reason for community mental health practitioners to make use of a community treatment order in some limited circumstances. [ABSTRACT FROM AUTHOR]

Transcultural psychiatry was developed in France to promote cultural and linguistic diversity and address the mental health needs of immigrants who were excluded from accessing other public mental health services. Professionals in health and social services refer patients to transcultural psychiatry consultations when miscommunications arise or when professionals determine that patients need culturally sensitive therapy. In transcultural psychiatry consultations, a group of therapists, composed primarily of psychologists and psychiatrists, as well as other health and social service professionals, receives a patient, the patient's family, and referring professionals. Previous research on transcultural psychiatry has emphasized the importance of culturally diverse therapy teams and the ways that therapists' diversity could permit patients to open up in consultation sessions. This study draws on ethnographic research in two transcultural psychiatry consultations in Île-de-France, and pays particular attention to the experiences of apprentice therapists, who were often graduate students in clinical psychology. Apprentice therapists reported being introduced to patients in ways that they would not choose themselves. As a result, therapists felt that they had to overemphasize their cultures or countries of origin and French therapists questioned their place in the group. This article describes how transcultural therapy groups are a theater in which belonging, identity, and Frenchness are contested and performed. Apprentice therapists proposed more intersectional and inclusive ways of portraying diversity in the transcultural groups. [ABSTRACT FROM AUTHOR]

This article explores the circulation of 'anti-psychiatry' in British film and television during the long 1960s, focusing on the controversial BBC television play In Two Minds (1967) and its cinema remake Family Life (1971). These films were inspired by R. D. Laing's ideas on the aetiology of schizophrenia, and were understood as uniting the personal and political motivations of progressive film-makers (Ken Loach, Tony Garnett, David Mercer) and progressive psychiatrists (Laing, David Cooper, Aaron Esterson). Drawing upon practitioner interviews with producer Garnett and director Loach, and extensive archival research on the production and reception of these films, this article contests previous scholarship on the popular circulation of anti-psychiatry and the movement's perceived polarisation from mainstream British psychiatry. While the reception of In Two Minds and Family Life did intensify an adversarial relationship between 'rebel' anti-psychiatrists and hard-line behaviourists such as William Sargant, the wider psychiatric field largely welcomed the films' contributions to mental health awareness and used the publicity to counter the idea of a 'battle' within the profession. This included leading UK mental health organisation the National Association for Mental Health looking to Loach and Laing as models for engaging contemporary audiences as it rebranded to MIND in 1972. This article contributes to historical understandings of the complex interactions between the fields of media and mental health, as well as recent scholarship challenging the idea of a clear split between anti-psychiatry and British medical orthodoxy. [ABSTRACT FROM AUTHOR]

In recent years, personality disorders – psychiatric constructs understood as enduring dysfunctions of personality – have come into ever-greater focus for British policymakers, mental health professionals and service-users. Disputes have focussed largely on highly controversial attempts by the UK Department of Health to introduce mental health law and policy (now enshrined within the 2007 Mental Health Act of England and Wales). At the same time, clinical framings of personality disorder have dramatically shifted: once regarded as untreatable conditions, severe personality disorders are today thought of by many clinicians to be responsive to psychiatric and psychological intervention. In this article, I chart this transformation by means of a diachronic analysis of debates and institutional shifts pertaining to both attempts to change the law, and understandings of personality disorder. In so doing, I show how mental health policy and practice have mutually constituted one another, such that the aims of clinicians and policymakers have come to be closely aligned. I argue that it is precisely through these reciprocally constitutive processes that the profound reconfiguration of personality disorder from being an obdurate to a plastic condition has occurred; this demonstrates the significance of interactions between law and the health professions in shaping not only the State’s management of pathology, but also perceptions of its very nature. [ABSTRACT FROM PUBLISHER]

The authors discuss the special section of the journal that explores the role of local communities in advancing the goals of the Movement for Global Mental Health. They explain how community engagement can address challenges such as the impact of context culture and local survival strategies on peoples' responses to adversity and illness. The integration of local community efforts for mental health into a strong global activist movement is highlighted.

Background: There is growing recognition of the importance of mental health problems in developing countries. In large part, however, we have very limited epidemiological data at national and/or community levels about the prevalence of mental illnesses. Aims: The purpose of this paper is to describe the reliability and validity characteristics of an assessment tool that may be useful for conducting community-level surveys (particularly in rural communities of developing countries) to obtain prevalence rates of mental illnesses. Methods: We used a sample of adults residing in a rural village in Nepal to assess disorders with a modified version of the DSM-III-R Checklist. We evaluated construct validity, scale reliability, convergent validity and discriminant validity. Results: There is strong evidence for the construct validity of generalized anxiety and depression in our sample. By contrast, the symptoms associated with mania and schizophrenia were not empirically distinct. Convergent validity is acceptable. As a test of validity characteristics, the pattern of sociodemographic correlations suggests that the specific social origins of disorder in Nepal will require further investigation. Conclusion: The first step in obtaining high quality information on the distribution of mental illness in developing countries is to establish some reliable and valid indicators of disorder. The checklist format for assessing disorder appears to meet this objective and offers the possibility that community-level prevalence studies can be reasonably conducted. [ABSTRACT FROM AUTHOR]

Background: This paper describes a Bosnian refugee, a survivor of war and ethnic cleansing, during a 3-year follow-up in a psychiatry clinic. Discussion: This case throws light on the tension between medicotherapeutic and sociomoral ways of understanding the effects of such experiences, and of the limitations of morally and politically neutral psychiatric categories and technologies. Suffering always invokes questions of values: in this case the clinical picture represented a moral protest at what had been done with such impunity, and a refusal to accommodate to a world which now seemed unintelligible. The clinical picture also embodied the collective outrage, and sense of unfinished business, which many back in Bosnia itself were carrying in the wake of the 1995 Dayton peace accords which effectively legitimised the lines of ethnic cleansing. Conclusions: DSM or ICD diagnoses of depressive disorder or post-traumatic stress disorder turned out to lack validity and explanatory power. Claims that victims of war and atrocity typically have an unmet need for mental health services are overstated. Recovery from the effects of war may depend on reestablishing a sense of intelligibility, a task that must primarily go on in social space rather than mental space. [ABSTRACT FROM AUTHOR]

This article introduces a thematic issue of Transcultural Psychiatry that presents recent work that deepens our understanding of the refugee experience—from the forces of displacement, through the trajectory of migration, to the challenges of resettlement. Mental health research on refugees and asylum seekers has burgeoned over the past two decades with epidemiological studies, accounts of the lived experience, new conceptual frameworks, and advances in understanding of effective treatment and intervention. However, there are substantial gaps in available research, and important ethical and methodological challenges. These include: the need to adopt decolonizing, participatory methods that amplify refugee voices; the further development of frameworks for studying the broad impacts of forced migration that go beyond posttraumatic stress disorder; and more translational research informed by longitudinal studies of the course of refugee adaptation. Keeping a human rights advocacy perspective front and center will allow researchers to work in collaborative ways with both refugee communities and receiving societies to develop innovative mental health policy and practice to meet the urgent need for a global response to the challenge of forced migration, which is likely to grow dramatically in the coming years as a result of the impacts of climate change. [ABSTRACT FROM AUTHOR]

Barbara Dick's paper is reviewed from the framework of a Theory of Living Human Systems and the hypotheses that are generated for Systems-centered* practice. From this framework, it appears that the driving force towards transforming from Flight into Fight at the boundary zones are restrained by an unmodified repetition compulsion which governs the dynamics of both the members and the group-as-a-whole. Thus the group communication pattern serves as a restraining rather than a driving force to individual change. [ABSTRACT FROM AUTHOR]

This paper considers the influence of the group analyst's own self-objects on her holding capacity in the group. It describes how a therapist can, like a depressed mother, become persecuted by her group members and unable to tolerate their dependency, frustration and separateness. There are links to the intense experiences of childbirth and the early postnatal period. [ABSTRACT FROM AUTHOR]

Little has been written about play in adult therapy groups. This paper compares children's games with therapeutic factors in group analysis and explores the roles of play and playfulness in group psychotherapy. [ABSTRACT FROM AUTHOR]

The article discusses the importance of social factors in mental health and the decline of interest in the field of social psychiatry. Topics include the definition of social psychiatry, its relevance in modern times and the need for modernization and strengthening of the field.

Since antiquity, attempts to conceptualise the aetiology of mental illness have included social constructionist, biomedical, and psychosocial theories. The change of these concepts over the centuries is reflected in therapeutic approaches as well as the location, layout and interior design of psychiatric institutions. This article focuses on the genealogy of one of these concepts – the proposed link between meteorological parameters, specifically air and sun, and mental illness. Based on detailed archival materials, including administrative records, medical notes and correspondence as well as oral histories, relating to the Devon County Mental Hospital near Exeter (UK), it traces this link over time within and beyond the medical community to the extent that it served as pretext for underlying social causes of the illness. In doing so, this article makes an empirical contribution to geographical perspectives on the construction of psychiatric institutions throughout history while also advancing such work in theoretical terms by drawing attention to the shifts in medical and lay conceptualisations of mental illness. [ABSTRACT FROM AUTHOR]

In 1995, a Swedish pilot study of Dialectical Behaviour Therapy (DBT) was launched to investigate its therapeutic efficacy and cost-effectiveness as treatment for Borderline Personality Disorder (BPD) in suicidal women. In the same year, a sweeping reform of psychiatric care commenced, dramatically reducing the number of beds by the end of the decade. The psychiatry reform was presented as an important factor prompting the need for a community-based treatment for Borderline patients. This article suggests that the introduction of DBT in Sweden, and its relationship to the reform, can only be adequately explained with reference to the wider political shift occurring at the time, whereby the Swedish welfare state and its guiding ethos of egalitarianism were abandoned in favour of a neoliberal 'choice revolution'. With the new liberalism, hard work and individual responsibility replaced the idea of a Swedish 'people's home', a nationwide community and social support network. This language was reflected in DBT, which sought to teach patients the 'skills' necessary 'to create a life worth living'. In this context, therapy was constituted as a form of 'work' that the patient had to undertake to improve. Moreover, DBT rejected the prevailing view of Borderline patients as 'manipulative' and 'aggressive', suggesting instead that they were 'helpless', 'weak' and unable to regulate their emotions. This new Borderline persona fit neatly into the new liberal discourse: she could be taught to become a rational and independent person able to cope in a society that valued individual responsibility over social support. [ABSTRACT FROM AUTHOR]

Mass media plays a central role in shaping public discourse on health and illness. In order to examine media representations of mental health and expert knowledge in this field, two major Swedish daily newspapers from the year 2009 were qualitatively analysed. Drawing on the theory of social representations, the analysis focused on how issues concerning mental health and different perspectives are represented. The results show how the concept of mental illness is used in different and often taken-for-granted ways and how the distinction between normal and pathological is a central underlying question. Laypersons’ perspectives are supplemented by views of professionals in the newspapers, where signs of confidence and dependence on expert knowledge are juxtaposed with critique and expressions of distrust. The newspaper discourse thus has salient argumentative features and the way that conflicts are made explicit and issues concerning authoritative knowledge are addressed indicates ambivalence towards the authoritative role of expert knowledge concerning mental health. In this way, the newspapers provide a complex epistemic context for everyday sense-making that can be assumed to have implications for relations between laypersons and professionals in the field of mental health. [ABSTRACT FROM AUTHOR]

Introduction: Violence and victimization are often viewed in black and white terms by mental health professionals, an approach which is belied by more nuanced perspectives from outside psychiatry. Methods: Given increasing empirical evidence of the pervasive burden of victimization in people with mental illness, authors focused on the available theories and evidences from the literature. Results: Authors summarize the theories of victimizations, the possible measures of this phenomenon and underlie the role of research to clarify the link between psychiatry, violence and victimization. Conclusion: Violence and victimization need more space in the psychiatric research. This could have important implications for the lives of patients, but also for public understanding. [ABSTRACT FROM AUTHOR]

The Global Mental Health (GMH) movement has raised questions of the translatability of psychiatric concepts and the challenges of community engagement. In Tonga, the local psychiatrist Dr Puloka successfully established a publicly accessible psychiatry that has improved admission rates for serious mental illnesses and addressed some of the stigma attached to diagnosis. On the basis of historical analysis and ethnographic fieldwork with healers, doctors, and patients since 1998, this article offers an ethnographic contextualization of the development and reception of Puloka’s three key interventions during the 1990s: (a) collaboration with traditional healers; (b) translation of psychiatric diagnoses into local cultural concepts; and (c) encouraging freedom of movement and legal appeal to involuntary admission. Dr Puloka’s use of medical anthropological and transcultural psychiatry research informed a community-engaged brokerage between the implications of psychiatric nosologies and local needs that can address some of the challenges of the Global Mental Health movement. [ABSTRACT FROM AUTHOR]

Over the past decades, the formerly socialist countries of East Central Europe and Eurasia have experienced a range of transformations which bear directly upon the domains of mental health, psychiatry, and psychology. In particular, the disciplines and professions concerned with the human mind, brain, and behavior (“the psy-ences”) were strongly affected by sociopolitical changes spanning the state-socialist and postsocialist periods. These disciplines’ relationship to the state, their modes of knowledge production, and the epistemic order and subjectivities they contributed to have all undergone dramatic ruptures. In this essay, we trace the literature on these issues across three thematic domains: (a) history and memory; (b) the reform of psychiatry in an era of global mental health; and (c) therapy and self-fashioning. We argue for a closer articulation between the social science and historical literature on socialism and its “posts” and the literature among anthropologists, sociologists, and historians on the sciences of the mind and brain, and we suggest that each of these literatures helps to critically open up and enrich the other. [ABSTRACT FROM AUTHOR]

This article addresses four major challenges for efforts to create synergy between the global mental health movement and cultural psychiatry. First, although they appear to share domains of mutual interest, the worlds of global mental health and cultural psychiatry have distinct lineages. Expanding their horizons by learning from adjacent disciplines would be mutually beneficial. A second challenge concerns the conceptualization of a new classification system for mental health problems. Adopting a classification system that integrates new insights from socio-neurobiology and from a networks perspective could bring cultural psychiatry and global mental health closer and change the way each field addresses the mental health gap, which constitutes the third challenge. I summarize attempts to achieve comprehensive mental health coverage around the globe and question whether the strategies employed to achieve these goals have been successful, both in high- (HIC) and low- and middle-income countries (LMIC). In LMIC, the dominant strategy needs to be complemented by mobilization of other community resources including local practitioners. A fourth challenge is the lack of mathematical models to guide action and research and solve major preoccupations such as access to care or multi-level analyses in complex ecological or health systems. [ABSTRACT FROM AUTHOR]

Body learning gives actors basic structures and references that enable them to codify their actions in a script or score. W ith this score, acquired through training, performing and transmitting, actors who work with theater anthropology methodology offer strategies and tools that healers can use with their patients. This actor's score has inspired a mode of working with patients both to understand the case history and guide the course of therapy. In this approach, patients are like authors who want to act out their dramaturgy, but who need a director-healer to organize the story and help them build their healing process. Together, patient and therapist work on stage to advance the treatment, at the same time enhancing their strategies and methods for collaboration. [ABSTRACT FROM AUTHOR]

Mental health practitioners, assessing children for possible psychiatric conditions, need to probe sensitive matters. We examine practitioners’ use of questions which try to clarify a given issue by offering alternative descriptions of how things are: one bland, and the other clearly undesirable in some way. The undesirable states of affairs can be described in serious terms (e.g. the child wanting to kill themselves) or, while still undesirable, in less serious ones (e.g. the child feeling temporarily upset). We find that if an undesirable state of affairs is described in seriously negative terms, it tends to be put as the first item in the pair of alternatives. We argue that this version of the familiar ‘optimistic questioning’ practice ensures that were the negative case to be chosen, it would be in spite of it being the more interactionally difficult answer to give. That makes the answer diagnostically more reliable. We discuss the pros and cons use of this practice in the environment of triage. [ABSTRACT FROM AUTHOR]

The population of the Netherlands has become increasingly diverse in terms of ethnicity and religion, and anti-immigrant attitudes have become more apparent. At the same time, interest in issues linked to transcultural psychiatry has grown steadily. The purpose of this article is to describe the most important results in Dutch transcultural psychiatric research in the last decade and to discuss their relationship with relevant social and political developments in the Netherlands. All relevant PhD theses (N = 27) between 2000 and 2011 were selected. Screening of Dutch journals in the field of transcultural psychiatry and medical anthropology and a PubMed query yielded additional publications. Forensic and addiction psychiatry were excluded from this review. The results of the review indicate three main topics: (a) the prevalence of psychiatric disorders and their relation to migration issues as social defeat and ethnic density, showing considerable intra- and interethnic differences in predictors and prevalence rates, (b) the social position of refugees and asylum seekers, and its effect on mental health, showing especially high risk among asylum seekers, and (c) the patterns of health-seeking behaviour and use of mental health services, showing a differentiated picture among various migrant groups. Anthropological research brought additional knowledge on all the above topics. The overall conclusion is that transcultural psychiatric research in the Netherlands has made a giant leap since the turn of the century. The results are of international importance and invite redefinition of the relationship between migration and mental health, and reconsideration of its underlying mechanisms in multiethnic societies. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various reports within the issue on topics including the longitudinal research on Cambodian refugees, healing and trauma of the North American society, and the exposure of North Americans to poverty, substance abuse and violence.

‘Deliberate self-harm’, ‘self-mutilation’ and ‘self-injury’ are just some of the terms used to describe one of the most prominent issues in British mental health policy in recent years. This article demonstrates that contemporary literature on ‘self-harm’ produces this phenomenon (to varying extents) around two key characteristics. First, this behaviour is predominantly performed by those identified as female. Second, this behaviour primarily involves cutting the skin. These constitutive characteristics are traced back to a corpus of literature produced in the 1960s and 1970s in North American psychiatric inpatient institutions; analysis shows how pre-1960 works were substantially different. Finally, these gendered and behavioural assertions are shown to be the result of historically specific processes of exclusion and emphasis. [ABSTRACT FROM PUBLISHER]

The author discusses the role of transcultural Psychiatry in mental health area. He states that transcultural psychiatry has always had at its heart a critique, implicit or explicit, of mainstream psychiatry and other disciplines. According to him, the emergence of global mental health represents an opportunity for the discipline of transcultural psychiatry to have far-reaching effects in many senses of that word.

An afterword to against "global mental health" is presented.