R. Tara & Graham Thornicroft 
Community Mental Health 
Putting Policy Into Practice Globally

There are wide inconsistencies between, and even within, countries
in how community-orientated care is defined and interpreted. The
analysis presented in this book take as a starting point an
evidence-based balanced care model in which services are provided
in community settings close to the populations served, with
hospital stays being reduced as far as possible, usually located in
acute wards in general hospitals. The surprising conclusion from
the research is that the same problems arise in all countries,
regardless of resource status, and thus the recommendations of this
book apply to mental health provision everywhere.

This book reviews the implementation of community-orientated
care using the balanced care model. It summarizes the steps,
obstacles and mistakes that have been encountered in the
implementation of community mental health care worldwide and
presents guidelines on how to avoid them. It proposes realistic and
achievable recommendations for the development and implementation
of community-orientated mental health care over the next ten years.
These guidelines will be of practical use to psychiatrists and
other mental health and public health practitioners at all levels
worldwide, including policy makers, commissioners, funders,
non-governmental organisations, service users and carers. A core
message of the book is that the mental health sector will more
powerfully advocate for better services in future through strong
and unified alliances, especially with powerful representation from
consumer/service user and carer groups.

Community-orientated care draws on a wide range of
practitioners, providers, care and support systems (both
professional and non-professional), though particular components
may play a larger or lesser role in different settings depending on
the local context and the available resources, especially trained
staff. Research by a WPA task force has demonstrated that most of
the challenges are common and global, but with local variations.
The book is therefore relevant to psychiatrists and mental health
workers in developed countries who are trying to deliver better
health care on reduced budgets and for those in the developing
economies who are in the position to modernise their mental health
care. It provides clear, concise guidance on policy and practice
decisions, learning from what has and has not worked in regions in
the world.

The book contains many tables documenting the evidence,
supported by an essential reference list, and a Key Points summary
for each chapter.

Highly Commended in the Psychiatry section of the href=’http://bma.org.uk/about-the-bma/bma-library/medical-book-awards/medical-book-awards-winners-listing’>2012
BMA Book Awards.

表中的内容

Contents

List of Contributors, viii

Foreword, xi

Acknowledgements, xiii

Section 1 Introduction, 1

1 Global mental health: the context, 3

2 Description of the world regions, 14

3 Overview of mental health policies worldwide, 23

Section 2 Implementation of community mental health services, 37

4 The current provision of community mental health services, 39

5 Policies, plans, and programs, 90

6 Scaling up services for whole populations, 97

7 Stigma, discrimination, and community awareness about mental illnesses, 119

8 Developing a consensus for engagement, 135

9 Human and financial resources, 140

10 Development, organization, and evaluation of services, 151

Section 3 Recommendations, 167

11 Lessons learned and recommendations for the future, 169

Appendix A Terminologies, 213

Appendix B Questions from a survey conducted with regional experts in the Africa region, 221

Appendix C Internet resources, 223

Index, 227

关于作者

Graham Thornicroft and Maya Semrau, Health Service
and Population Research Department, Institute of Psychiatry, King’s
College London, UK

Atalay Alem, Department of Psychiatry, Faculty of
Medicine, Addis Ababa University, Ethiopia

Robert E. Drake, Dartmouth Psychiatric Research Center,
NH, USA

Hiroto Ito, National Institute of Mental Health, National
Centre of Neurology and Psychiatry, Tokyo, Japan

Jair Mari, Department of Psychiatry, Universidade Federal
de São Paulo, Brazil

Peter Mc George, New Zealand Mental Health Commission,
Wellington, New Zealand

R. Thara, Schizophrenia Research Foundation (SCARF),
Chennai, India