Medical Anthropology - Mental Health

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Mental health is one of the most neglected fields of healthcare. There is so much suffering related to mental health all over the world, which is either not recognized or goes untreated because of lack of expertise or other resources. Although stress and distress have been important topics in medical anthropology, respectively mental health itself has not received sufficient attention in either anthropology or public health. This issue has assumed international importance with the emergence of marked increases in psychiatric and behavioral problems, in tandem with exponentially increasing numbers of refugees worldwide and escalating disruption of social structure such as family and local communities. More over mental health problems and behavior problems are closely related to health problems of both infectious and chronic nature, therefore unraveling the basis of mental health and physical health risk, and thus the extension of such research to developing efficient treatment and preventative measures demands a combination of both biological and psychosocial approaches.

Preliminary results from the world’s largest survey on mental health indicates that mental health is widespread and untreated and that wealthy people with mental illness receive more and better treatment than poor people with severe mental illness. One to five percent of the population of most countries surveyed had serious mental illness according to the findings, published in The Journal of the American Medical Association, and in most of the countries nine to seventeen percent of those interviewed had some episode of mental illness in the last year, whether serious or less severe. Around the world it was found that mental illness causes as many days of work lost as any physical problems such as cancer, heart attack, or back pain. The level of role impairment that was found associated with serious mental disorders was staggering: more than a month in the past year when the respondents reported totally unable to work.

In poor countries, about eighty percent of serious cases went untreated, but even in rich countries thirty-five to fifty percent of cases had not been treated. The surveys asked about treatment not just by psychiatrists and psychologists but family practitioner, members of the clergy, shamans and herbalists. The findings were based on 60,643 face to face interviews with adults in each country. Eight countries were defined as rich: The United States, Germany, France, Italy, Belgium, Spain, The Netherlands, and Japan. Six were deemed poor or nearly poor: Mexico, Columbia, Ukraine, China, Lebanon, and Nigeria. Within each country whether rich or poor, the study took into account the economic status of the participants. The ninety minute interviews assessed a wide range of ills, including agoraphobia, obsessive-compulsive disorders, post-traumatic stress syndrome, bi-polar disorder, bulimia, major depression and alcohol and drug abuse. The study did not try to diagnose schiziophrenia because that requires a psychiatrist (Compared with diagnostic criteria for all other mental illness, criteria for diagnosing schiziophrenia is always evolving.) Researchers of this study acknowledged that methodology needed refinement.

There were some general trends that were clear and there were widespread unexplained disparities. Twenty-six percent of Americans were judged to have mental illness compared with four percent of the residents of Shanghai and five percent of Nigerians. The differences were even more extreme in smaller categories. The Dutch were found to have thirty more times the drinking problems than the Italians had and four times the problem of the French. Eighteen percent of Americans had anxiety disorders versus twelve percent of the French, eleven percent of Lebanese and about ten percent of Columbians. Europeans other than the French were in the seven percent range while Nigerians and Chinese were the calmest. The data above...
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