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 Table of Contents    
BOOK REVIEW  
Year : 2013  |  Volume : 55  |  Issue : 2  |  Page : 209
Community mental health in India


Professor of Psychiatry, Christian Medical College, Vellore - 632 002, Tamil Nadu, India

Click here for correspondence address and email

Date of Web Publication7-May-2013
 

How to cite this article:
Jacob K S. Community mental health in India. Indian J Psychiatry 2013;55:209

How to cite this URL:
Jacob K S. Community mental health in India. Indian J Psychiatry [serial online] 2013 [cited 2020 Feb 23];55:209. Available from: http://www.indianjpsychiatry.org/text.asp?2013/55/2/209/111477



Edited by: B. S. Chavan, N. Gupta, P. Arun, A. Sidana, S. Jadhav

Publisher name and Address: Jaypee Brothers Medical Publishers, New Delhi, India.

Published in 2012

Pages: 662, Price: 1295/-









The community psychiatry movement, which attempted to bring mental healthcare to people living in the community, started many decades ago. However, its impact on the delivery of such care in India has been marginal. The current re-strategized National Mental Health Programme is a long way from the vision of integration of mental health services into primary care. "Community Mental Health in India" attempts to bring together the diverse strands and discusses many issues related to the field.

The book is edited and authored by leaders in the field of mental health and community mental health in India. It has contributors from different parts of the world, which adds an international flavor to the project. Sections in the book include Introduction, Historical Concepts and Evolution, Dimensions of Community Psychiatry, Legislative Issues, Relationship with Psychiatric Sub-Specialities, Psychiatric Emergencies in the Community, Complementary Models and Alternatives to Hospitalisation, International Perspectives, Clinical Anthropology, Administration, Governance, and Research. It also includes a section on personal and popular narratives of suffering.

The book discusses relevance, evolution, shift to general hospital psychiatry and primary care, national and district programmes for community mental health, integration with general health care, role of non-governmental organizations, relevant legislation, and public education. It has chapters on community psychiatry programmes in the United States of America, United Kingdom, Australia, Singapore, Malaysia, Sri Lanka, and Pakistan. In sync with its broad perspective of mental health care in the community, it includes chapters on families of people with mental illness, stigma, disability, homelessness, gender issues, primary prevention of mental disorders, indigenous therapy, traditional healing, psychosocial rehabilitation, and counselling. There are chapters that discuss psychiatric and mental health issues from a cultural perspective.

The strengths of the book include the fact that it attempts to be exhaustive in its approach. Many of its contributors are pioneers, national, and international authorities in the field. The book is a compendium of information on the subject. It compiles material on different aspect of the topic. The book brings together a vast body of literature. It highlights the theory, plans, and perspectives and reflects the state of community mental health care in the country. It discusses the complex issues facing community psychiatry and highlights the lacunae in mental health care delivery in India. A careful reading of the book does reveal several reasons for the failure of implementation of the program on a national scale. The top-down model, absence of public participation, superficial analysis of "community," budgetary and funding problems, human resource limitations, lack of an operational blueprint, sole focus on psychotropic medication, professional apathy, over-burdened primary care system, bureaucratic approach, and the idealistic vision of the pioneers sans the reality of India did not help the cause. The book is a resource for those trying to understand community mental healthcare and its delivery in resource-poor settings.

Nevertheless, a more critical analysis of the reasons for the failure of the program in India would have added to the book significantly. An effort at integration of the diverse strands brought together in the book would have further improved its appeal. An attempt to provide a possible framework, grounded in the reality of India, for a practical model for community mental health care would have placed it not just as a reference material, but also as a blueprint for the future. Such an approach would have also contributed to the debate on the mechanisms for rejuvenation of community psychiatry in the country.

While the book focuses on India, it has lesions for other low-and middle-income countries. The book fills a gap in existing literature. It should be in every library in medical schools, psychiatry departments, and health facilities, and in organisations interested in mental health care across the country.

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Correspondence Address:
K S Jacob
Professor of Psychiatry, Christian Medical College, Vellore - 632 002, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


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