Contemporary Issues in Mental Health Care in sub-Saharan Africa

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Seventy percent of the global burden of mental disorders is located in low and middle income countries (LMIC),including sub-Saharan Africa (SSA). However, in Africa,only 0.62% of the national health budget is allocated to mental health compared to a global median of 2.8% and 5% in Europe. The government is the source of funding in 62%of patients with severe mental disorder in the World Health Organisation (WHO), Africa Region, the lowest of all the WHO regions, and lower compared to a global median of 79%. This is compounded by poor resources, with mental health outpatient facilities in WHO Africa Region being less that 10% of the global median. To address these problems, the WHO launched its Mental Health Action Gap Programme (mhGAP) in 2008, to scale-up mental health services in low and middle income countries (LMIC). The book is directed to all policy makers in sub-Saharan Africa to aid decision making about the urgent need for sustainable and relevant mental health care strategies, and the important areas that need priority. The book should be helpful to local and international researchers in formulating research questions relevant to the African continent and it will be of interest to medical practitioners and students in the region as adjunct to standard text books.

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Date de parution 29 décembre 2017
Nombre de visites sur la page 3
EAN13 9789789211746
Langue English

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IBADAN MEDICAL SPECIALISTS GROUP 2017
Contemporary Issues in Mental Health Care in subSaharan Africa
editors Olayinka Omigbodun Femi Oyebode
series editor Olufunso Adedeji
BookBuilders • Editions Africa
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©2017 Ibadan Medical Specialists Group
ISBN: 978-978-921-159-3
No part of this publication may be reproduced, stored in a retrieval system or transmitted by any form or by any means, electronic, mechanical, photocopying , recording, or otherwise without the expressed written consent of the the copyright owner.
Published in Nigeria by BookBuilders • Editions Africa 2 Awosika Avenue, Bodija, Ibadan email: bookbuildersafrica@yahoo.com mobile: 0805 662 9266; 0809 920 9106
Printed in Ibadan Oluben Printers, Oke-Ado mobile: 0805 522 0209
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C O N T E N T S
Preface. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v
Contributors.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v ii
1.
2.
3.
4.
5.
6.
7.
Emerging Mental Health Systems in sub-Saharan Africa Jibril Abdulmalik and Oye Gureje. . . . . . . . . . . . . . . . . . . 1
Pathways to Mental Health Care in sub-Saharan Africa Ugo Ikwuka and Femi Oyebode. . . . . . . . . . . . . . . . . . . . 19
Community Psychiatry in sub-Saharan Africa. Helen Sasegbon.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Community Mental Health Service Delivery at the Neuropsychiatric Hospital, Aro, Abeokuta Timothy OlaoluAdebowale. . . . . . . . . . . . . . . . . . . . . . . . 59
Psychiatric Disorders in Pregnancy and Postpartum Women Abiodun Abioye and Bode Williams. . . . . . . . . . . . . . . 75
The Changing Landscape of Child and Adolescent Mental Health in sub-Saharan Africa Olayinka Omigbodun, Kwabena Kusi-Mensah, Tolulope Bella-Awusah and Cornelius Ani.. . . . . . . . 93
Intellectual Disability (Learning Disability) Yetunde C Adeniyi and Taiwo Adewunmi. . . . . . . 123
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contents cont’d. . .
8
9.
Psychoactive Substance Misuse in West Africa Olawale Lagundoye and BabajideAdeyefa. . . . . . . 153
Management of Older Adult Mental Health Conditions in sub-Saharan Africa Olugbenga Akande, Abel A. Ojagbemi and Olusegun Baiyewu.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
10. Culture and Mental Health Olatunji F. Aina.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203
11. Interface between Historical Group Trauma and Contemporary Politics in Nigeria: The Civil War Experience Femi Adebajo. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221
12. Mental Health Legislation in Sub-Saharan Africa Jibril Abdulmalik, Adegboyega Ogunwale and Akintunde Akinkunmi. . . . . . . . . . . . . . . . . . . . . . . . . . 233
Index.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245
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P R E F A C E
Seventy percent of the global burden of mental disorders is located in low and middle income countries (LMIC), including sub-Saharan Africa (SSA). However, in Africa, only 0.62% of the national health budget is allocated to mental health compared to a global median of 2.8% and 5% in Europe. The government is the source of funding in 62%of patients with severe mental disorder in the World Health Organizat ion (WHO), Africa Region, the lowest of all the WHO regions, and lower compared to a global median of 79%. This is compounded by poor resources, with mental health outpatient facilities in WHO Africa Region being less that 10% of t he global median. To address these problems, the WHO launched its Mental Health Action Gap Programme (mhGAP) in 2008, to scale-up mental health services in low and middle income countries (LMIC). Cult ure plays significant and multiple roles in mental illness. It plays a role in the pathogenesis, elaboration and reaction t o mental illnesses. Culture also influences the pathways to management, and in sub-Saharan Africa, about 40-70% of mentally ill patients first seek alternative treatment with spiritual and/or traditional healers. This usually leads to delay in seeking bio-medical help.
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P r e f a c e
Cultural formulation is now incorporat ed in the Diagnostic and Statistical Manual (DSM)of Mental Disorders since the 4th edition wit h the main goal to assist clinicians in identifying cultural-contextual factors that affect therapeutic choices. The purpose of this book is to address some of the contemporary problems in mental health care in sub-Saharan Africa.
The book is directed to all policy makers in sub-Saharan Africa to aid decision making about the urgent need for sustainable and relevant mental health care strategies, and the important areas that need prioritisation. The book should be helpful to local and international researchers in formulating research questions relevant to the African continent and it will be of interest to medical practitioners and students in the region as adjunct to standard text books.
I am grateful to all the contributors for their time, effort and hard work in bringing this book to life. And I wish to express my sincere gratitude to my editorial colleagues, Professor Olayinka Omigbodun and Professor Femi Oyebode, for the invaluable expertise they brought to bear on the manuscript.
Olufunso Adebola Adedeji. MBBS, MD, FRCSEd. Honorary Senior Clinical Lecturer, School of Clinical and Experimental Medicine University of Birmingham, United Kingdom Series Editor, October 2017
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C O N T R I B U T O R S
Jibril Abdulmalik, MBBS, MSc,MHPM, FWACP Senior Lecturer & Consultant Psychiatrist Department of Psychiatry, College of Medicine, University of Ibadan, Nigeria Abiodun Abioye, MBBS, MRCPsych. MScsultant. Con Psychiatrist, Partnership in Care, London, United Kingdom Olufe m i Adebajo, MBBS, MRCPsych (UK). Cert NonClinical Psychopharmacology. Consultant Psychiatrist. BetsiCadwaladr University Health Board, Bangor, Wales, United Kingdom Timothy Olaolu Adebowa le, MBBS, D.Psych (Manchester), FWACP (Psych). Chief s t Consultant Psychiatri and Director of Clinical Services, Neuropsychiatric Hospital, Aro, Abeokuta, Nigeria
Yetunde C Adeniyi, MBBS, FWACP, MSc. Child Psychia tri s t, Child & Adolescent Mental Health, Un iversity College Hospital, Ibadan, Nigeria
Taiwo Adewunmi, MBBS, Esk &. Consultant Psychiatrist, Tees Wear Valley NHS Trust, Durham, United Kingdom
Babajide Adeyefa, MBBS, MWACP (Psych). Senior Registrar in Psychiatry, Depa rtmen t of Psychiatry, University College Hospital, Ibadan, Nigeria
Olatunji F. Aina, MBBS, FWACP. Professor of Psychiatry, College of Medicine, University of Lagos, Lagos, Nigeria. Editor-in-Chief,Nigerian Journal of Psychiatry
Olugbenga Akande, MBBS, MSc, MBA, MRCPsych.Consultant Psychiatrist and Medical Director John Munroe Group, Leek, Staffordshire, United Kingdom
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Contributors
Akintunde Akinkunmi, MB, LLM, FRCPsych., FRCP, VR. Psychiatrist. Chief Medical Officer (Reserves), HQ 2 n d Medical Brigade, Queen Elizabeth Barracks, Strensall, York, United Kingdom
Cornelius Ani, MBBS, MSc, MRCP, MRCPsych, MD, (Res), Academic Unit of Child and Adolescent Psychiatry, Imperial College London, London, United Kingdom Olusegun Baiyewu, MBBS, FMC(Psych), FWACP. Professor, Depa rtment of Psychiatry, University Hospital Ibadan, Ibadan, Nigeria T olulope BellaAwusah, MBBS, MSc. CAMH, FWACP. Department of Child and Adolescent Psychiatry, University College Hospital, Ibadan, Nigeria Oyewusi Gureje , MB BS, MSc. PhD. DSc. FRCPsych. Professor and Director of Institute of Neurosciences, Un i versity College Hospital, Ibadan, Nigeria Ugo Ikwuka, PhDof Psychology, University of. Department Wolverhampton, Wolverhampton, United Kingdom.
Kwabena KusiMensah, BSc, MBCHB, MSc. CAMH, MWACP. Department of Psychiatry, KomfoAnokye Teaching Hospital, Kumasi, Ghana
Olawale Lagundoye, MBBS, FRCPsych.Consultant in Addiction Psychiatry, Sheffield Treatment & Recovery Team, Fitzwilliam Centre, Sheffield, United Kingdom
Ade gboye ga Ogunwale, MBBS, PGD (Statistics), LLM, FWACP. Sen i or Con s ulta n t Ps ych i atrist, Forensic Unit, Neuropsyciatric Hospital, Aro, Abeokuta, Nigeria
Abel A. Ojagbemi, MBBS, PhD, FMCPsych, FWACP. Lecturer, Department of Psychiatry, University College Hospital, Ibadan, Nigeria
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Contributors
Olayinka Omigbodun, MBBS, MPH, FWACP, FMCPsych. Professor and Head of Department of Psychiatry, and con sultant in Child and Adolescent Psychiatry, University College Hospita l, Ibadan, Nigeria. Di rector, Centre for Child & Adolescent Mental Health, University of Ibadan, Nigeria.
Fe m i Oyebode, MBBS, MD, PhD, FRCPsych. Professor and Head of Department of Psychiatry, Universi ty of Birmingham, United Kingdom
Helen Sasegbon, MBBS, MSc. FWACP.ych i a tri s t, St Ps Andrew’s Healthcare, Northampton. United Kingdom.
Bode Williams, MBBS, MRCOG. Consultant Obstetrician, Liverpool Women’s Hospital, Crown Street, Liverpool, United Kingdom
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