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The Human Nature Review Human Nature Review  2002 Volume 2: 431-432 ( 14 October )
URL of this document http://human-nature.com/nibbs/02/society.html

Book Review

Psychiatry in Society
edited by Norman Sartorius, Wolfgang Gaebel, Juan Jose Lopez-Ibor, and Mario Maj
Chichester: John Wiley and Sons, 2002

Reviewed by Dr. Itzhak Levav, Special Adviser for Mental Health, Ministry of Health, Department for Information and Evaluation of Mental Health Services, Jerusalem, Israel.

The World Psychiatric Association has published this book, and deserves congratulation for this initiative. The reason is simple, Psychiatry in Society provides the reader with a large variety of timely topics within the field of social psychiatry, eleven in number, that were prepared by twenty-one distinguished authors from many different parts of the world. Both features, the timely topics and the global community of writers, create the uniqueness of the book. Its emphasis on current macrosocial issues that influence (or must influence) practice is of universal interest.

The book is opened by L. Eisenberg in a chapter that discusses ‘The Impact of Sociocultural Changes in Psychiatry’. This chapter is a delight: the author selects recent studies and weaves their findings into a coherent and colourful fabric that enables him to make his case..." Because all human disease is social, changed social conditions alter the epidemiology and course of disease". By the end of this brief chapter, the reader comes to understand where she stands in reference to her time, thus challenging the often ahistorical position of most psychiatrists (and other mental health workers) that compromises practice. One line of this intellectually stimulating chapter is worth quoting: "Modernization... is not a royal road to better health", a rather sobering sentence in the mouth of a reformer.

Chapter 2, by H. Haffner, dovetails nicely with the previous one. Haffner covers ‘Changes in Health Care Systems and Their Impact on Mental Health Care’. This is a chapter to be read and discussed by psychiatric residents and senior personnel who frequently spend much teaching time covering biological or, less often, the psychological, means of treatment even though the way psychiatrists operate depends to a great extent on the way in which the social and economic systems organize mental health care. Indeed, what the psychiatrist offers the patient is what the organized system of care allows. Haffner clarifies this very well by following an historical thread. The chapter deals with many related issues; and some of its statements may provoke vivid discussion, for example " this once again underlines the fact that mental health care can never fully be merged in general health care. But it is equally plain that mental health care must remain rooted in medical science".

Chapter 3, by G. Lewis and R. Araya, deals with a current topic of crucial importance but one that is seldom discussed, ‘Globalization and Mental Health’. Those among us who think that globalization has had, and has, adverse effects on aspects of mental health, including care, may not be fully satisfied with this chapter since it does not discuss specific studies that show the impact of globalization on incidence, treatment and rehabilitation. But, to be fair to the authors, specific studies are wanting. To fill the void, the authors rely on past work to provide plausible bases for their theses. Whether or not we feel satisfied with this chapter, we should give credit to the editors for including this subject and to the authors for attempting to tackle it.

Chapters 4 and 5 deal with other issues that arise from society and that pattern and guide the practice of psychiatry. Chapter 4, refers to ‘The Impact of Legislation on Mental Health Policy’ and Chapter 5 to ‘ The New Ethical Context of Psychiatry’.

The following six chapters are less theoretical and more practice-oriented. ‘Community Mental Health Care: Promises and Pitfalls’, by P. Bebbington, S. Johnson and G. Thornicroft brings much evidence to a field of action that is ideologically discussed by both those who are for and, particularly, by those who are against. This explains why, after reviewing facts with regard to the best way to deliver care, the authors are capable of taking a cautious stand, showing the reader that knowledge based on science is not compatible with a priori conclusions.

In Chapter 8, ‘Mental Health Problems in Refugees’, B. Saraceno, S. Saxena and P. Maulik cover a good amount of the current literature from an epidemiologic perspective, thus providing the bases for mental health action in this relatively recent field of social psychiatry.

The remaining chapters cover other timely subjects such as quality of life, disasters, and the homeless mentally ill. These all come with a rich and varied bibliography. The book is closed by a chapter on ‘Mass Media and Psychiatry’. Undoubtedly the media shapes the attitudes and beliefs of the community at the same time that it reflects them. This chapter awakens our appetite for greater understanding and use of social communication in mental health with regard to promotion, prevention and care.

To summarize, this book is a necessary item in any list of readings in all psychiatric residence programs. Senior psychiatrists may find it stimulating to the same degree.

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© Itzhak Levav.


Levav, I. (2002). Review of Psychiatry in Society edited by Norman Sartorius, Wolfgang Gaebel, Juan Jose Lopez-Ibor, and Mario Maj. Human Nature Review. 2: 431-432.

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