Mental Health in Africa and the Americas Today

A book of conference Proceeding.

Edited by Samuel O. Okpaku, M.D., Ph. D.

Chrisolith Books, Nashville (USA), 1991.

Samuel O. Okpaku, MB CH B, Ph.D., MRCP (I), FRCP (C), is Associate Research Professor of Public Policy and Associate Clinical Professor of Psychiatry at Vanderbilt University. A graduate of Edinburgh University Medical School, Scotland, he has training and experience in both internal medecine and psychiatry. In addition he holds a Ph.D. (Social Welfare and Research) from Brandeis University. A Nigerian who has studied and worked abroad for almost three decades, he has been engaged in research with ranges from biological psychiatry to sociocultural investigations. His current reseach activities include strategies to reduce disability and improve the quality of life in severaly mentally ill individuals.Dr Okpaku has previously held faculty appointments at Yale university and the University of Pennsylvania. He has a continuing interest in African Healing Systems.

This comprehensive collection of papers raises fundamental questions about the future of psychiatry in a global society, which is faced with increasing stress, family disruptions and shrinking resources. The papers collected here were presented at the first joint meeting of the African Psychiatric Association, American Psychiatric Association and Blacks Psychiatrists of America in 1986 at Nairobi, Kenya. Written by outstanding mental health professionals from several cultures, the book emphasizes the low priority of mental health as a component of public health services. In addition the book underscores the importance of the role of mental health services delivery as an integral part of primary health care.

This is a volume of historic significance, as well as a ready-reference with professional and practical value. Mental health professionals, practitioners and policy makers engaged in contemporary multicultural and transcultural settings will find this book to be a vivid description of mental health in African, American and Caribbean societies – a welcome addition to their continuing education.


About the Book . XIII

Acknowledgement . XV

Preface . XVII

Introduction . XXI

SECTION I : Historical and Sociocultural Factors

  • 1. The Mentally 111 in Modem and Traditional African Societies . 1
    Ayo Binitie

  • 2. Development of Psychiatry in Africa . 17
    Tolani S. Asuni

  • 3. Social Consequences of Psychoses for Psychotic Patients in Western Province, Kenya, After Treatment . 33
    G.PM. Assen

  • 4. Acute Psychosis and Rapid Social Change in Swaziland . 53
    E.A. Guinness

  • 5. Psychiatry in Libya’s Eastern Region . 91
    Selim M. Elbadri

  • 6. Monosymptomatic Delusions of Smell : Are These New Symptoms in East Africa ? . 97
    M.A. Fazel and A.M. Shah,

  • 7. Notes on the History of Blacks in American Psychiatry . 107
    Jeanne Spurlock

  • 8. Psychiatric Care of the AIDS Patient in Africa and the Americas . 123
    Joyce M. Johnson

SECTION II : Adult and General Psychiatry

  • 9. Biological Approaches to Mental Health Problems in Africa Today . 137
    A.0. Odejide and S.W Acuda

  • 10. Possible Cultural Variations in Adult Development . 151
    Samuel 0. Okpaku,

  • 11. The Emergence of Psychological Discourse in Kenya . 165
    Marie Coleman Nelson

  • 12. Epidemiology of Mental Disorders in Kenya . 171
    Manohar Dhadphale

  • 13. The Role of EEG in Diagnosis and Management of Psychoneurotic Disorders in Nairobi . 179
    S.C. Gatere

  • 14. Major Mental Illness in Two Kenyan Rural Outposts . 187
    Lawrence E. Banta

  • 15. Case Study of James Peter, An Example of Transitional Group Psychotherapy in Malawi . 195
    Karl Peltzer

  • 16. Forensic Psychiary in Africa Today . 213
    Tolani Asuni

  • 17. Crime and Mental Illness in Africa : A Retrospective Study of Court Referrals To A Provincial Psychiatric Clinic in Kenya . 223
    F.G. Matete

  • 18. Psychosomatic Structuring Among Africians . 231
    Sobbie A.Z. Mulindi

  • 19. The Relationship of Psyche and Soma as Viewed by American Psychiatrists . 245
    David R. Hawkins

  • 20. Hornoracial and Heteroracial Behavior in the United States . 257
    Chester M. Pierce and Wesley E. Profit

SECTION III : Child Psychiatry

  • 21. Child Psychiatry in Kenya . 267
    F.G. Njenga, and L. Wairimu Ndirangu

  • 22. Black Children in Psychiatric Outpatient Treatment in the United States . 275
    Harry H. Wright and Elisabeth A. Cole

  • 23 . Innovations in Mental Health Care for Children and Adolescents in the United States and Britian . 289
    Felton Earls

  • 24 . Suicidal Adolescents in the USA : A Sociocultural-Psychological Approach to Assessment and Treatment . 311
    Lee Ann Hoff


  • 3.1 Child Psychiatry in Kenya . 325

  • 3.2 Black Children in Psychiatric Outpatient Treatment . 327

  • 3.3 Innovations in Mental Health Care for Children and Adolescents in the United States and Britain . 329

  • 3.4 Suicidal Adolescents in the USA : A Sociocultural- Psychological Approach to Assessment and Treatment . 331

  • 3.5 Child Psychiatry . 333

SECTION IV. Substance Abuse

  • 25. Cannabis Psychosis : Facts and Myth . 339
    R. Onyango Sumba

  • 26. Specific Problems of Drug Abuse in Kenya . 347
    S.W Acuda.

  • 27. Medical and Social Aspects of Khat Use in Kenya . 359
    O.E. Omolo

  • 28. Trihexyphenidyl in Zimbabwe . 367
    Myrl S. Manley

  • 29. Special Aspects of Alcoholism Among American Blacks . 375
    Roy W Menninger

SECTION V. Training, Education and Service Delivery

  • 30. Problems in Psychiatry Services in Sub-Sahara African Countries . 387
    G. Mustafa

  • 31. Postgraduate Psychiatric Education in Africa . 395
    Ayo Binitie

  • 32. Training of Mental Health Nurses in Kenya : Challenges and Problems . 401
    C.M. Mbugua

  • 33. The Role of Voluntary Agencies in the Development of Mental Health Programs in Kenya . 407
    Lawrence E. Banta

  • 34. Community Mental Health Services in Nairobi, Kenya . 413
    M.M.0. Okonji

  • 35. Providing Mental Health Services With Meager Resources in Tanzania . 419
    G. Bugaisa and N. L. Rugeiyarnu

  • 36. The Chronic Mentally Ill : What Do We Know, And Why Aren’t We Implementing What We Know ? . 433
    John A. Talbott

  • 37. The Crisis Model’s Compatibility With Meager Resources . 461
    Lee Ann Hoff

  • 38. Social, Ethical, and Economic Issues in American Psychiatry . 475
    Carol C. Nadelson

  • 39. Payment Systems in the United States . 483
    Jay B. Cutler


INDEX . 503

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