MacMillan Education LTD, London, 1991.
Suman Fernando is a Fellow of the Royal College of Psychiatrists and (in 1990) the Chairperson of the Transcultural Psychiatry Society (UK). He was educated in Sri Lanka and at Cambridge, and has practised psychiatry in both Sri Lanka and Britain. A member of the Mental Health Act Commission since 1986, he is now Chair of its Standing Committee on Race and Culture.
Theories and traditions that we inherit and live with determine our current understanding of mental health. African, Asian and native American traditions promote ways of thinking that are different from those in the West dominated by Western psychiatry. Informed throughout by a deep awareness of both racial and cultural issues, the author describes and analyses mental health theory, practice, tradition and innovation around the globe in the context of a diversity of world-views and of problems arising from racism. Drawing on a wide range of sources, the book is written in a clear, direct style and does not spare sacred cows.
A thoughtful account of racism and its influence on psychology and psychiatry, a disturbing description of the mechanics of psychiatry and an illuminating exploration of mental health and mental disorder across the globe set the stage for a powerful second section of the book. In this, the author argues cogently that psychiatric imperialism at a global level and racist way of working at an individual level must be combatted in order to enable us to move forward into truly culturally based concepts of mental health. In following this through, the book ends on an imaginative and constructive note offering ideas on remodelling and restructuring our thinking and our practices in order to produce a basis for achieving sound mental health for all.
The book provides an extensive list of references and serves both as a background text and as a stimulating and exciting vision of what mental health really means in a global context.
Contents
List of Figures . ix
Acknowledgements . x
Introduction . 1
Part I Theory and Tradition . 7
- 1. Race, Culture and Ethnicity . 9
- Myths and realities of race . 12
- Racial groups and ethnic groups . 19
- Summary . 21
- 2. Racism . 24
- General effects . 28
- Mental health and mental disorder . 32
- Psychology and psychiatry . 40
- 3. Western Psychiatry . 51
- History . 53
- Diagnosis . 59
- Medical belief systems . 63
- Holism, mind and body . 66
- Conclusions . 73
- 4. Mental Health and Mental Disorder . 75
- Health, illness and madness . 76
- Worldviews : psychology, religion and health . 82
- Distress : idioms of expression . 99
- Coping with stress . 103
- Summary . 106
Part II Practice and Innovation . 111
- 5. Applied Psychiatry . 113
- Racial bias . 114
- The global scene : psychiatric imperialism . 128
- Colour-blind, culture-blind psychiatry . 137
- Conclusions . 143
- 6. Different Forms of Psychiatry . 146
- Asian psychiatry . 152
- African psychiatry . 159
- Western psychiatry (from the outside) . 162
- Cross-cultural collaboration . 165
- Conclusions . 168
- 7. Technologies for Mental Health . 170
- Western psychiatric techniques . 175
- Herbal remedies . 180
- Acupuncture . 181
- Yoga . 183
- Japanese psychotherapies . 184
- Healing and liberation techniques . 185
- Conclusions . 194
- 8. Mental Health for All . 196
- Redefining mental illness . 199
- Redefining mental health . 201
- Mental health promotion . 208
- Conclusions . 212
Bibliography . 214
Index . 236