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Mental and
behavioural disorders are a major public health problem. They
are frequently found in all societies and cultures, are more
disabling than many chronic and severe physical diseases,
and do not easily get better or limit themselves without treatment.
Yet, although simple, effective and acceptable treatments
are available, they are not utilised sufficiently. There is
a need to improve the identification and management of mental
disorders at the primary-care level.
In all societies,
the prevalence of mental disorders in prisons is high, but
access to services to treat them is often very low. Prison
healthcare staff face a particularly difficult job in providing
good-quality care within this environment. In addition, especially
in countries where the conditions that their prisoner-patients
are held in are poor, prison healthcare staff face the practical
and ethical challenge of advocating for change.
The World
Health Organization (WHO) has developed a range of clinical
tools to assist primary-care practitioners (even without psychiatric
training) and community health workers (even without advanced
medical training) to deal appropriately with the mentally
ill people with whom they come into contact. The latest of
these tools is this book. It is a further development of the
primary-care version of the state-of-the-art classification
of mental disorders for use in clinical practice and research
(ICD-10 Chapter V, Primary Care Version). It is the first
guide to mental health for primary-care workers in prisons
throughout the world. Although developed initially in the
UK, a future development will adapt it to form a 'generic'
international version that can be adapted in turn to local
needs in different countries.
The WHO would
be pleased to see this primary-care prison version of the
mental disorders classification become part of all medical
and nursing curricula for prison practitioners, since it sets
out precisely what a general practitioner should know in diagnosing
and treating mental-health problems.
Dr Bedirhan Ustun
World Health Organization
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