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