Volume 3, Number 1 - February 2004 - World Psychiatric Association

More documents

Recommendations

Info

The World Psychiatric Association (WPA)World PsychiatryThe WPA is an association of psychiatric societies aimed toincrease knowledge and skills necessary for work in the fieldof mental health and the care for the mentally ill. Its membersocieties are presently 123, spanning 106 different countriesand representing more than 150,000 psychiatrists. The WPAorganizes the World Congress of Psychiatry every three years.It also organizes international and regional congresses andmeetings, and thematic conferences. It has 55 scientific sections,aimed to disseminate information and promote collaborativework in specific domains of psychiatry. It has producedrecently several educational programmes and series ofbooks. It has developed ethical guidelines for psychiatricpractice, including the Madrid Declaration (1996). Furtherinformation on the WPA can be found in the websitewww.wpanet.org.WPA Executive CommitteePresident – A. Okasha (Egypt)President-Elect – J.E. Mezzich (USA)Secretary General – J. Cox (UK)Secretary for Finances – S. Tyano (Israel)Secretary for Meetings – P. Ruiz (USA)Secretary for Education – R. Montenegro (Argentina)Secretary for Publications – M. Maj (Italy)Secretary for Sections – G. Christodoulou (Greece)WPA SecretariatDepartment of Psychiatry and Behavioral Sciences, MetropolitanHospital Center, New York Medical College, 1901 FirstAvenue, Suite 4M-3, New York, NY 10029-7404, USA.Phone: +12124237001; E-mail: wpasecretariat@wpanet.org.World Psychiatry is the official journal of the WorldPsychiatric Association. It is published in three issues peryear and is sent free of charge to psychiatrists whose namesand addresses are provided by WPA member societies andsections. State-of-the-art, research and mental health policypapers are welcome for publication in the journal. The relevantproposals should be sent to the office of the Editor.Editor – M. Maj (Italy).Editorial Board – A. Okasha (Egypt), J.E. Mezzich (USA), J.Cox (UK), S. Tyano (Israel), P. Ruiz (USA), R. Montenegro(Argentina), G. Christodoulou (Greece).Advisory Board – H.S. Akiskal (USA), R.D. Alarcón (USA),H. Freeman (UK), M. Kastrup (Denmark), H. Katschnig(Austria), J.J. López-Ibor (Spain), D. Moussaoui (Morocco),P. Munk-Jorgensen (Denmark), F. Njenga (Kenya), J. Parnas(Denmark), V. Patel (India), N. Sartorius (Switzerland), R.Srinivasa Murthy (India), J. Talbott (USA), M. Tansella(Italy), J. Zohar (Israel).Managing Editor – P. Pegoraro (Italy).Published by Masson Italy, a MediMedia Company, ViaMuzio Attendolo detto Sforza 7/9, 20141 Milan.Office of the Editor – Department of Psychiatry, University ofNaples SUN, Largo Madonna delle Grazie, 80138 Naples,Italy. Phone: +390815666502; Fax: +390815666523; E-mail:majmario@tin.it.
EDITORIALMental patients in prisons:punishment versus treatment?AHMED OKASHAPresident, World Psychiatric AssociationOne issue that has attracted the attention ofour profession for decades is the struggle againstpolitical abuse of psychiatry, i.e. preservingpolitical opponents or people otherwise breakingthe law from being kept in mental hospitalsunder the pretext of mental illness. Investigationsand efforts to monitor and prevent suchviolation included visits to mental hospitals andattempts to ensure that no person is being keptthere for reasons other than his or her sufferingfrom a mental disorder. The scope of such initiativeshas been widely covered in the literature.The Hawaii and Madrid Declarations,which set guidelines and regulations to preventabuse of our profession, have been a valuableproduct of this concern.The other side of the coin, i.e. the incarcerationof mental patients or their neglect in prisons,should not receive lesser attention andconcern. Despite efforts over the last 30 years topromote diversion from jail for individuals withserious mental illness who have engaged incriminal behavior, few jail diversion programshave been adequately implemented. A soberingGuardian article on March 3, 2003 reports300,000 mentally ill people to be held in USprisons. The US Bureau of Justice reports thatan estimated 16% of the two million prisonersin the US are mentally ill, “often because thereis nowhere else for them to go. So serious is theproblem that one jail in Los Angeles hasbecome in effect the biggest mental institutionin the country”. The situation has been exacerbatedby the closure of many mental institutions:between 1982 and 2001, the numbers ofpublic hospital beds available for the mentallyill decreased by 69% in the US. According toOscar Morgan, a senior consultant at theNational Mental Health Association (NMHA)and a former mental commissioner for the stateof Maryland, this was a major issue for theprison service and “it is acknowledged now thatmany people in the prison system could, withproper treatment, be elsewhere”.The high numbers reported from the US areprobably because of the transparency of thesubject and its coverage in the media. The samephenomenon is to be expected in many othercountries: a recent report form India revealedequally high figures of mental patients in prisons.In several countries mental patients are inprisons because they did not have the chance tobe examined before being convicted of a crime.In many countries which adopted the deinstitutionalizationpolicy, the community care systemis not reliable and is lacking in both financialand trained human resources to be able to providethe necessary service for mental patients,which contributes to the increased number ofmental patients in prisons. It is also noteworthythat many Ministries of Finance did not channelthe budgets of closed mental hospitals intoother forms of mental health care services.One disorder that stands out in this respect issubstance abuse, which has been reported tohave a high association with violence. Illicitdrug abuse requires access to the black market;from there the road of substance abusers frequentlyleads into prison rather than into substanceabuse rehabilitation centers (1). Othersymptoms/disorders showing various degrees ofassociation with criminal behavior includedelusions, organic brain disorder, major affectivedisorder and antisocial personality disorder.Investigations of representative samples of USprison inmates (2-5) and Canadian penitentiaryinmates (6) have revealed higher prevalencerates of mental disorders, particularly of themajor mental disorders such as schizophreniaand major affective disorders, within these facilitiesthan in the general population. Most of themajor mental disorders were present before thecurrent period of incarceration (7).Offenders in prison experienced more socialmaladjustment than offenders in drug addictiontreatment, they were less preoccupied by theirdrug consumption and less motivated to change(8). If anything, this should call for a treatmentenvironment that responds more to rehabilitativeneeds than to punitive ones. Implications ofjail diversion services for mental health professionalsinclude learning how to collaborate with1
Page 1: PAWorld PsychiatryOFFICIAL JOURNAL
Page 5 and 6: SPECIAL ARTICLEMental health: scarc
Page 7 and 8: delegate long-term care. As a conse
Page 9 and 10: patient at the time of scanning: Fu
Page 11 and 12: Normals Schizophrenics Differences.
Page 13 and 14: 40. Rubin RT, Ananth J, Villanueva-
Page 15 and 16: These behaviors typically occur for
Page 17 and 18: for depression. In a chart-review s
Page 19 and 20: o-controlled trial of fluoxetine in
Page 21 and 22: Qualifying phrases from other categ
Page 23 and 24: a series of personality diagnoses,
Page 25 and 26: Mental Health Intervention Research
Page 27 and 28: current classification systems, esp
Page 29 and 30: DSM, are based more on ‘commonsen
Page 31 and 32: I was trained in the early 1970s,wh
Page 33 and 34: trusted? Are Africans in fact talki
Page 35 and 36: al Learning Test, were not signific
Page 37 and 38: Table 1 Antisaccade task and neurop
Page 39 and 40: with probable lesions involving the
Page 41 and 42: ity for schizophrenia using optimiz
Page 43 and 44: RESEARCH REPORTA cross-cultural stu
Page 45 and 46: Recent studies carried out in South
Page 47 and 48: RESEARCH REPORTDepression among old
Page 49 and 50: found around 10 % of case level dep
Page 51 and 52: cal study. Eur Arch Psychiatry Clin
Page 53 and 54:
additional information that they fe
Page 55 and 56:
It is difficult for me to talk abou
Page 57 and 58:
of mental health is to help [people
Page 59 and 60:
practice, the number of patients se
Page 61 and 62:
lines for the Treatment of Schizoph
Page 63 and 64:
In Balochistan and Sindh provinces,
Page 65 and 66:
WPA NEWSSeptember 2005: CairoPEDRO
Page 67:
AcknowledgementThis publication has
show all

Volume 3, Number 1 - February 2004 - World Psychiatric Association

Create successful ePaper yourself

Delete template?

Save as template?