Managing complex psychiatric presentations in low income countries

Where there is no psychiatrist, 2nd edition
Patel V, Hanlon C
Royal College of Psychiatrists, 2017
(£9.80; 360 pp)
ISBN 9781909726833

The geographical maldistribution of psychiatric services across Australia is stark. On a global scale, this unequal provision is magnified with virtually no trained specialist mental health workforce in many low income countries. That role falls to the capable, competent generalist health care worker prepared to manage physical health conditions. Where there are no psychiatrists provides valuable insight and guidance to the generalist working in the harsh context and complexity of mental health presentations in low resourced settings. Patel and Hanlon, who are both psychiatrists working in low income countries, address the absence of expert psychiatric care in countries where mental health services are minimal or non‐existent. Using simple illustrations and well organised flow charts, they provide step by step guidance to approaching more than 30 clinical mental health problems, across the lifespan and in differing clinical populations, in complex social settings rarely considered in the traditional education and training of western health workers. Neither an academic nor a scholarly text, this book is more a general health worker field guide or survival manual when confronted with varying complex psychiatric presentations in resource‐poor countries. From the most reticent psychiatrist to the general health practitioner with a wealth of experience but limited formal mental health training, this text is likely to provide satisfying psychiatric explanations and solutions to the most pragmatic readers. Conveniently available as an online version and with global relevance, the value and utility of Where there are no psychiatrists is likely to be without parallel in the furthest parts of the world. It will therefore be a valued resource for the few who venture far. Nonetheless, the benefits of this book can be great — perhaps for those who need it the most and have the least.