Всемирная психиатрия. №3 2016

Психическое здоровье в мире: настоящее состояние и перспективы развития

Graham Thornicroft, Tanya Deb, Claire Henderson

Centre for Global Mental Health, King’s College London, Institute of Psychiatry, Psychology & Neuroscience, London SE5 8AF, UK

Стр. 272-281

1481 просмотров

Опубликовано: 1 октября 2016

Аннотация / Abstract

Данная статья представляет обзор ключевых вопросов, стоящих перед специалистами, способными повлиять на планирование и обеспечение систем психического здравоохранения, а также перед теми, кто отвечает за организацию оказания услуг, получение инвестиций в данный сектор и несет ответственность за пациентов. В статье рассматриваются следующие вопросы: а) формулировка задач «организации психического здоровья» б) концептуальная основы, необходимые для клиник и организации психиатрической помощи в) возможности для более широкого использования ресурсов общества с целью улучшения психического здоровья, включающая в себя образовательные учреждения и рабочие места г) данные о качестве развития служб психиатрической помощи в различных регионах мира д) необходимость в развитии служб психиатрической помощи в странах с низким и средним уровнями дохода (в соответствии с особенностями каждого региона; е) как регистрировать качество оказания психиатрической помощи в рамках интегрированных моделей для выявления и лечения людей с коморбидными длительными состояниями; ж) возможные неблагоприятные последствия деинституциализации. Затем мы представляем серию из десяти рекомендаций для будущего усовершенствования систем здравоохранения в области поддержки и лечения людей, страдающих психическими заболеваниями. Ключевые слова: общество охраны психического здоровья, психиатрическая служба, страны с низким и средним уровнями дохода, вмешательства на основе доказанных данных, школы, рабочие места, модель хронических заболеваний, деинституализация. (World Psychiatry 2016; 15: 276–286) Большинство людей, имеющие психические расстройства не получают никакого лечения1,2. Такой «разрыв в лечении» всё больше осознаётся в мире3-6. Всемирная организация здравоохранения опубликовала в 2010 г. первое издание Программы действий по отставанию в психическом здоровье7-9, которое содержит руководства по выявлению и лечению девяти категорий психических и неврологическ...

Материал для специалистов

Полный текст статьи доступен только зарегистрированным пользователям.

Вход / Регистрация

1. Wang PS, Aguilar-Gaxiola S, Alonso J et al. Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO World Mental Health Surveys. Lancet 2007;370:841-50.
2. Thornicroft G. Most people with mental illness are not treated. Lancet 2007;370:807-8.
3. Demyttenaere K, Bruffaerts R, Posada-Villa J et al. Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA 2004;291:2581-90.
4. Saxena S, Thornicroft G, Knapp M et al. Resources for mental health: scarcity, inequity, and inefficiency. Lancet 2007;370:878-89.
5. Collins PY, Patel V, Joestl SS et al. Grand challenges in global mental health. Nature 2011;475:27-30.
6. Collins PY, Saxena S. Action on mental health needs global cooperation. Nature 2016;532:25-7.
7. World Health Organization. mhGAP intervention guide for mental, neurological and substance use disorders in non-specialized health settings. Geneva: World Health Organization, 2010.
8. Dua T, Barbui C, Clark N et al. Evidence-based guidelines for mental, neurological, and substance use disorders in low- and middle-income countries: summary of WHO recommendations. PLoS Med 2011;8: e1001122.
9. Barbui C, Dua T, Van Ommeren M et al. Challenges in developing evidence-based recommendations using the GRADE approach: the case of mental, neurological, and substance use disorders. PLoS Med 2010;7: e1000322.
10. Thornicroft G, Tansella M. Better mental health care. Cambridge: Cambridge University Press, 2009.
11. Thornicroft G, Alem A, Antunes Dos Santos R et al. WPA guidance on
steps, obstacles and mistakes to avoid in the implementation of communitymental health care. World Psychiatry 2010;9:67-77.
12. Slade M. Personal recovery and mental illness. A guide for mental health professionals. Cambridge: Cambridge University Press, 2009.
13. Warner R. Recovery from schizophrenia: psychiatry and political economy. Hove: Brunner-Routledge, 2004.
14. Drake RE, Bajraktari I, Tansella M. Technology and behavioural health: an implementation challenge. Epidemiol Psychiatr Sci 2014;23:313-5.
15. Slade M, Amering M, Farkas M et al. Uses and abuses of recovery: implementing recovery-oriented practices in mental health systems. World Psychiatry 2014;13:12-20.
16. Thornicroft G, Szmukler G, Mueser K et al. Oxford textbook of community mental health. Oxford: Oxford University Press, 2011.
17. Thornicroft G, Tansella M. Components of a modern mental health service: a pragmatic balance of community and hospital care – Overview of systematic evidence. Br J Psychiatry 2004;185:283-90.
18. Thornicroft G, Tansella M. The balanced care model for global mental health. Psychol Med 2013;43:849-63.
19. Thornicroft G, Tansella M. The balanced care model: the case for both hospital- and community-based mental healthcare. Br J Psychiatry 2013; 202:246-8.
20. Thornicroft G, Tansella M, Law A. Steps, challenges and lessons in developing community mental health care. World Psychiatry 2008;7:87-92.
21. World Health Organization. World mental health atlas 2014. Geneva: World Health Organization, 2014.
22. Miller G. Mental health in developing countries. The unseen: mental illness’s global toll. Science 2006;311:458-61.
23. World Bank. World Bank list of economies. Washington: World Bank, 2014.
24. Desjarlais R, Eisenberg L, Good B et al. World mental health. Problems and priorities in low income countries. Oxford: Oxford University Press,1995.
25. Eaton J. Ensuring access to psychotropic medication in sub-Saharan Africa. Afr J Psychiatry 2008;11:179-81.
26. Beaglehole R, Bonita R. Global public health: a scorecard. Lancet 2008; 372:1988-96.
27. Saxena S, Maulik P. Mental health services in low and middle income countries: an overview. Curr Opin Psychiatry 2003;16:437-42.
28. Alem A. Community-based vs. hospital-based mental health care: the case of Africa. World Psychiatry 2002;1:99-100.
29. Becker T, Koesters M. Psychiatric outpatient clinics. In: Thornicroft G, Szmukler GI, Mueser KT et al (eds). Oxford textbook of community mental health. Oxford: Oxford University Press, 2011:179-91.
30. Rodriguez JJ. Mental health care systems in Latin America and the Caribbean. Int Rev Psychiatry 2010;4:317-24.
31. Thornicroft G, Becker T, Holloway F et al. Community mental health teams: evidence or belief? Br J Psychiatry 1999;175:508-13.
32. Tyrer S, Coid J, Simmonds S et al. Community mental health teams (CMHTs) for people with severe mental illnesses and disordered personality. Cochrane Database Syst Rev 2000;2:CD000270.
33. Dieterich M, Irving CB, Park B et al. Intensive case management for severe mental illness. Cochrane Database Syst Rev 2010;10:CD007906.
34. Holloway F, Sederer L. Inpatient treatment. In: Thornicroft G, Szmukler GI, Mueser KT et al (eds). Oxford textbook of community mental health. Oxford: Oxford University Press, 2011:223-31.
35. Johnstone P, Zolese G. Systematic review of the effectiveness of planned short hospital stays for mental health care. BMJ 1999;318:1387-90.
36. Lasalvia A, Tansella M. Acute in-patient care in modern, communitybased mental health services. Where and how? Epidemiol Psichiatr Soc 2010;19:275-81.
37. Lelliott P, Bleksley S. Improving the quality of acute inpatient care. Epidemiol Psichiatr Soc 2010;19:287-90.
38. Lloyd-Evans B, Slade M, Jagielska D et al. Residential alternatives to acute psychiatric hospital admission: systematic review. Br J Psychiatry 2009; 195:109-17.
39. Crowther RE, Marshall M, Bond GR et al. Helping people with severe mental illness to obtain work: systematic review. BMJ 2001;322:204-8.
40. Patel V, Chisholm D, Parikh R et al. Addressing the burden of mental, neurological, and substance use disorders: key messages from Disease Control Priorities, 3rd edition. Lancet 2016;387:1672-85. 284 World Psychiatry 15:3 - October 2016
41. Wahlbeck K. Public mental health: the time is ripe for translation of evidence into practice. World Psychiatry 2015;14:36-42.
42. Petersen I, Evans-Lacko S, Semrau M et al. Promotion, prevention and protection: interventions at the population- and community-levels for mental, neurological and substance use disorders in low- and middleincome countries. Int J Ment Health Syst 2016;10:30.
43. Rehm J, Chisholm D, Room R et al. Alcohol. In: Jamison D, Breman J, Measham A et al (eds). Disease control priorities in developing countries, 2nd ed. New York: Oxford University Press, 2006:887-906.
44. Rehm J, Mathers C, Popova S et al. Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders. Lancet 2009;373:2223-33.
45. World Health Organization. Preventing suicide: a global imperative.Geneva: World Health Organization, 2014.
46. Petersen I, Lund C, Stein DJ. Optimizing mental health services in lowincome andmiddle-income countries. Curr Opin Psychiatry 2011;24:318-23.
47. Lund C, De Silva M, Plagerson S et al. Poverty and mental disorders: breaking the cycle in low-income and middle-income countries. Lancet 2011;378:1502-14.
48. Thornicroft G, Mehta N, Clement S et al. Evidence for effective interventions to reduce mental-health-related stigma and discrimination. Lancet 2016;387:1123-32.
49. Clement S, Lassman F, Barley E et al. Mass media interventions for reducing mental health-related stigma. Cochrane Database Syst Rev 2013;7: CD009453.
50. Knapp M, McDaid D, Parsonage M. Mental health promotion and prevention:the economic case. London: Personal Social Services Research Unit, London School of Economics and Political Science, 2011.
51. Evans-Lacko S, Henderson C, Thornicroft G et al. Economic evaluation of the anti-stigma social marketing campaign in England 2009-2011. Br J Psychiatry 2013;202(Suppl. 55):s95-101.
52. Probst TM, Gold D, Caborn J. A preliminary evaluation of SOLVE: addressing psychosocial problems at work. J Occup Health Psychol 2008;13:32-42.
53. Durlak JA, Weissberg RP, Dymnicki AB et al. The impact of enhancing students’ social and emotional learning: a meta-analysis of school-based universal interventions. Child Dev 2011;82:405-32.
54. Rahman A, Mubbashar MH, Gater R et al. Randomised trial of impact of school mental-health programme in rural Rawalpindi, Pakistan. Lancet 1998;352:1022-5.
55. Kelly CM, Mithen JM, Fischer JA et al. Youth mental health first aid: adescription of the program and an initial evaluation. Int J Ment Health Syst 2011;5:4.
56. Barry MM, Clarke AM, Jenkins R et al. A systematic review of the effectiveness of mental health promotion interventions for young people in low and middle income countries. BMC Public Health 2013;13:835.
57. Kagitcibasi C, Sunar D, Bekman S et al. Continuing effects of early enrichment in adult life: the Turkish Early Enrichment Project 22 years later. J Appl Dev Psychol 2009;30:764-79.
58. Rahman A, Iqbal Z, Roberts C et al. Cluster randomized trial of a parentbased intervention to support early development of children in a lowincome country. Child Care Health Dev 2009;35:56-62.
59. Ssewamala FM, Han CK, Neilands TB. Asset ownership and health and mental health functioning among AIDS-orphaned adolescents: findings from a randomized clinical trial in rural Uganda. Soc Sci Med 2009;69:191-8.
60. Chibanda D, Mesu P, Kajawu L et al. Problem-solving therapy for depression and common mental disorders in Zimbabwe: piloting a task-shifting primary mental health care intervention in a population with a high prevalence of people living with HIV. BMC Public Health 2011;11:828.
61. Thornicroft G, Semrau M, Alem A et al. Global mental health: putting community care into practice. London: Wiley-Blackwell, 2011.
62. Thornicroft G, Alem A, Drake RE et al. Community mental health: putting policy into practice globally. London: Wiley-Blackwell, 2011.
63. Hanlon C, Wondimagegn D, Alem A. Lessons learned in developing community mental health care in Africa. World Psychiatry 2010;9:185-9.
64. Semrau M, Barley EA, Law A et al. Lessons learned in developing community mental health care in Europe. World Psychiatry 2011;10:217-25.
65. Drake RE, Latimer E. Lessons learned in developing community mental health care in North America. World Psychiatry 2012;11:47-51.
66. McGeorge P. Lessons learned in developing community mental health care in Australasia and the South Pacific.World Psychiatry 2012;11:129-32.
67. Thara R, Padvamati R. Community mental health care in South Asia. World Psychiatry 2013;12:176-7.
68. Ito H, Setoya Y, Suzuki Y. Lessons learned in developing communitymental health care in East and Southeast Asia.World Psychiatry 2012;11:186-90.
69. McPake B, Mensah K. Task shifting in health care in resource-poor countries. Lancet 2008;372:870-1.
70. Shumbusho F, van GJ, Lowrance D et al. Task shifting for scale-up of HIV care: evaluation of nurse-centered antiretroviral treatment at rural health centers in Rwanda. PLoS Med 2009;6:e1000163.
71. Kengne AP, Fezeu L, Awah PK et al. Task shifting in the management of epilepsy in resource-poor settings. Epilepsia 2010;51:931-2.
72. Chu K, Rosseel P, Gielis P et al. Surgical task shifting in Sub-Saharan Africa. PLoS Med 2009;6:e1000078.
73. Labhardt ND, Balo JR, Ndam Met al. Task shifting to non-physician clinicians for integrated management of hypertension and diabetes in rural Cameroon: a programme assessment at two years. BMC Health Serv Res 2010;10:339.
74. Patel V, Weiss HA, Chowdhary N et al. Effectiveness of an intervention led by lay health counsellors for depressive and anxiety disorders in primary care in Goa, India (MANAS): a cluster randomised controlled trial. Lancet 2010;376:2086-95.
75. Patel VH, Kirkwood BR, Pednekar S et al. Improving the outcomes of primary care attenders with common mental disorders in developing countries: a cluster randomized controlled trial of a collaborative stepped care intervention in Goa, India. Trials 2008;9:4.
76. Chatterjee S, Chowdhary N, Pednekar S et al. Integrating evidence-based treatments for common mental disorders in routine primary care: feasibility and acceptability of the MANAS intervention in Goa, India. World Psychiatry 2008;7:39-46.
77. Chatterjee S, Leese M, Koschorke M et al. Collaborative community based care for people and their families living with schizophrenia in India: protocol for a randomised controlled trial. Trials 2011;12:12.
78. Chatterjee S, Naik S, John S et al. Effectiveness of a community-based intervention for people with schizophrenia and their caregivers in India (COPSI): a randomised controlled trial. Lancet 2014;383:1385-94.
79. Rahman A, Fisher J, Bower P et al. Interventions for common perinatal mental disorders in women in low- and middle-income countries: a systematic review and meta-analysis. Bull World Health Organ 2013;91:593-601.
80. Kohrt BA, Jordans MJ, Rai S et al. Therapist competence in global mental health: development of the ENhancing Assessment of Common Therapeutic factors (ENACT) rating scale. Behav Res Ther 2015;69:11-21.
81. Sodhi S, Banda H, Kathyola D et al. Supporting middle-cadre health care workers in Malawi: lessons learned during implementation of the PALM PLUS package. BMC Health Serv Res 2014;14(Suppl. 1):S8
82. Kakuma R, Minas H, van Ginneken N et al. Human resources for mental health care: current situation and strategies for action. Lancet 2011;378:1654-63.
83. Ssebunnya J, Kigozi F, Kizza D et al. Integration of mental health into primary health care in a rural district in Uganda. Afr J Psychiatry 2010;13:128-31.
84. Balaji M, Chatterjee S, Koschorke M et al. The development of a lay health worker delivered collaborative community based intervention for people with schizophrenia in India. BMC Health Serv Res 2012;12:42.
85. Kigozi F, Ssebunnya J. The multiplier role of psychiatrists in low income settings. Epidemiol Psychiatr Sci 2014;23:123-7.
86. Prince M, Patel V, Saxena S et al. No health without mental health. Lancet 2007;370:859-77.
87. Von Korff M, Goldberg D. Improving outcomes in depression. The whole process of care needs to be enhanced. BMJ 2001;323:948-9.
88. Oni T, McGrath N, BeLue R et al. Chronic diseases and multi-morbidity – a conceptual modification to the WHO ICCC model for countries in health transition. BMC Public Health 2014;14:575.
89. Joska JA, Obayemi A Jr, Cararra H et al. Severe mental illness and retention in anti-retroviral care: a retrospective study. AIDS Behav 2014;18:1492-500.
90. Gaynes BN, Pence BW, Atashili J et al. Changes in HIV outcomes following depression care in a resource-limited setting: results from a pilot study in Bamenda, Cameroon. PLoS One 2015;10:e0140001.
91. World Health Organization . Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva: World Health Organization, 2008.
92. Wagner EH, Austin BT, Von Korff M. Organizing care for patients with chronic illness. Milbank Q 1996;74:511-44.
93. Wagner EH, Austin BT, Davis C et al. Improving chronic illness care: translating evidence into action. Health Aff 2001;20:64-78.
94. World Health Organization . Innovative Care for Chronic Conditions: building blocks for action. Geneva: World Health Organization, 2002.
95. Tsai AC, Morton SC, Mangione CM et al. A meta-analysis of interventions to improve care for chronic illnesses. Am J Manag Care 2005;11:478-88.
96. Coleman K, Austin BT, Brach C et al. Evidence on the Chronic Care Model in the new millennium. Health Aff 2009;28:75-85. [PMC free article]
97. Semrau M, Evans-Lacko S, Alem A et al. Strengthening mental health systems in low- and middle-income countries: the Emerald programme. BMC Med 2015;13:79.
98. Lund C, Tomlinson M, De Silva M et al. PRIME: a programme to reduce the treatment gap for mental disorders in five low- and middle-income countries. PLoS Med 2012;9:e1001359.
99. Von Korff M, Gruman J, Schaefer J et al. Collaborative management of chronic illness. Ann Intern Med 1997;127:1097-102.
100. World Health Organization and Calouste Gulbenkian Foundation . Integrating the response to mental disorders and other chronic diseases in health care systems. Geneva: World Health Organization, 2014.
101. Hipgrave DB, Alderman KB, Anderson I et al. Health sector priority setting at meso-level in lower and middle income countries: lessons learned, available options and suggested steps. Soc Sci Med 2014;102:190-200.
102. Ku GM, Kegels G. Adapting chronic care models for diabetes care delivery in low-and-middle-income countries: a review. World J Diabetes 2015;6:566-75.
103. Maher D, Harries AD, Zachariah R et al. A global framework for action to improve the primary care response to chronic non-communicable diseases: a solution to a neglected problem. BMC Public Health 2009;9:355.
104. Mahomed O, Asmail S, Freeman M. An integrated chronic disease management model: a diagonal approach to health system strengthening in South Africa. J Health Care Poor Underserved 2014;25:1723-9.
105. Mahomed OH, Asmall S. Development and implementation of an integrated chronic disease model in South Africa: lessons in the management of change through improving the quality of clinical practice. Int J Integr Care 2015;15:e038.
106. Nuno R, Coleman K, Bengoa R et al. Integrated care for chronic conditions: the contribution of the ICCC Framework. Health Policy 2012;105:55-64.
107. Wahlbeck K, Westman J, Nordentoft M et al. Outcomes of Nordic mental health systems: life expectancy of patients with mental disorders. Br J Psychiatry 2011;199:453-8.
108. Thornicroft G. Physical health disparities and mental illness: the scandal of premature mortality. Br J Psychiatry 2011;199:441-2.
109. Lawrence D, Hancock KJ, Kisely S. The gap in life expectancy from preventable physical illness in psychiatric patients in Western Australia: retrospective analysis of population based registers. BMJ 2013;346:f2539.
110. Liu NH, Daumit GL, Dua T et al. Excess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice, policy and research agendas. World Psychiatry (in press).
111. Thornicroft G, Bebbington P. Deinstitutionalisation – from hospital closure to service development. Br J Psychiatry 1989;155:739-53.
112. World Health Organization . World health report 2001. Mental health: new understanding, new hope. Geneva: World Health Organization, 2001.
113. Sisti DA, Segal AG, Emanuel EJ. Improving long-term psychiatric care: bring back the asylum. JAMA 2015;313:243-4.
114. Lamb RH, Bachrach LL. Some perspectives on deinstitutionalization. Psychiatr Serv 2001;52:1039-45.
115. Leff J, Thornicroft G, Coxhead N et al. The TAPS Project. 22: A five-year follow-up of long-stay psychiatric patients discharged to the community. Br J Psychiatry 1994;165(Suppl. 25):13-7.
116. Winkler P, Barrett B, McCrone P et al. Deinstitutionalised patients, homelessness and imprisonment: systematic review. Br J Psychiatry 2016;208:421-8.
117. Salisbury TT, Thornicroft G. Deinstitutionalisation does not increase imprisonment or homelessness. Br J Psychiatry 2016;208:412-3.
118. Knapp M, Beecham J, Anderson J et al. The TAPS project. 3: Predicting the community costs of closing psychiatric hospitals. Br J Psychiatry 1990;157:661-70.
119. Taylor TL, Killaspy H, Wright C et al. A systematic review of the international published literature relating to quality of institutional care for people with longer term mental health problems. BMC Psychiatry 2009;9:55.
120. Prins SJ. Does transinstitutionalization explain the overrepresentation of people with serious mental illnesses in the criminal justice system? Community Ment Health J 2011;47:716-22.
121. Fakhoury W, Priebe S. Deinstitutionalization and reinstitutionalization: major changes in the provision of mental healthcare. Psychiatry 2007;6:313-6.
122. Corrigan PW, Markowitz FE, Watson AC. Structural levels of mental illness stigma and discrimination. Schizophr Bull 2004;30:481-91.
123. Thornicroft G. Shunned: discrimination against people with mental illness. Oxford: Oxford University Press, 2006.
124. Kohn R, Saxena S, Levav I et al. Treatment gap in mental health care. Bull World Health Organ 2004;82:858-66.
125. Chesney E, Goodwin GM, Fazel S. Risks of all-cause and suicide mortality in mental disorders: a meta-review. World Psychiatry 2014;13:153-60.
126. Thornicroft G. Premature death among people with mental illness. BMJ 2013;346:f2969.
127. Fekadu A, Medhin G, Kebede D et al. Excess mortality in severe mental disorders: a 10-year population-based cohort study in rural Ethiopia. Br J Psychiatry 2015;206:289-96.
128. Mehta N, Clement S, Marcus E et al. Systematic review of evidence for effective interventions to reduce mental health related stigma and discrimination: medium and long-term effectiveness and interventions in low- and middle-income countries. Br J Psychiatry 2015;207:377-84.
129. Corrigan PW, Morris SB, Michaels PJ et al. Challenging the public stigma of mental illness: a meta-analysis of outcome studies. Psychiatr Serv 2012;63:963-73.
130. Griffiths KM, Carron-Arthur B, Parsons A et al. Effectiveness of programs for reducing the stigma associated with mental disorders. A meta-analysis of randomized controlled trials. World Psychiatry 2014;13:161-75.
131. Eaton J, McCay L, Semrau M et al. Scale up of services for mental health in low-income and middle-income countries. Lancet 2011;378:1592-603.
132. Gaebel W, Grossimlinghaus I, Heun R et al. European Psychiatric Association (EPA) guidance on quality assurance in mental healthcare. Eur Psychiatry 2015;30:360-87.
133. Drew N, Funk M, Tang S et al. Human rights violations of people with mental and psychosocial disabilities: an unresolved global crisis. Lancet 2011;378:1664-75.
134. Bauer MS, Williford WO, Dawson EE et al. Principles of effectiveness trials and their implementation in VA Cooperative Study #430: ‘Reducing the efficacy-effectiveness gap in bipolar disorder'. J Affect Disord 2001;67:61-78.
135. Thornicroft G, Lempp H, Tansella M. The place of implementation science in the translational medicine continuum. Psychol Med 2011;41:2015-21.
136. Thornicroft G. Evidence-based mental health care and implementation science in low- and middle-income countries. Epidemiol Psychiatr Sci 2012;21:241-4.
137. United Nations . Convention on the Rights of Persons with Disabilities. New York: United Nations, 2006.
138. Campbell-Hall V, Petersen I, Bhana A et al. Collaboration between traditional practitioners and primary health care staff in South Africa: developing a workable partnership for community mental health services. Transcult Psychiatry 2010;47:610-28.
139. Abbo C, Ekblad S, Waako P et al. The prevalence and severity of mental illnesses handled by traditional healers in two districts in Uganda. Afr Health Sci 2009;9(Suppl. 1):S16-22.
140. Ngoma MC, Prince M, Mann A. Common mental disorders among those attending primary health clinics and traditional healers in urban Tanzania. Br J Psychiatry 2003;183:349-55.
141. Shankar BR, Saravanan B, Jacob KS. Explanatory models of common mental disorders among traditional healers and their patients in rural south India. Int J Soc Psychiatry 2006;52:221-33.
142. Starcevic V. Overcoming therapeutic pessimism in hypochondriasis. Am J Psychother 2002;56:167-77.
143. Slade M. 100 ways to support recovery. London: Rethink, 2009.
144. United Nations . The 2030 Agenda for Global Action and the Sustainable Development Goals. New York: United Nations, 2015.
145. Thornicroft G, Patel V. Including mental health among the new sustainable development goals. BMJ 2014;349:g5189.
146. Gureje O, Thornicroft G. Health equity and mental health in post-2015 sustainable development goals. Lancet Psychiatry 2015;2:12-4.
147. Votruba N, Eaton J, Prince M et al. The importance of global mental health for the Sustainable Development Goals. J Ment Health 2014;23:283-6.
148. Minas H, Tsutsumi A, Izutsu T et al. Comprehensive SDG goal and targets for non-communicable diseases and mental health. Int J Ment Health Syst 2015;9:12.

ЖУРНАЛЫ

ИНТЕРАКТИВ

СПЕЦИАЛИЗАЦИИ

ИЗДАНИЯ-ПАРТНЕРЫ

Психическое здоровье в мире: настоящее состояние и перспективы развития

Материал для специалистов

ЖУРНАЛЫ

ИНТЕРАКТИВ

СПЕЦИАЛИЗАЦИИ

ИЗДАНИЯ-ПАРТНЕРЫ

Психическое здоровье в мире: настоящее состояние и перспективы развития

Материал для специалистов

Con-Med Passport