Development in mental health services - a world view

The limited resources in developing countries, combined with the inappropri ate legacy of the colonial era, has meant that a large proportion of their population has been deprived of even basic mental health services. In this chapter we first review the major causes of mental disorder in the developi ng world, and then the social and environmental factors associated with the se disorders. The strategy initiated by the World Health Organization (WHO) of mental health services based in primary care has been the major theme i n the development of new services, with National Mental Health plans descri bing how the specialized mental health services should be best organized in each country. Having reviewed services in a variety of countries, we descr ibe the four phases of the development of community mental health services in Pakistan, as this is a country which the authors know best and has an ad vanced service. We finish by describing the problems which are likely to ar ise as progressively more people dr ift into the megacities of the future.