187558 Community Based Primary Care for Mental Illness in Developing Countries

Tuesday, October 28, 2008: 12:30 PM

Martin Gittelman , Psychiat, NYU Med School, Ny, NY
In developing countries persons with severe mental illness who do not receive treatment are at risk of premature death. Even in countries with extensive networks of primary care stations such as Indonesia (Puskesmas), existing resources are too few to do more than diagnose and occasionally provide medication. Personnel are scarce, stigma is high and often persons with mental illness become separated from families and suffer premature death. This presentation will describe a simple paradigm initiated under the auspices of the WHO, which has now been utilized and evaluated in the past decade. It involves the use of supervised primary health care workers who provide education, vocational training, and titrated medication to identified patients living at home. The comparative results for the utilization of typical and atypical antipsychotic medication on relapse and need for hospitalization as well as side effects and morbidity and mortality will be presented.

Learning Objectives:
Describe the current situation of persons with mental illness in developing countries. Discuss the impact of psychiatric hospital closings, and recruitment of health and mental health personnel in developing countries for employment in developed countries and the impact on morbidity and mortality of the mentally ill in developing countries. Describe the evaluation of a model program designed to ameliorate the problem of scarce public mental health personnel in developing countries.

Keywords: International Health, Primary Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I served as Co Adviser(with Pierre Bailly Salin) to the MOPH China for the World Health Organization (Western Pacific Office in designing and initiating this program
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.