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It is well known that mental health disorders cause substantial functional limitations and disability (Surgeon General, 1999). Less well known is the central role that mental health plays in economic disparities. The prevalence of depressive disorders is almost 3 times as high among individuals in the bottom 20% than among individuals in the top 20% of the income distribution, a much steeper gradient than for hypertension, heart disease, arthritis, chronic pain, or the number of medical problems (Sturm & Gresenz, 2002). In addition, individuals with mental disorders are less likely to have savings than individuals with physical health problems and the disparity widens with advancing age (Gresenz & Sturm, 2000).

Mental disorders lead to difficulties in social, occupational and marital relations. Failure to detect mental disorder denies patients potentially effective treatment. This study aimed to assess the prevalence and nature of mental disorders at the primary care settings and the recognition of these disorders by the attending physicians. Over a period of eight weeks, consecutive and consenting patients who attended three randomly selected primary health care facilities in Sagamu Local Government Area of Ogun state were recruited and administered a questionnaire that included a socio-demographic section and Patient Health Questionnaire (PHQ). A total of 412 subjects took part in the study. Subject age ranged from 18-90 years with a mean age of 52.50±21.08 years. One hundred and seventy-six (42.7%) of the subjects were males. A total of 120 (29.1%) of the subjects had depressive disorder, 100 (24.3%) had anxiety disorder, 196 (47.6%) somatoform disorder and 104 (25.2%) met the criteria for an alcohol related problem. The PHC physicians were only able to diagnose disorders relating to mental health in 52 (12.6%) of the subjects. Health and work situations accounted for more than three-quarters of the causes of stress experienced by the subjects. We conclude that there is a high prevalence of mental disorders among patients seen in primary care settings and that a significant proportion of them are not recognized by the primary care physicians. Stress relating to health, work and financial problems is common among primary health care attendees. Physicians in primary health care should be alert to the possibility and the impact of undetected psychiatric morbidity.

The purpose of this paper is to describe mental health-related contact with educational professionals amongst children in the British Child and Adolescent Mental Health Survey (BCAMHS) 2004.

BCAMHS 2004 was a community-based survey of 5,325 children aged 5-16, with follow-up in 2007. This paper reports the percentage of children with a psychiatric disorder that had mental health-related contact with education professionals (categorised as teachers or specialist education services) and the percentage with specific types of psychiatric disorders amongst those contacting services.

Two-thirds (66.1 per cent, 95 per cent CI: 62.4-69.8 per cent) of children with a psychiatric disorder had contact with a teacher regarding their mental health and 31.1 per cent (95 per cent CI: 27.5-34.7 per cent) had contact with special education either in 2004 or 2007, or both. Over half of children reporting special education contact (55.1 per cent, 95 per cent CI: 50.0-60.2 per cent) and almost a third reporting teacher contact in relation to mental health (32.1 per cent, 95 per cent CI: 29.7-34.6 per cent) met criteria for a psychiatric disorder.

Many children in contact with education professionals regarding mental health experienced clinical levels of difficulty. Training is needed to ensure that contact leads to prompt intervention and referral if necessary.

This is the first paper to report on mental health-related service contact with education professionals in the 2004 BCAMHS survey along with its 2007 follow-up. It identifies high levels of teacher contact which represent challenges in supporting staff with training, resources and access to mental health services.

Depressive disorder has been defined by increasingly specific neurophysiological mechanisms and features during the past two decades. At the same time, depression has grown into an epidemic proportion and become a major public health problem. Consequently, the scope of depressive experience and conduct has also widened and the meaning of depression has multiplied and become equivocal. This chapter analyses how this tension is handled in current Western mental health care. The focus of the study is the role of neuroscientific views in mental health reasoning and practice. The empirical case is the mental health discussion in Finland from the late 1980s to the present day. The analysis of the historical change in understandings of depression in Finnish psychiatry and mental health care provides a view of the relevance of neuroscientific models in defining depressive illness and outlining diagnostic and treatment practices. Moreover, the analysis brings forth the relationship of neuroscientific concepts to other ways of defining depression – epidemiology, diagnostic classification, psychodynamic and other psychological theories – within clinical reasoning. A conclusion to be drawn from the analysis of the Finnish case is that neurobiological concepts of depression have only limited influence on the ways in which the disorder is conceived within the practical context of mental health care. It seems that the idea of depression as a multi-factorial disorder remains a good enough conceptual framework for clinical practice. Even the influence of neurosciences on treatment is still somewhat marginal. Within current practices of depression management, it is not the brain that is treated but risks, symptoms, and persons.

Sex and gender are regarded as critical structural determinants of mental health and mental illness. Mental illness is a complex phenomenon, and risky behaviour and substance use commonly occur simultaneously or subsequent to one another. A gendered vulnerability in biological, environmental, and behavioural risk factors has been registered in the development and escalation of mental illness. Studies have found that women who use drugs experience greater physical and mental health repercussions than men. Women who use drugs present higher rates of depression and anxiety, suicidal tendencies, isolation and general psychological distress. This chapter addresses the most common mental illnesses associated with women who use drugs: depression, anxiety, trauma-related disorders, and eating disorders.

The general public and professionals from a range of backgrounds have increasingly become interested in autism spectrum disorders. This interest is particularly relevant to learning disability practitioners. Both autism and learning disabilities are independently associated with increased risk of mental health problems. Thus, when a person has learning disabilities and an autism spectrum disorder, a comprehensive assessment for mental health problems is of paramount importance. This paper provides an overview of the assessment of mental health problems in adults and children with neurodevelopmental disorders. The general assessment principles are outlined followed by assessment issues related to specific conditions such as psychoses, mood disorders and attention deficit hyperactivity disorder. Finally conclusions on the clinical implications are drawn.

This paper reports outcomes from a holistic, recovery‐based, user‐led group training for people with DSM‐IV bipolar disorder. Drawn from professional therapies and personal experience of the illness by the user‐researcher, the training was delivered over 12 weekly sessions. Using a case‐study approach, an experimental design incorporated pilot (eight participants), main study (five) and control groups (six). Self‐report scales measured mood, coping, empowerment and quality of life pre‐, post‐ and six months post‐training. Semi‐structured interviews noted individual change within the same time frame. Interviews with mental health professionals, medical note analysis and user‐researcher observations also informed the study. Findings from self‐report questionnaires indicated that participants experienced improved mood stability, symptom severity, coping and quality of life and greater empowerment. Out of the six controls, two indicated slight but slow recovery, four continued to use poor coping skills, and two of these four experienced major relapses.

This report highlights the current understanding of personality disorders with specific emphasis on service provision in the context of recent policies and guidelines issued by the Department of Health. It gives an overview of the wide range of perspectives of various stakeholders. It explores the key aspects of collaboration and the implications of a collaborative approach to delivering services for people with personality disorders. It also makes recommendations for implementation and identifies the organisations involved in the process of collaboration.

To examine the exercise experiences of women with obsessive-compulsive disorder (OCD) in order to highlight the complex relationship between mental illness and physical activity, as it intersects with other identities and social locations (e.g., gender and sexuality) as well as other mental health conditions (e.g., eating disorders and exercise addiction).

Semi-structured interviews were conducted with 14 women who self-identify as having OCD. A thematic analysis was conducted to understand the role of physical activity in the participants’ lives.

The participants experience holistic benefits from being physically active. At the same time, however, their symptoms of OCD and related disorders (e.g., eating disorders) make it challenging to be physically active in meaningful and healthy ways.

Public health messages promoting exercise as a form of therapy must take into account the complex relationship between physical activity and mental illness. Additional research and programing is also needed in order to help women with mental health issues be physically active in safe and enjoyable ways.

While awaiting resolution of their legal process, undocumented migrants (UM) face several challenges, including limited access to public health care. The purpose of this paper is to survey UM attending a detention centre in Oporto (Portugal) to estimate the prevalence of mental health disorders in this population.

A retrospective chart review was performed with the relevant sociodemographic and clinical data of all UM in the process of coercive removal from Portuguese territory, observed by Doctors of the World, during three years (2014–2016). The Tenth Version of International Classification of Mental and Behavioural Disorders was used for nosological classification.

In total, 393 detainees were eligible for the study. Most detainees were male (84 per cent) and 76 months was the mean length of stay in Portugal before detention. In total, 29 per cent of detainees were diagnosed with a mental and behavioural disorder. The most prevalent diagnosis was neurotic, stress-related and somatoform disorders (47 per cent). UM with dual diagnosis (28 per cent) led to the articulation with the integrated centres of drug addiction, which provided and monitored opioid substitution therapy. Female UM were more prone to develop any mental and behavioural disorder when compared to men (χ²=7,017; p<0.05).

In total, 9 per cent of the detainees were excluded from this study due to incomplete data on their medical charts. Some detainees presented oppositional behaviour, hostility towards others and refused to be assessed by the medical team. Both situations could have biased the prevalence of mental disorders. Finally, the appropriateness of the western model of mental health disorders (ICD-10) in the study population is controversial, considering the culture-bound phenomenology and syndromes.

This paper identified the most prevalent mental health disorders in UM detained in Portugal. The most prevalent mental health disorders were either stress-related (associated with the detention itself) or related to previous patterns of substance abuse. Given the study outcomes, it is highly recommended to mobilise human and technical resources to provide specialized mental health care to UM at least while detention policies could not be changed.