Mental Health in Global Perspective

Abstract

In the foregoing chapters, a variety of mental and psychosomatic disorders have been compared across nations or cultures, and an attempt has been made to show how, for each disorder, this type of comparison could lead us to a better understanding than studies undertaken only within single societies. Insofar as most of these disorders are thought to have distinct etiologies, and insofar as even those with supposedly related etiologies, such as depression and suicide, prove to vary relatively independently at the international level, there would seem to be little point in attempting to generalize about them, except perhaps with respect to research methodology. However, one of the hopes implicit in the pursuit of Comparative Psychiatry is that it might contribute to preventive action, and when one looks at preventive psychiatry one finds that it has addressed itself less to reducing specific disorders than to promoting general mental health. In the previous chapters I have for the most part avoided referring to mental health, since the term carries two quite different meanings, both rather vague. Nevertheless, there are two good reasons why a book on Comparative Psychiatry should include some reference to possible differences in society-wide mental health or ill-health. One of these reasons is that there are certain nations or cultures that appear to suffer more, or to suffer less, from a wide spectrum of psychopathological disturbances than might be expected from the chance association of factors affecting different diseases. The other reason is the increasing demand at both a national and an international level for what are called “quality of life” measures, i.e., ways of assessing societal effectiveness which tap more refined aspects than merely the economic; and much of what comes under that heading overlaps what is usually meant by mental health, as was recognized by the (U.S.) National Commission on Mental Illness and Health when it sponsored the first large-scale survey of “quality of life” [237].