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ss triple helix - autumn 2003,  Where there is no Psychiatrist: A Mental Health Care Manual (Book Review)

Where there is no Psychiatrist: A Mental Health Care Manual (Book Review)

Where there is no Psychiatrist: A Mental Health Care Manual - Vikram Patel - Gaskell 2003 - £10 Pb 266 pp - ISBN 1 90124 275 7

The concept for the manual appears to have arisen from David Werner's book 'Where there is No Doctor', which was published initially in 1977. This book was a great success, being used widely by health care workers especially in developing countries. 'Disabled Village Children' and 'Where there is no Dentist' followed this. With the publication of this manual, Vikram Patel has attempted to meet a similar need for mental health problems.

The format of this manual is very different from a traditional textbook of Psychiatry .The approach is more problem and context-orientated. For example, there is a chapter entitled 'Behaviours that cause concern' and another entitled 'Habits that cause problems'. There are multiple boxes, tables and illustrations. The use of boxes and tables certainly helps in focusing on important aspects and things to remember. However it would have been more useful if the material in the boxes were in larger print. The overall impression is of an overcrowded book. The artistic illustrations are not very useful except for giving variety from reading the text. It is difficult to have meaningful artistic illustrations in Psychiatry.

The author states in his preface that the manual has been written with the needs of the general health worker in mind. He suggests that this would include anyone from a community health worker to a general practitioner. It is very difficult to write a manual to meet the needs of such a varied readership. However, from my experience as the General Secretary of the Evangelical Medical Fellowship of India, I agree that this manual would be useful in developing countries and mission hospitals and mission stations. As a Psychiatrist currently practising in Australia, I feel that it has less to offer health workers in developed westernised nations.

Some Christians may have difficulty with parts of the manual, for example the section on sexual problems. Apart from this, the content is mostly noncontroversial and the author has done a good job in attempting to meet a great need in developing countries where mental health professionals are scarce.

Reviewed by
Kuruvilla George
Deputy Chief Psychiatrist of Victoria, Australia and formerly General Secretary, Evangelical Medical Fellowship of India
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