Books, Articles and Research
Developing the philosophy of recovery in South African mental health services
The growth in power and importance of the recovery movement around the world has had an increasing effect on how mental health care is viewed and implemented. This article explores positive outcomes associated with new understandings of recovery and the recovery movement and ways in which a recovery framework can be incorporated into mental health services in South Africa.
Sustainable development helps us to flourish
This article examines the connection between sustainable environmental practices and positive mental health, suggesting that efforts to improve conditions for our planet have the potential to also improve mental health throughout society. The author explores ways the natural environment is connected to psychological wellness, emphasizing ways it serves one's needs, not only for food and water, but also for one's spiritual and emotional wellness. In the Mental Health Foundation of New Zealand's recognition of these described connections, some common goals for their work with organizations are listed: integrating social, cultural, economic, and environmental goals; regenerating natural and social capital; affirming the value of local communities; valuing nature intrinsically; and promoting non-material sources of happiness.
Victorious Black Women brings hope, provides hope to women of color
This Peers Envisioning and Engaging in Recovery Services (P.E.E.R.S.) article describes the efforts of an Oakland, CA-based organization: Victorious Black Women. Victorious Black Women operates on the premise that the road to healing for black women is linked to the sharing of stories with one another. This article discusses Victorious Black Women's overall approach to healing and recovery for women of color and the personal experiences of their Co-Founder, Renee Harris, who describes how someone reaching out to her meant a huge step in her own recovery journey. In recognizing the influence of culture on self-expression and ways of coping with stress, this organization also works to educate the community about culturally competent mental health services to help women of color.
Native American tribal communities provide hope for overcoming historical trauma
This Peers Envisioning and Engaging in Recovery Services (P.E.E.R.S.) article discusses the historical trauma experienced by many Native American tribal communities and the hope for overcoming it. Suicide, infant mortality, and unemployment rates of Native American tribal communities are among the highest in the country. The historical trauma intervention model described in this article takes an approach to healing that includes four main components: confronting the trauma, understanding the trauma, releasing the pain, and transcending the trauma.
WHO European review of social determinants of health and the health divide
This article discusses the disparities in health that still exist between and within countries in the European region. Specifically, the article examines a review of inequities in health between and within countries across the WHO European region. The authors explore ongoing research that has contributed to an understanding of social causes of these inequities, and they go on to describe policies that will help in reducing the current health divide.
Mental-health advocate is also a symbol of recovery
Newly elected Board President of the National Alliance on Mental Illness, Keris Myrick, shares her story of recovery and continued efforts to educate others on recovery and discrimination issues as they relate to mental disorders. In this article she describes a negative experience of being locked in an emergency room psychiatric area while awaiting services, how many individuals of color receive mental health services that oftentimes involve a police car and handcuffs, and ways she has learned to cope with her symptoms while also striving to make a difference for others.
Adaptation guidelines for serving Latino children and families affected by trauma
The adaptation guidelines discussed in this publication highlight key factors that should be addressed when adapting mental health practices to be used in working with Latino/Hispanic individuals impacted by trauma. Focus groups composed of experts in various fields including child trauma research, clinical practice, and cultural diversity discussed a number of important areas to consider while supporting Latino/Hispanic children and families. Some of the key areas identified are cultural values, immigration, child welfare, communication and linguistic competence, and diversity among Latinos.
Pathways to integrated health care: Strategies for African American communities and organizations; Consensus statements and recommendations
In a roundtable discussion hosted by the U.S. Department of Health and Human Services Office of Minority Health, dozens of health professionals including psychologists, counselors, primary care doctors, and individuals from advocacy organizations discussed efforts to address health disparities that impact African Americans. These professionals explored the history of these health inequalities, some successful integrated care models, and recommendations for countering these disparities. This report summarizes the group's findings and goes on to emphasize the need for culturally designed prevention methods to holistically address the wellness and mental health of African Americans.
Integrated care for Asian American, Native Hawaiian and Pacific Islander communities: A blueprint for action; Consensus statements and recommendations
This report covers a meeting in August 2011 of 40 stakeholders committed to enhancing the lives of Asian American, Native Hawaiian, and Pacific Islander (AANHPI) communities. The stakeholders met to discuss how to create a national agenda to review benefits of integrated care for AANHPIs. The group included providers, consumers, policy makers, and healthcare administrators in primary health care, integrated care, mental health, substance use, and disabilities. The Blueprint for Action discusses the need for integrated care to have a holistic, public health approach that works across the life span, as well as the need to have research and data that include AANHPIs. The blueprint includes recommendations to inform both governmental and non-governmental partners of culturally and linguistically responsive approaches and models of care.
Darryl Strawberry opens up: Baseball legend discusses overcoming depression
In this article Darryl Strawberry shares some of his life experiences as a professional baseball player, what it was like growing up in a home with an abusive father, and how he dealt with his depression and substance use as an African-American man. Strawberry discusses the common misconceptions regarding mental and substance use disorders in the African-American community and makes the point that depression does not discriminate. Through his memoir Straw: Finding My Way, he hopes to inspire all people experiencing mental health challenges to get help.
A questionnaire survey on attitudes and understanding towards mental disorders
This study sought to gather information about attitudes and general understanding of mental disorders among people in Hong Kong, China. Questionnaires were used to collect data from over 1,000 participants who represented different age groups and socioeconomic statuses. Survey data showed increased knowledge and acceptance among survey participants who had regular contact with people with mental health conditions. The study concluded that people developing and implementing mental health awareness programs should incorporate strategies to increase social contact between individuals with mental disorders and those without these disorders in the general public.
America's plague of incarceration: A plague of prisons; the epidemiology of mass incarceration in America
This review of Ernest Drucker's book A Plague of Prisons: The Epidemiology of Mass Incarceration in America discusses the theme of Drucker's book, which is the significant individual and societal damage that has resulted from treating drug use as a criminal problem rather than as a public health crisis. The review also covers Drucker's recommendations for remedying this situation. Drucker discusses the need for prevention strategies including drug treatment, education, and job training; and concrete community supports to allow for reintegration upon release from prison. He also notes the need for drug law reforms and addressing of targeting of minorities and impoverished communities by law enforcement.
Let's get real: Real Skills for people working in mental health and addiction
Let's get real: Real Skills for people working in mental health and addiction is an implementation plan that works to ensure that mental health and addiction services are based on essential knowledge, skills, and attitudes that support recovery, are person-centered, and are culturally competent. Visitors to the Ministry of Health of New Zealand's Web site can download at no cost the full Let's get real implementation plan, which discusses the Let's get real framework, planned steps, and the roles of providers and organizations.
Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence.
This article examines research evidence that shows lesbians, gay men, and bisexuals (LGB) having higher rates of mental disorders than heterosexuals. In seeking to understand this disparity, the author has developed and presents a framework to examine the factors contributing to this increased prevalence. He suggests that minority stress, which includes prejudice and discrimination experienced or anticipated by LGBs as well as a number of other factors, makes for a hostile and stressful environment that leads to the development of mental disorders.
Gender differences in mental health
In an effort to identify effective approaches to treating and preventing mental disorders, this paper examines gender differences in various mental disorders including eating disorders, schizophrenia, and depression.
"Mental health is everybody's business": Roles for an intersectoral approach in South Africa
This study, which involved surveys, structured interviews, and focus groups, evaluates South Africa's progress in engaging multiple sectors of society in addressing the social determinants of mental health. This study also provides recommendations for this type of collaboration to help guide other countries in these types of efforts. Study findings included the need to develop programs and make legislative changes, the importance of raising awareness in various sectors to build engagement across these sectors, and the need for an overall structured approach to action to promote and support mental health.
Improving the physical health of people with serious mental illness: A systematic review of lifestyle interventions
This literature review explores the quality of research in the U.S. on the topic of unmet health needs of people with mental disorders and lifestyle interventions that could improve overall health and reduce premature morbidity. Through the review, researchers were also able to summarize intervention strategies, explore various health outcomes, and assess the role that race, ethnicity, and culture played in these interventions.
Homelessness, poverty and social exclusion in the United States and Europe
This paper examines high rates of homelessness across different nations in the context of various forms of social exclusion: income, wealth, housing, and incarceration. The author goes on to explain the impact that discrimination and societal choices have on homelessness across societies and identifies racial minorities and individuals with mental disorders as having the highest rates of homelessness everywhere.
Recovery model: A Christian appraisal
This article examines recovery from the perspective of a Christian worldview, in the context of Christian theology and psychology. The author discusses how others' negative attitudes and harmful beliefs regarding people with mental disorders can be a barrier to recovery, the concept of empowerment as being fundamental to Christian theology, and the role that key Christian concepts such as sin, grace, and redemption play in recovery from a Christian perspective. The article examines this issue including implications for individuals, communities, and providers.
Tenemos Voz National Latino Consumer Network
This network is comprised of Latinos with mental and substance use disorders who work to promote holistic approaches to health and wellness in recovery through equal access to treatment. The network engages in advocacy to influence policy, eliminate disparities, and improve treatment outcomes. It also provides educational and networking opportunities and support for consumer/survivors.
The Community Defined Evidence Project (CDEP)
This project is a collaborative effort between the National Latino Behavioral Health Association (NLBHA) and National Network to Eliminate Disparities in Behavioral Health (NNED) to advance understanding of effective community-based practices for Latinos. The project plans to develop an evidence base that uses key cultural and community indicators and to use this information to influence research, evaluation, policymakers, and funders to support efforts to implement and use community-based practices to reduce disparities and improve both access and quality of care for Latinos..
Issues of access to and inclusion in behavioral health services for lesbian, gay, bisexual, transgender, questioning and intersex consumers
In recognition of behavioral health disparities experienced by lesbian, gay, bisexual, transgender, questioning, and intersex (LGBTQI) individuals, this article discusses key goals of an LGBTQI initiative to reduce inequalities in behavioral health outcomes. These goals focus on prevention of mistreatment, culturally affirmative environments of care, and clinically competent behavioral health care for LGBTQI consumers. Recommendations for data collection and trainings are made and a vision is outlined for inclusion that is responsive to the needs of LGBTQI individuals.
Evidence-based practices and multicultural mental health
Current trends in the behavioral health field show a significant increase in the promotion of evidence-based practices (EBPs) and requirement that they be incorporated into health and behavioral health care services. This emphasis reflects efforts to increase quality and accountability in services provided. This article not only addresses the use of EBPs and what it means for health and behavioral health services but also how they relate to better care for multicultural populations. Some key factors discussed include the history of EBPs, cultural competence and adaptations of EBPs, and recommendations for policy.
Racial Disparity in Mental Health Services: Why Race Still Matters
This book explores ways in which various factors such as racial identity, substance abuse, and socioeconomic conditions relate to differences in health and behavioral health services provided to different racial groups. Throughout this book, a number of experts from different disciplines discuss how various populations, including adolescents, the elderly, and minorities in general, experience inequality in today's system. Some specific topics discussed include, culture and race in provider-client relationships, cultural competence and improving mental health in African American women, and race/ethnicity and adolescent substance abuse.
Beyond the storms: Reflections on personal recovery in Devon
This book is a collection of personal stories of recovery shared by individuals who have experienced behavioral health problems and emotional distress. As individuals share their journeys through recovery they describe the despair and difficulty they were confronted with, as well as the hope, endurance, triumph, and determination associated with the recovery process. This book also describes techniques and makes suggestions that readers can use to manage their own recovery such as, developing a WRAP plan, acknowledging small achievements, and taking personal responsibility.
Social capital and psychiatry: Review of the literature.
This article explores social capital as it relates to mental health. The writers provide a history and several definitions for social capital, discuss the available literature on social capital's relationship with mental health, and conclude with recommendations for further exploring this relationship. The writers also discuss how clinicians and mental health systems may benefit from an increased understanding of social capital.
Poverty and social exclusion in the WHO European Region: Health systems respond
This report from the World Health Organization includes studies from several countries, each examining the relationship between poverty and health, including mental health. The report includes information about how this relationship influences access to care and provides suggestions for addressing the needs of people experiencing poverty or social exclusion.
Within our reach: Ending the mental health crisis
This book, written by former first lady Rosalynn Carter with Susan Golant and Kathryn Cade, offers an assessment of the current state of mental health. The book focuses on both the progress Mrs. Carter has seen during her 35 years of advocacy and the serious issues that must still be addressed before the mental health system can adequately meet the needs of people with mental health problems.
Shunned: Discrimination against people with mental illness
Thornicroft's book explores how negative perceptions affect the lives of people with mental health problems.
More us than them: positive depictions of mental illness on Australian television news
This 2007 study reviewed television news coverage of mental health issues, including self-depictions from people with mental health problems and views expressed by mental health experts and politicians. Investigators conducted a broad-ranging content and frame analysis of mental health problems as depicted in the Australian television news media. The study supports the importance of involving people with histories of mental health problems in news coverage.
Determinants of minority mental health and wellness
This compilation of articles examines social, cultural, and economic factors that impact the mental wellness of people of color in America.
Addressing racism: Facilitating cultural competence in mental health and educational settings
This resource provides information on strategies to eliminate racism and enhance the cultural competence of mental health and education systems and programs.
Firewalkers: Madness, Beauty & Mystery
VOCAL Virginia used grant funding from SAMHSA's Campaign for Mental Health Recovery to produce a living anthology of stories of people who have experienced the turbulence of a mental health crisis. A guide to radically rethinking mental health, Firewalkers redefines mental illness as "a journey of emotional turbulence, crazy blessings, ecstatic visions, and mad gifts."
Towards social inclusion in mental health?
This article explores the uses of the terms "social exclusion" and "social inclusion" in a mental health context. Focusing on social inclusion as a remedy for the ills of social exclusion, this article discusses implications for contemporary mental health policy, practice, and research and concludes that a better theoretical understanding of causal mechanisms is needed to enable the development of more socially inclusive mental health services.
Compeer friends: A qualitative study of a volunteer friendship programme for people with serious mental illness
This study explored the benefits and drawbacks of an intentional friendship programme (Compeer, Inc), which develops new social relationships for people with serious mental illness by matching them in one-to-one relationships with community volunteers for weekly social activities.
Changing Attitudes of High School Students towards Peers with Mental Health Problems
This study evaluated the effects of a program in Serbia to reduce discrimination toward adolescents with mental health problems.
"Culture in psychiatric epidemiology: Using ethnography and multiple mediator models to assess the relationship of caste with depression and anxiety in Nepal
The study aimed to identify mediators underlying caste-based disparities in mental health in Nepal. Caste-based disparities in mental health in rural Nepal are statistically mediated by poverty, lack of social support, and stressful life events. Interventions should target these areas to alleviate the excess mental health burden born by Dalit/Nepali women and men.
Psychotic symptoms and general health in a socially disadvantaged migrant community in Bologna
This cross-sectional study aims to evaluate the prevalence of psychotic symptoms among Romanian immigrants living in very poor conditions at an abandoned hotel in Bologna and to highlight the possible correlation with general health status, distress and socio-demographic characteristics.
SESAMI study of employment support for people with severe mental health problems: 12-month outcomes
In the context of UK policy to promote employment for people with disability as a means to greater social inclusion, this study investigated how people with severe mental health problems fare in existing supported employment agencies. The aim of the study was to identify factors associated with successful placement in work and to test the impact of working on psychological well-being in this group.
Patient ethnicity and perceptions of families and friends regarding depression treatment
"Black Americans are less likely than white Americans to seek professional treatment for depression. Whether treatment recommendations are sought and implemented by patients will be influenced by the role families and friends play in diagnostic acceptance and treatment decisions. Researchers investigated the association of ethnicity with the perceived need for treatment of depression by family and friends of older primary care patients.
An unholy alliance: substance abuse and social exclusion among assertive outreach patients
The object of this study is to investigate the relationship between social exclusion and outcomes of people with mental illness and substance abuse problems receiving assertive outreach treatment in London.
Discrimination, historical loss and enculturation: Culturally specific risk and resiliency factors for alcohol abuse among American Indians
This report investigates the effects of discrimination, historical loss and enculturation on meeting diagnostic criteria for 12-month alcohol abuse among American Indians who share a common culture in the upper Midwest.
A cross-cultural study of employers' concerns about hiring people with psychotic disorder: implications for recovery
In this study, we tested this lay approach by comparing employers' concerns about hiring people with psychotic disorder for entry-level jobs in US and China.
Social distance towards people with mental illness in southwestern Nigeria
The aim of the present study was to assess the lay public's attitude (social distance) towards people with mental illness in southwestern Nigeria and examine the factors correlating with such an attitude.
Becoming culturally competent in ethnic psychopharmacology
This article will focus on the realm of ethnic psychopharmacology and propose a practice model for nurses to become culturally competent in the area of ethnic psychopharmacology.
The experience of Black consumers in the mental health system--identifying barriers to and facilitators of mental health treatment using the consumers' perspective.
The goal of the present study was to identify barriers to and facilitators of mental heath treatment among Blacks who have a documented need for mental health services.
The association between perceived discrimination and underutilization of needed medical and mental health care in a multi-ethnic community sample
This study examines the association between perceived discrimination and underutilization of needed medical and mental health care, in a representative, multi-ethnic community sample. Data were derived from a cross sectional survey of 10,098 White, U.S.-born Black, African-born Black, American Indian, Hispanic, and Southeast Asian adults in Hennepin County, Minnesota.The higher prevalence of discrimination among racial and ethnic minorities may contribute to their underutilization of health care services. Future research is needed to understand the impacts of different types of discrimination on different groups.
The prevalence of perceived discrimination among African American and Caribbean Black youth
This study examined ethnic, gender, and age differences in perceived discrimination and the association between perceived discrimination and psychological well-being in a nationally representative sample of Black adolescents.
Gender, race-ethnicity, and psychosocial barriers to mental healthcare: An examination of perceptions and attitudes among adults reporting unmet need
This study investigates correlates of psychosocial barriers to mental health care in a population of adults reporting unmet need for mental health care, focusing on gender and race-ethnicity.
Racial/ethnic discrimination and health: Findings from community studies
The authors review the available empirical evidence from population-based studies of the association between perceptions of racial/ethnic discrimination and health. This research indicates that discrimination is associated with multiple indicators of poorer physical and, especially, mental health status. However, the extant research does not adequately address whether and how exposure to discrimination leads to increased risk of disease.
Assessment of need for a school-based mental health programme in Nigeria: Perspectives of school administrators
In this study key informants from southwest Nigeria were interviewed to identify their perspectives on child mental illness and needs for a school mental health programme.
Needs and preferences for receiving mental health information in an African American focus group sample
The purpose of this study is to better understand the mental health/illness information and service delivery preferences among African American residents of Baltimore. Researchers conducted four focus groups (n = 42) among African American adults currently unconnected with the mental health system.
Health care providers' perspective of the gender influences on immigrant women's mental health care experience
The primary goal of this study was to explore how contextual factors intersect with race, gender, and class to influence the ways in which immigrant women seek help and to increase awareness and understanding of what would be helpful in meeting the mental health care needs of the immigrant women.
Overt and subtle racial discrimination and mental health: Preliminary findings for Korean immigrants
In this article the authors examined differential effects of overt and subtle forms of racial discrimination among Korean immigrants on 2 dimensions of mental health--positive affect and depressive symptoms, and explored the mediating roles of emotional arousal and cognitive appraisal.
Cultural differences in access to care
As high-profile reviews have appeared and international interest has grown, sophisticated studies of the U.S. population continue to document racial and ethnic disparities in initiation of mental health care and in continuity of care. Many explanations focus on cultural factors: trust and treatment receptiveness, culturally distinctive beliefs about mental illness and mental health, culturally sanctioned ways of expressing mental health-related suffering and coping styles, and client preferences for alternative interventions and treatment-seeking pathways, as well as unresponsive programs and providers.
Newspaper reporting on schizophrenia: A content analysis of five national newspapers at two time points
This study aimed to assess change in the quality of reporting of schizophrenia in UK national daily newspapers, comparing 1996 with 2005. There is little evidence that the quality of reporting of schizophrenia has changed over time. This suggests a need for the implementation of effective measures to bring newspaper reporting in line with current guidelines.
Social capital, anticipated ethnic discrimination and self-reported psychological health: A population-based study
This study investigates the association between anticipated ethnic discrimination and self-reported psychological health, taking generalized trust in other people into consideration. The 2004 Public Health Survey in Skåne, Sweden, is a cross-sectional postal questionnaire study including a total of 27,757 respondents aged 18-80 with a 59% response rate.
Perceived discrimination and the well-being of immigrant adolescents
This study draws on the social-discount and social-rejection hypotheses to examine the effect of perceived discrimination on immigrant youths? depressive moods, self-efficacy, and preferences for in-group socialization experiences. Data from a panel study of immigrant young adolescents (aged 12?18) who came to Israel from countries of the former Soviet Union during the preceding 6 years was used (n = 732).
Insight and psychosis: Comparing the perspectives of patient, entourage and clinician
In this study, the authors hypothesized that socio-cultural factors influence insight in patients with schizophrenia. The authors tested this hypothesis through comparison of insight in 18 triads, each composed of a patient, a family member and a clinician. The sample consisted of patients who were first diagnosed with psychosis in the last two years, and who were either immigrants from Africa or the Caribbean Islands, or Canadian born. Insight was assessed by analysis of narratives collected from patients, family members and clinicians for a research project on the negotiation of treatment.
The influence of culture on immigrant women's mental health care experiences from the perspectives of health care providers
In this article, the authors suggest that although cultural knowledge and practices influence immigrant women's coping choices and strategies, awareness of social and economic differences among diverse groups of immigrant women is necessary to improve the accessibility of mental health care for immigrant women.
Use of health care services for psychological distress by immigrants in an urban multicultural milieu
This article finds that research in the United States tends to attribute low rates of use of mental health services by immigrants to economic barriers. The author's purpose of the study was to examine this issue in the context of Canada's universal health care system.
Immigrant perceptions of discrimination in health care: The California Health Interview Survey 2003
In this article the authors examined whether foreign-born persons are more likely to report discrimination in healthcare than U.S.-born persons in the same race/ethnic group, whether the immigration effect varies by race/ethnicity, and whether the immigration effect is "explained" by sociodemographic factors.
Greek police officers' attitudes towards the mentally ill
This study examines the attitudes of the Greek police towards the mentally ill, and the problems that arise during the transfer of mentally ill people to psychiatric emergency departments.
Survey of attitudes of mental health professionals in Singapore towards at-risk mental states
An anonymous survey containing a clinical vignette and questions related to the diagnosis and management of ARMS was sent out to all registered psychiatrists and psychiatric trainees in Singapore.
Demystifying Mental Illness in Any Language
This article explores the challenges of bringing mental health care to some immigrant communities. , Challenges include not only language barriers, but also negative attitudes and misconceptions about mental health issues and seeking treatment for these issues specific to particular communities. This article looks at providing mental health care across cultures by building trust in communities and normalizing the experience of treatment.
The journey of Native American people with serious mental illness: Executive summary
This report describes the first national conference on Native American people with serious mental illness. Describes meeting of State, tribal, and Federal mental health officials; providers; families; and consumers to tackle mental health delivery issues for Native Americans and to overcome barriers for developing coordinated, efficient, and culturally relevant systems of care.
No comfort in the rural south: Women living depressed
An article discussing the opportunities for research and strategy that exist for providing mental health services to women in a rural area.
Advocacy for mental health: Roles for consumers and family organizations and governments
The World Health Organization urges countries to become more active in advocacy efforts to put mental health on governments' agendas. Health policy makers, planners and managers, advocacy groups, consumer and family organizations, through their different roles and actions, can move the mental health agenda forward. This paper outlines the importance of the advocacy movement, describes some of the roles and functions of the different groups and identifies some specific actions that can be adopted by Ministries of Health.
Church-based support groups for African American families coping with mental illness: Outreach and outcomes
This study examined the outreach efforts used to provide information about support groups to congregants as well as the participation outcomes reported by families who attended support group meetings.
Social network's healing power is borne out in poorer nations
This article describes the findings of a 3-decade-long study by the World Health Organization (WHO) which found that mental health consumers in poorer countries have higher rates of recovering from schizophrenia. Key findings described explore the role that family support, culture, and other social networks have on individuals with schizophrenia. This article discusses the differences in the roles of doctors, the invaluable role of families, and the importance of integrating social and cultural supports with medicine to achieve more positive outcomes.
Mental health: culture, race, and ethnicity: A supplement to Mental health: A report of the Surgeon General
This report is a supplement to the first ever Surgeon General's Report on Mental Health, Mental Health: A Report of the Surgeon General. This supplement covers the four most recognized racial and ethnic minority groups in the United States and the barriers to services that are encountered by persons of certain social and cultural groups.
Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health surveys
Little is known about the extent or severity of untreated mental disorders, especially in less-developed countries. This study estimates prevalence, severity, and treatment of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) mental disorders in 14 countries (6 less developed, 8 developed) in the World Health Organization (WHO) World Mental Health (WMH) Survey Initiative.