Biopolitical Paternalism and Its Maternal Supplements: Kinship Correlates of Community Mental Health Governance in China

This article examines how the community mental health program run by the Chinese state conceptualizes, mobilizes, and molds the family. My fieldwork shows that, on the one hand, the program defines care biomedically and connects it to managing security risks in the population. The state fashions itself as paternal while displacing most responsibilities for patient care and management onto the supposedly authoritative families. On the other hand, caregivers—mostly women and the elderly—may resort to practices publicly denounced but privately enabled by the program, such as covert medication and home confinement. They do so not only to manage patients from a position of vulnerability and deprivation but also to compassionately engage with patients’ suffering and non-medical desires. These two entangled kinship correlates of state power, which I call “biopolitical paternalism” and its “maternal supplements,” prove critical for understanding the work of community governance in China and beyond.

A Qualitative Inquiry Addressing the Experience of Depression in Impoverished Ethnically Diverse Women: Implications for Developing a Community-Based Model

BACKGROUND: Literature suggests that a disparity exists relative to the higher prevalence of depression among the population of impoverished ethnically diverse women, the services available, and care received resulting in a significant health issue for women. OBJECTIVES: An exploratory–descriptive qualitative study explored the experiences of depression among the population and key stakeholders to inform the development of a community-based program to reduce depression and improve the quality of life of ethnically diverse women residing in an urban community. DESIGN: Data were collected using focus groups and individual interviews with members of the population and key community representatives, transcribed verbatim, reviewed for accuracy, coded, and analyzed for themes. RESULTS: Compassion, ease, and hope emerged as the three overarching foundational themes. CONCLUSION: An intentional infrastructure and strategies to create an experience of compassion, ease, and hope appear to be essential core components of a successful community mental health program model for impoverished women experiencing depression.

Morbidity profile of patients attending the centers for mental health service provided jointly by the Government of Nepal and Community mental health service of Community Mental Health and Counseling- Nepal (CMC-Nepal)

Introduction: Community mental health program initially conducted in Lalitpur district by UMN and later in the western region demonstrated the possibility of providing mental health services in the primary health care level if proper mental training is provided to different levels of health workers and the program is well supervised. Community Mental Health and Counseling- Nepal (CMC-Nepal) extended the same model of community mental health program to several other districts of the country after taking permission from the Ministry of Health and Population. The basic objective of the study was to prepare morbidity profile of patients attending the centers for mental health conducted jointly by the government of Nepal and Community Mental Health and Counseling- Nepal (CMC-Nepal). Material and method: Ten days block training in mental health for health assistant (HA) and Auxiliary Health Workers (AHW) was conducted by the CMC-Nepal. Senior psychiatrists, psychologists and psychiatric nurse were the trainers. Materials like mental health manual, audiovisuals, flip charts and case stories were used during training by the facilitators. An especially developed patient record card was used for case record, diagnosis and treatment. The study was carried out in between July 2010 to June 2011. A total of 6676 cases were studied during the study period. Results: Community mental health program identified 4761 total new cases in 12 months (July 2010 to June 2011), out of which 2821 were females (59%) and 1940 were males (41%). Similarly total old cases both females and males were 6676 registered in these centers for treatment. Out of all new cases patients with Anxiety Neurosis emerged as the largest group (50%) followed by Depression (24.88%). Other commonly diagnosed conditions were Epilepsy (7.5%), Psychosis (5.3%) and Conversion disorder (5.7%) and unspecified cases (6.5%). The implications of the results are discussed, in the current context. Conclusion: Mental health services need to be provided at the community so as to prevent cases of prolonged subjection to mental illness and also prevent cases of stigma and discrimination. DOI: http://dx.doi.org/10.3126/jpan.v2i1.8569 J Psychiatrists’ Association of Nepal Vol .2, No.1, 2013 14-19

Development of a sustainable community mental health program in a remote region: the Austral Institute for Mental Health

This paper described a community-based rehabilitation program in a remote region of Argentina. The program is located in Neuquén Province, in the Patagonia region. At the time it was initiated, about 20 years ago, the province had an excellent system of primary care, but one in which mental disorders were neglected. There were only a few psychiatrists in the province, and none involved in community care of people with severe mental disorders. Starting from this point, the "Austral" program was developed by making use of the local resources (such as primary care doctors) that were available, and it later earned a reputation as a model program.In 2012, Neuquén became a site of the RedeAmericas, a National Institute of Mental Health funded regional mental health network in Latin America.

Are Koreans Prepared for the Rapid Increase of the Single-Household Elderly? Life Satisfaction and Depression of the Single-Household Elderly in Korea

Purpose. In Korea, it has been estimated that the number of the single-household elderly increased 45% from 2005 to 2010. This research was conducted to provide empirical resources for development of a community mental health program by an explorative investigation on depression, coping mechanism, and life satisfaction of a single-household elderly population.Design and Methods. This research applied a descriptive survey research design. Participants were 225 single-household elderlies residing in Seoul, Korea. The geriatric depression scale and the satisfaction with life scale were used to check the level of depression and life satisfaction of the participants.Results. Results showed that 46.3 percent of the participants were categorized as having light-to-severe level of depression, and 80.5 percent of the participants responded that they were dissatisfied with their lives. This research demonstrated that the level of depression and life satisfaction of the Korean single-household elderly is statistically significantly related to age and gender as well as coping resources and human resources.Implications. Current public health services in Korea for the single-household elderly are still lacking and require active support, intervention, and research to provide effective programs and services. Case management, counseling, and various programs based on Korean culture including support from family members and community-based assistance are recommended to help the vulnerable population.