Emergencies in Psychiatry in Low - and Middle-Income Countries

One of the cardinal facets of the delivery of mental healthcare is the attention given to emergency conditions-which is the focus of this book. The manifestations of psychiatric emergencies in low- and middle-income countries may be coloured by many factors, such as culture, the social context and religious belief systems. Hence, there is a need to not only understand these, but also formulate logical and acceptable forms of intervention. This book attempts to give the reader an overview of the kinds of psychiatric emergencies that can occur and the strategies employed to manage these in developing countries. The chapters on anxiety disorders, psychotic disorders, personality disorders and substance abuse disorders describe the presentation and management of these disorders in the emergency setting. The book deals with special population groups, such as women, children and the elderly, who require different modes of intervention. The next group of chapters addresses emergencies following psychosocial and environmental events. Among the aspects covered are grief, suicidal behaviour and psychiatric emergencies following disasters. These chapters have a special significance, considering the rising rate of suicide and increase in the frequency of disasters in developing countries. The chapters on suicidal and uncooperative patients dwell on particularly challenging clinical situations, emphasizing ethical issues and the need to ensure the safety of the patient. A discussion of the medicolegal aspects of a psychiatric emergency in developing countries is of relevance since many countries still follow outdated and archaic legal procedures. As patients often present to the emergency department both with psychiatric as well as physical symptoms, a few chapters are devoted to psychiatric emergencies associated with medical disorders, sexual disorders and drug-related issues. This book aims to meet the needs of physicians, researchers and all emergency care personnel dealing with those in a state of emotional crisis. It should serve to help all types of mental health professionals in developing countries to effectively and appropriately manage the various kinds of psychiatric emergencies.

LAKSHMI VIJAYAKUMAR is Founder Trustee, SNEHA, Chennai, Tamil Nadu, India. Sneha has been working in the field of suicide intervention for the past 25 years. Sneha extends emotional support to the depressed, desperate and suicidal when they feel there is no one to turn to. They need someone with whom they can share their pain and misery in confidence; someone who would listen, understand and accept them unconditionally.

R. THARA is Director, Schizophrenia Research Foundation (SCARF), Chennai, Tamil Nadu, India. SCARF is one of the very few NGOs in the world to be named as a Collaborating Centre of the World Health Organization (WHO) for Mental Health Research and Training. SCARF is also the Indian co-ordinating site for the anti-stigma programme of the World Psychiatric Association.