Living with Mental Illness in a Globalised World : Combating Stigma and Barriers to Healthcare book cover
1st Edition

Living with Mental Illness in a Globalised World
Combating Stigma and Barriers to Healthcare

ISBN 9780367698294
Published May 4, 2021 by Routledge
190 Pages

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Book Description

Living with Mental Illness in a Globalised World systematically examines the manifold contributions to the burdens of living with mental illness in a developing and globalised world. It explores the stigma of mental illness, the burden of which compares to the symptoms of and is sometimes considered more disabling than the illness itself.

The book starts by reviewing the socio-psychological and cultural processes that contribute to stigma and providing evidence-based interventions to combat it. Chapters critically investigate the ideological and instrumental barriers to mental healthcare and establish that determining the conceptualisations of mental illness helps to unravel the reasons for the underutilisation of mental health services. A compelling case is made for a complementary healthcare model and bottom-up approach that is sensitive to the spiritual and cultural needs of the people.

The text’s specific examination of mental healthcare in African countries makes it a timely piece for assisting mental health professionals in understanding the inequities in care that Black Asian and Minority Ethnic groups face and how to improve mental healthcare and delivery to these groups.

Table of Contents

Foreword by Femi Oyebode



Part One

Attitudes towards Mental Illness


Chapter 1 The Socio-psychological Processes of Stigma

Chapter 2 Types of Mental Illness Stigma

Public Stigma


Associative Stigma

Chapter 3 Stigma Predisposing Factors


Causal Explanations for Mental Illness

(Mis)conceptualisation and (Mis)representation of Mental Illness

Nature and Symptom Presentation of Illness

Diagnosis of Mental Illness and Psychiatric Hospitalisation

Chapter 4 Consequences of the Stigma of Mental Illness

Social Exclusion

Structural Discrimination

Increased Burden of Disease

Impedance of Help-seeking

Impedance of Treatment and Recovery

Chapter 5 Pervasiveness of Stigma

The Developing World

The Developed World

Demographic Correlates of Stigmatising Attitudes

Chapter 6 Improving Stigmatising Attitudes




A Multi-dimensional Approach

Part Two

Barriers to Mental Healthcare


Chapter 7 Help-seeking Determinants and Ideological Barriers

The Sociocultural Context

The Conceptualisation of Disease

Cultural (In)appropriateness of Care

Mental Health Literacy

Culture of Self-reliance

Stigma of Mental Illness

Chapter 8 Help-seeking Determinants and Instrumental Barriers

The Social Network

Experience of the Mental Health System

Inadequacy of Services

Case for Integrated Primary Care

Chapter 9 Ideological vs. Instrumental Barriers to Mental Healthcare

Barriers to Help-seeking: Socio-demographic Correlates

Part Three

Pathways to Mental Healthcare: Evolving an Effective Design


Chapter 10 Pathways to Mental Healthcare

The Biomedical Model

The ‘Free Market’ Model

    • Spiritual Pathway (Faith Healers)
    • Traditional Pathway 1
    • Traditional Pathway 2: The Social Network

Chapter 11 Patterns of Mental Healthcare Pathways in Sub-Saharan Africa

Chapter 12 Conclusion: Towards a Complementary Model of Mental Healthcare


Subject index

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Ugo Ikwuka, PhD, lectures at the University of Wolverhampton, UK. He has published several works on causal attributions for mental illness, pathways to mental healthcare, and barriers to accessing mental healthcare.


"Ugo Ikwuka’s book is an extraordinary achievement. It forensically interrogates the field and it is the only book to my knowledge that systematically examines and records the manifold contributions to the burdens of living with mental disorder in a globalised world. It is sensitively written and with deep insight. I feel very privileged to be associated with it." —From the Foreword, Femi Oyebode MBBS, MD, PhD, FRCPsych, Hon FRCPsych, professor of Psychiatry, University of Birmingham; consultant psychiatrist, National Centre for Mental Health Birmingham; former chief examiner, Royal College of Psychiatrists


"This text provides an in-depth and broad-ranging analysis of the challenges facing mental health from a global perspective in the 21st Century, with a particular emphasis on low and middle-income countries. The consequences of global disparities in mental healthcare and mental health education have implications for global economic health and political stability too. This book offers a thoughtful and robust analysis of the priorities and solutions that should be considered if the world is to overcome mental healthcare inequalities." Dr Niall Galbraith, PhD, DHealthPsych CPsychol, AFBPsS, HCPC Registered Health Psychologist. Reader in Health Psychology, Department of Psychology, University of Wolverhampton, UK.