1st Edition

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

By Ugo Ikwuka Copyright 2021
    190 Pages
    by Routledge

    190 Pages
    by Routledge

    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.

    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


    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.