Globalisation, that worldwide phenomenon through which national boundaries are breaking down, has, paradoxically, sharpened the realities of cultural differences and similarities rather than blurred them. We are living in a world where the average clinician can no longer afford to be concerned only with the subcultures within their own culture but must learn to deal with patients from distinctly different cultural backgrounds. The study of cultural psychiatry has consequently taken on a new lease of life in recent years. Among the protagonists of this renewed focus must be counted the editors of this textbook. Editing two books of cultural psychiatry within the same year can be a task reserved only for the gurus. That they have managed to ensure that the Textbook of Cultural Psychiatry is complementary to, rather than being a rehash of, their other volume, Culture and Mental Health: A Comprehensive Textbook, attests to the depth of their authority in the field.
Organised into six parts, the Textbook of Cultural Psychiatry is an authoritative source of information for students, teachers, mental health practitioners and researchers. The part dealing with aspects of management is, for me, one of the major achievements of this volume. Students, as well as teachers, should find the chapters on psychopharmacology and psychotherapy across cultures very illuminating indeed. The chapter on spiritual aspects of management is perhaps emblematic of the general approach in this book: practical and yet not prescriptive; informative, not dogmatic. Contemporary issues are given a fresh and informed look. For example, the chapter on affective disorders addresses the challenge of how to interpret the starkly divergent rates of mental illness found in community surveys, the reports of which have been emerging at an increasing frequency in recent years. Almost inevitably, the reported better outcome of schizophrenia in low- and middle-income countries, an issue of continuing debate, also receives attention in the chapter on schizophrenia and related psychoses even though, I think, insufficient attention is paid to the opposing views and data. The chapters dealing with racism, migration and mass displacement, issues of considerable importance to psychiatry and mental health, add to the overall appeal of this book.
Even though glimpses of what Kirmayer, in the first chapter of the book, refers to as ‘a persistent legacy of colonialism… that can be seen in the continuing romance with exoticism’ are still visible in some chapters, most have managed not to treat culture as an ethnic phenomenon, viewed as exotic and mythical, but as something that pervades the lives of everyone, the clinician as well as the patients seeking care. Still, other chapters show the ambiguity and lack of precision that have characterised cultural psychiatry: such as the interchangeable use of ‘developing’, ‘Third World’, and ‘non-Western’ countries.
Overall, this textbook is destined to become a vital resource for anyone interested in how culture shapes our mental life, in health and in disease.
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