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Logo of jepicomhJournal of Epidemiology and Community HealthVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
J Epidemiol Community Health. 2007 September; 61(9): 839.
PMCID: PMC2660012

Mental health systems compared: Great Britain, Norway, Canada, and the United States

Reviewed by Joaquim J F Soares

Edited by Olson RP. Springfield, USA: Charles C Thomas, 2006, pp 381 (hardbook), $89.95, ISBN 0‐398‐07658‐8,

In my work in Sweden I meet people who are involved in mental health issues: politicians, administrators, care planners and providers, students, teachers and researchers. Although their work and needs may differ, they often mention the complexities of the mental health care system and call for “easily” accessed, confident, comprehensive and compiled information on mental health from legislation and prevalence to the delivery of services. This would facilitate, if not improve, their work and decision processes whether they are related to, for example, allocation of resources, planning programmes or teaching. These experiences may not correspond to those of persons in a similar position in other comparable countries, but I wouldn't be surprised if they were.

Interestingly, R. Paul Olson (editor) and co‐authors Arnulf Kolstad, Danny Wedding, Haldis Hjort, John L. Arnett, John N. Hall and Patrick DeLeon have found it useful to describe and compare mental health systems, albeit in Great Britain, Norway, Canada and the United States, in a book entitled Mental health systems compared, published and distributed by Charles C Thomas Publisher. The book has 381 pages and consists of seven chapters preceded by information about the authors, a foreword and preface and a concluding index. It also includes 10 figures and 66 tables.

The first chapter provides an overview of the issues to be addressed, definitions and information on the scope of mental disorders, the selected countries, comparative domains/evaluation criteria and how the subsequent chapters will be organised and brief information on the authors and intended audience. This is followed by four chapters, one each for Great Britain, Norway, Canada and the United States. These chapters are organised in three sections: description (introduction, need for mental health services, policies/programmes, delivery/financing systems), evaluation (access/equity, quality/efficacy, cost/efficiency, financing/fairness, protection/participation, population relevance) and recommendations (improvements at various levels). The penultimate chapter deals with convergence and divergence between the systems in various areas (access/equity) and the last one provides, among other things, general recommendations.

This book provides massive and pertinent information about mental health systems embracing various areas from service needs to the population relevance. In addition, it compares the systems and offers recommendation to improve the systems. This book is likely to be useful for people (e.g. health planers) who work with mental health, primarily in Great Britain, Norway, Canada and the United States, but also for people in other countries by cross‐fertilization. At least, this book will be useful in my work when teaching and talking about mental health, and I suspect that Swedish actors directly involved in mental health (e.g. planers) will welcome it providing access. Had Sweden been included, I am sure.

However, the usefulness of this book could be improved further. Mental health systems evolve, develop and change, and information may lose its relevance rather rapidly. Therefore, the publisher, editor and authors may want to consider publishing the book at relatively regular intervals, e.g. every 5 years. The systems addressed are Anglo‐Saxon or Anglo‐Saxon oriented and from well‐developed countries. Broadening the countries included in terms of culture and development may facilitate the ultimate aim, the overall improvement of mental health services.

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