Paradigms Lost challenges key paradigms currently held about the prevention or reduction of stigma attached to mental illness using evidence and the experience the authors gathered during the many years of their work in this field. Each chapter examines one currently held paradigm and presents reasons why it should be replaced with a new perspective. The book argues for enlightened opportunism (using every opportunity to fight stigma), rather than more time consuming planning, and emphasizes that the best way to approach anti-stigma work is to select targets jointly with those who are most concerned. The most radical change of paradigms concerns the evaluation of outcome for anti-stigma activities. Previously, changes in stigmatizing attitudes were used as the best indicator of success. Paradigms Lost and its authors argue that it is now necessary to measure changes in behaviors (both from the perspective of those stigmatized and those who stigmatize) to obtain a more valid measure of a program's success. Other myths to be challenged: providing knowledge about mental illness will reduce stigma; community care will de-stigmatize mental illness and psychiatry; people with a mental illness are less discriminated against in developing countries.
Paradigms Lost concludes by describing key elements in successful anti stigma work including the recommended duration of anti-stigma programmes, the involvement of those with mental illness in designing programmes, and the definition of programmes in accordance with local circumstances. A summary of weaknesses of currently held paradigms and corresponding lists of best practice principles to guide future anti-stigma action and research bring this insightful volume to an apt conclusion.

Ethics, Culture, and Psychiatry: International Perspectives is a textbook that explores the best ways to promote the use of the Declaration of Madrid, which outlines ethical standards for psychiatric practice throughout the world. The book is written with two questions in mind, both easy to pose and difficult to answer: - Is it possible to formulate a set of principles that will be valid for all psychiatrists, regardless of the cultures to which they belong or in which they live and practice, or are there as many sets of ethical principles as there are cultures?- If there is such a set of principles, what should we do to ensure that psychiatry as a discipline makes a significant contribution to societal good without helping the evil?

To facilitate the exploration of this territory, 15 experts from a variety of cultures examine the most pressing ethical issues prevalent within the current practice of psychiatry. Many of the dilemmas probed in this book are routinely encountered by clinicians who work in increasingly multicultural societies. The text covers issues that are broadly relevant to clinical practice and research, including: - An overview of ethics and societies around the world- Discussions of ethical practices and dilemmas specific to various cultural regions- Transcultural debate on overarching issues, such as incompetent patients, informed consent, and mental health law reform- The complete copy of The Declaration of Madrid printed in the appendix

Readers will find that this is a textbook that stimulates and supports, rather than closes, the debate on ethical aspects of professional psychiatric behavior. Ethics, Culture, and Psychiatry: International Perspectives is much more than just a book on ethics -- it is a major contribution to understanding the impact of culture and history on the ethical practice of medicine around the world, and a continuous search for a consensus on how to live together and make contributions to the well-being of people with mental illness, their families, and the family of humans on our planet.