Download Self Care

Mental Self care
Dr S. O. Malomo
B.Sc, MB.ChB, FWACP
Content
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Learning objectives
Pre - test
Introduction
Definitions
Common mental conditions needing self-care
Self Care in Mental Disease Prevention
Self Care in Mental Health Promotion
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Content
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Self Care in Mental Disease Management
Mental self-care skills
Resources for mental self-care
Post – test
Conclusion
References
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Learning objectives
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At the end of this interaction participants
should be able to:
Discuss the role of self care in mental health
Counsel patients on the use of self care in
mental health prevention and promotion.
Counsel patients on appropriate self care
measures in the management of common
mental conditions.
Discuss common mental self care skills.
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PRE - TEST
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Which of the following is false concerning mental health:
A. A person without mental illness is mentally healthy
B. A mentally healthy person feels good with himself and is comfortable with
others.
C. A mentally healthy man is able to cope with demands, challenges and changes of
everyday life.
D. Persistent emotional upset may indicate mental illness
E. Mental illnesses are generally characterized by abnormalities of mood, thought,
and/or behaviour
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One of the following has been shown to prevent mental disease in children
A. Reducing alcohol intake during pregnancy
B. Maternal education and good parenting practices
C. Early introduction of Cow’s milk to prevent malnutrition
D. Completion of immunization schedule
E. Starting school very early in life
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The following self care practices will help relieve anxiety except
A. Talking to someone you can trust
B. Regular physical exercise
C. Increased exposure to the source of distress
D. Stress rehearsals before exposure to stressful events
E. Helping others
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A.
B.
C.
D.
E.
Alcohol abuse is characterized by one of the following:
Intense cravings for alcohol on a daily basis
Loss of control to limit drinking on any given occasion
Physical dependence with withdrawal symptoms
Regular use resulting in daily living problems
Tolerance with need to increase the amount taken
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Self care practice for alcohol problems may include the following except:
A. Use of ‘Now awareness technique’
B. Avoid eating while drinking to prevent vomiting.
C. Join a support group
D. Drinking slowly
E. Alternating alcoholic beverage with non - alcoholic drinks
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Introduction
• When people feel unwell they engage in self
care more than 80% of the time.
• Only in 2-3% of situations do they go to a
doctor.
• So self care has always been the predominant
form of health care.
• Most people go to the doctor when they
sense they lack the resources needed to deal
with the problem themselves.
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Introduction
• The primary goal of a health system should be
to help people take care of themselves.
• With global rise in health care costs,
enhancing and promoting effective medical
self care is assuming high priority.
• Health is a state of physical, social and mental
wellbeing.
• Hence there can be no health without mental
wellbeing.
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Introduction
• A mentally healthy person feels good with
himself and is comfortable with others.
• He is also able to cope with demands,
challenges and changes of everyday life.
• However, every healthy person is subject to
periods of emotional upset like anger,
sadness, anxiety etc.
• When these become disturbing, interfere with
daily life or last for weeks and months, a
mental illness may be present.
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Introduction
• Mental illnesses are generally characterized by
abnormalities of mood, thought, and/or
behaviour
• One in four people in the world will be
affected by mental or neurological disorders at
some point in their lives.
• Around 450 million people currently suffer
from mental disorders.
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Introduction
• With appropriate information and resources
people can take greater control of their
mental wellbeing.
• This lecture will discuss the role of self care in
mental disease prevention, mental health
promotion and management of mental illness.
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Definitions
• Medial Self care can be described as all health
decisions and measures taken by individuals for
themselves and their families to get well and stay
well.
• It includes decisions on personal hygiene, food
choices, exercise, avoidance of health hazards,
care of minor ailments and chronic diseases etc.
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Definitions
Mental health is “a state of well-being in which the
individual
• realizes his or her own abilities,
• can cope with the normal stresses of life,
• can work productively and fruitfully,
• is able to make a contribution to his or her
community.”
It is estimated that only about 17% of U.S adults are
considered to be in a state of optimal mental health.
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Definitions
• Mental illness is defined as “collectively all
diagnosable mental disorders” or “health
conditions that are characterized by alterations in
thinking, mood, or behaviour (or some
combination thereof) associated with distress
and/or impaired functioning.”
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Common Mental Problems/Disorders
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Anger
Anxiety
Stress
Burnout
Post-traumatic Stress Disorder
Obsessive-Compulsive Behavior
Grief/Bereavement
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Common Mental Problems/Disorders
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Phobias
Relationship/Marital Problems
Parenting Issues
Alcohol/Drug Dependence
Depression/Bipolar Disorder
Sexual Concerns
Schizophrenia
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Self Care in Mental Disease
Prevention
• Good prenatal, antenatal and perinatal care to
prevent mental disease in children later in life.
• Maternal education and good parenting practices
to reduce child abuse, psychological and
behavioural problems
• Early monitoring of growth development of
children by mothers to prevent intellectual
disabilities
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Self Care in Mental Disease
Prevention
• Breast feeding
• Iodine supplement has been found to prevent
neurological impairment
• Avoidance of alcohol during pregnancy to prevent
low birth weight, fetal alcohol syndrome and other
intellectual disabilities in babies
• Stimulating home and school environment can
improve self esteem and good social behaviour.
• Early detection of behavioural problems by
teachers
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Self Care in Mental Disease
Prevention
• Wearing of helmets and seat belts to prevent head
injuries that can lead to mental disorders and
disabilities.
• Improved marital communication to prevent
relationship problems.
• Good retirement plan to prevent depression in the
senior citizens and the elderly.
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Self Care in Mental Health Promotion
• Take good care of your body – personal hygiene,
good nutrition, rest and sleep, exercise, avoid
health hazards and drugs of abuse.
• Work – Life balance: pay attention to leisure
activities and holidays
• Impact others positively
• Learn and do new things – new language, new
books, visit museums, travel to new places
• Explore nature and art
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Self Care in Mental Health Promotion
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Manage stress
Limit unhealthy mental habits
Engage in meaningful creative work
Make time for contemplation and appreciation
Build supportive relationships – real world rather
than virtual interactions
• Connect with people through volunteer work,
special interest groups etc
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Self Care in Mental Health Promotion
Avoid risk factors for mental health compromise:
• Poor connection or attachment to primary
caretaker early in life.
• Traumas or serious losses, especially early in life.
• Learned helplessness.
• Chronic illness that is disabling, or isolating
• Substance abuse.
Go for strong relationships, a healthy lifestyle, and
coping strategies
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Self Care in Mental symptoms/illness
• The Self Care measures described here are not
meant to replace professional care.
• In any case accompanied with distress that
interferes with daily life, the symptoms should be
evaluated by a professional.
• In such cases self care should be used with or after
professional care
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Anxiety
• Anxiety is a feeling of dread, fear or distress over a
real or imagined threat to one’s mental or physical
well-being.
Self Care
• Lessen exposure to the cause of distress
• Talk about it to someone you can trust
• Avoid caffeinated drinks, nicotine, stimulants
• Limit alcohol.
• Regular physical exercise and daily relaxation
exercise
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Anxiety
• Plan your schedule and keep to what you can cope
with physically and emotionally.
• Do stress rehearsals for stressful events that can
not be avoided.
• Help others
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Alcohol problems
• These include alcohol abuse and/or dependence.
• Alcohol abuse is the repeated use of alcohol that
results in daily living problems.
• Alcohol dependence is characterized by:
- Cravings
- Loss of control
- Physical dependence
- Tolerance
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Alcohol problems
• Cut down on parties
• Avoid drinking if possible
• Reduce amount of alcohol – mixing, alternating,
slow drinking
• Eat while drinking
• Don’t drink alcohol if you are pregnant
• Talk to people you can trust to support your effort
• Find other hobbies to replace drinking time e.g.
relaxation exercise, movies, sport etc.
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Alcohol problems
• Realize your role as a model to your children,
students, subordinates etc.
• Don’t mix drinking with driving, drugs or operating
machines
• Use ‘Now awareness technique’
• Join a support group
• Avoid keeping wine, beer and drugs at home
• Avoid people and places associated with drinking
and drugs
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Anger
• Anger is a natural reaction to frustrating and/or
painful events and is most often harmless
• When excessive or chronic it may be associated
with relationship problems, drug and alcohol
addiction, headaches, domestic violence,
depression etc.
• Share your angry feelings with a person you trust
and feel safe with, such as a friend, spouse,
teacher, etc.
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Anger
• Take responsibility for your feelings
• Make a list of situations in which you feel
excessive anger and see if you can change the
pattern
• When angry channel your energy into positive or
creative ventures – exercise, writing, painting.
• Distract yourself when in anger – provoking
situations: music, breathing exercise
• Find humor in situations that result in anger.
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Anger
• When angry don’t respond immediately. Think
before you speak or act. Allow anger to go down
first and consider the consequences before you
respond.
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Bipolar Disorder
• This is a mood disorder and should be diagnosed
by a professional.
• Self care measures are directed to the care giver
• Help the person realize the unusual behaviour and
the need to seek treatment
• Encourage compliance with medical care
• Protect the person and others from harm
• Be observant and make your observations known
to the doctor.
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Burnout
• This is a condition of feeling exhausted or worn
out which can result from anything that demands
more energy than you can give.
• Presents with fatigue, emotional exhaustion, loss
of enthusiasm etc.
Self Care in preventing Burnout
• Don’t spread yourself too thin
• Be aware of signals that precede burnout –
persistent tiredness, headaches, body aches etc
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Burnout
• Reduce long hours of work or study and take
regular 5-10 min relaxation breaks.
• Take daily breaks from work for a lunch outside, a
walk, an exercise session etc.
• Prioritize your work load and manage time
• Attempt to do well, but don’t try to be perfect.
• Get enough sleep and exercise everyday
• Take a vacation at least once a year to relax and do
the things you enjoy.
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Burnout
Self Care for Burnout
• Take a vacation or leave of absence to renew
• Get plenty of rest
• Re-assess your career goals and life priorities
• Regular aerobic exercise
• Set up a healthy daily routine including leisure.
• Get well organized – To do list, time management
• Eat regular healthy meals at regular intervals
everyday
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Burnout
Self Care for Burnout
• Take on only what you can manage and learn to
say ‘NO’
• Delegate tasks at work
• Make and take time for leisure activity that you
enjoy every day
• Spend time away from situations that cause stress
• Discuss your feelings and problems with family,
friends and colleagues.
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Depression
Depression is characterized by fatigue, loss of
energy, loss of interest and feelings of sadness, guilt,
hopelessness etc.
• Take medications prescribed by the doctor
• Seek medical advice before taking herbs and other
alternative therapies.
• Avoid un-prescribed and illegal drugs.
• Regular exercise and healthy foods
• Avoid isolation – stay with people you can trust.
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Depression
• Talk to someone you trust about your feelings
• Do things you enjoy – reading, music, warm bath,
relaxation exercises etc.
• Keep an emergency number ready in case you
need urgent help or feel desperate.
• If you notice suicidal thoughts, get professional
help immediately.
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Drug abuse and dependence
• Drug abuse is the repeated use of a drug that
results in distress and daily living problems
• Drug dependence is addiction and is characterized
by craving, need for increased amounts and
withdrawal symptoms
Self Care
• Use medications only as prescribed and for the
intended purpose
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Drug abuse and dependence
• Before taking more than one drug or taking drug
with alcohol, ask your doctor.
• Don’t use medicines prescribed for someone else
• Ask your doctor before taking sleeping pills,
tranquillizers and strong pain killers.
• Avoid persons and situations that may lure you
into taking drugs.
• Join self help groups for drug users
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Drug abuse and dependence
• Talk to people who will listen to your feelings and
concerns without judging you.
• Calm music, breathing exercises
• Regular vigorous exercises
• Do things that builds your confidence e.g.
volunteer work, martial arts etc.
• Learn something new
• Realize you are a role model to your children
• Use Now awareness technique
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Grief/Bereavement
• Grief is a deep sadness or sorrow that results from
a loss.
• The loss is often related to job situation,
property/business, relationships, Health and life
matters.
• Learning that grief is a normal human reaction to a
loss and about the stages of grief can help the
healing process.
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Grief/Bereavement
The griever generally goes through four stages:
• Shock
• Denial
• Disorganization
• Recovery and Acceptance
Self Care for the griever
• Maintain good health habits – eat well, exercise
• Express your feelings freely.
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Grief/Bereavement
• Allow friends and family to assist. Do not stay
alone. Discuss your feelings and concerns.
• Share and maintain memories of the lost loved
one
• Join a support group for the bereaved.
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Parenting Issues
• Parents face many issues in raising children which
includes:
- Safety of the children
- Physical and emotional care
- Knowing right from wrong
- Dealing with the stresses of life stages
• When problems persist and interferes with the
lives of parents and their children, professional
help may be needed.
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Parenting Issues
Self Care for parenting problems
• Learn effective parenting skills
• Show unconditional love which gives the child a
sense of security, belonging and support
• Condemn wrong behaviour but maintain your
love.
• Set and stick to specific standards of behaviour
• Discipline should be carried through, don’t issue
empty threats.
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Parenting Issues
• Discipline should be consistent, clear, private,
reasonable, flexible, independence promoting,
and authoritative.
• Make time for your children
• Make time for your spouse
• Teach right from wrong and show example
• Listen to your children’s ideas and encourage free
communication.
• Guide children by offering suggestions
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Parenting Issues
• Be realistic – expect to make mistakes and allow
the children to make theirs. Be aware of outside
influences.
• Praise children when they do something well.
• Educate children on special issues like drug and
alcohol abuse, HIV/AIDS, unsafe sexual practices,
random violence
• Communicate freely and let them know they can
count on you in a crisis
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Phobias
• A phobia is an irrational fear of a specific situation,
activity or object.
• It presents with anxiety symptoms when exposed
to the feared situation
• Types include Specific phobias, social phobias and
agoraphobia
Self Care
• List the irrational fears and figure out what they
mean and how you can deal with them
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Phobias
• Learn and practice relaxation techniques like
controlled breathing and tension control.
• Enroll in appropriate specific courses e.g. public
speaking course.
• Use Now awareness technique.
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Relationship/Marital Problems
Common problems in relationship include:
• Problems with communication
• Misunderstandings
• Power struggles
• Different attitudes to money, sex, work, child
rearing, time, in-laws and other family issues
Self Care
• Learn to listen to the other person without
interruption.
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Relationship/Marital Problems
• When discussing problems focus on how to solve
the problem and not who is to blame
• Remind each other and build on the positive
strengths of the relationship
• Seek to understand your partner’s position on
issues before seeking to be understood.
• Discuss each other’s sexual needs and develop
areas of compatibility.
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Relationship/Marital Problems
• Discuss money matters, explore options together
and agree on how to develop and fund family
budget
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Stress
• Stress is the body’s response to any increased
demand.
• Stress may manifest as increased heart rate, rapid
breathing, irritability, lack of concentration,
insomnia, lowering of the immune system etc.
Self Care
• Maintain a regular daily programme of healthy
eating, good health habits and adequate sleep.
• Exercise regularly
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Stress
• Balance work and play
• Laugh a lot. It serves as a relaxation technique
• Accept what you can not change rather than
worrying.
• When you have troubles talk about it with a friend
relative or clergy
• Reward yourself with things that make you feel
good
• Do relaxation exercise daily.
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Stress
• Budget your time using a ‘To Do List’
• Avoid procrastination
• Do a stress rehearsals by practicing for stressful
events
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Mental Self Care Skills
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Assertive Skills
Sleep Hygiene
Anger Management Skills
Relaxation techniques
Cognitive restructuring
Breathing exercises
Journaling
Emotional support
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Mental Self Care Skills
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Become an expert in your mental illness
Identify target symptoms
Identify and avoid triggers
Take an active role in your treatment
Set a goal to live a healthy life
Develop a plan for getting well
Build a community of people who support and
understand you
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Mental Self Care Resources
• Books – Minding your mental health by the
American institute for preventive
medicine
• Online materials – articles, books, websites
• Short courses on coping skills
• Support groups – Alcoholics anonymous, Anxiety
and depression association, Narcotics
anonymous etc.
• Social support – Family, Friends, Colleagues.
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POST - TEST
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A doctor in a busy private practice complains of feeling of exhaustion, persistent
fatigue and loss of enthusiasm for his work lasting about 3 months. Examination
did not yield any physical abnormality. The most likely diagnosis is:
A. Anxiety disorder
B. Acute Stress disorder
C. Burnout
D. Post-traumatic stress disorder
E. Depression
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The following self care practices are advisable in the management of depression
except:
A. Take your medications as prescribed by the doctor
B. Regular exercise and healthy foods
C. Talk to someone you trust about your feelings
D. Take herbs that boost the immune system
E. Avoid isolation – stay with people you can trust
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Mrs. A. B. lost her husband in a tragic accident 3 days ago. She had been crying
uncontrollably since then. One of the following statements is true concerning
her:
A. She is in the shock stage of grief
B. She should be told to stop crying and pull herself together
C. Pictures and objects that will bring his memories should be kept away
D. She should be encouraged to express her feelings
E. She needs to be alone at this time
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Which one of the following is false concerning effective parenting skills
A. Show unconditional love to your children
B. Guide children by telling them DOs and DONTs
C. Discipline should be in private
D. Teach them to know right from wrong
E. Discipline should be carried through, don’t issue empty threats
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Mental self care skills include the following except
A. Reactive Skills
B. Sleep Hygiene
C. Relaxation techniques
D. Cognitive restructuring
E. Journaling
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Conclusion
• Self Care is the predominant form of health care
• Mental Self Care has a role in preventing mental
disease, promoting mental health and managing
mental illness.
• Teaching people appropriate mental self care will
empower them to take greater responsibility for
their mental health.
• The Family physician is uniquely positioned to
promote appropriate mental self care.
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References
• World Health Organization. Strengthening Mental
Health Promotion. Geneva, World Health
Organization (Fact sheet no. 220), 2001.
• Medical Self Care by American Institute for
Preventive Medicine. Available at
www.healthylife.com
• Minding your mental health by Don R. Powell,
Ph.D. and the American Institute for Preventive
Medicine. Available at
http://www.healthylife.com/mymh/SecIa.htm
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References
• Improving Emotional Health - Strategies and Tips
for Good Mental Health. Available at
http://www.helpguide.org/articles/emotionalhealth
• Coping Skills for Mental Illness. Available at
http://www.mental-illness-resources.com/copingskills.html
• Prevention and promotion in Mental Health.
http://www.who.int/mental_health
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THANK YOU
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