Download Mental Health and Illness

Mental Health and Illness
An Epidemiological Perspective
1
Mental Health-Everybody’s
Business
• Peter Sims
• Professor of Public Health
medicine
• University of Papua New
Guinea
• <[email protected]>
2
Teaching and Learning Aims
• There is ignorance,
superstition, stigma and
fear around Mental Illness
• Aetiology, pathogenesis
diagnosis and treatment
are imperfect.
• There is a different
paradigm and a less
rigorous epidemiology
3
Often sad,sometimes
mad,occasionally bad
•
•
•
•
The medical model is
insufficient
Diagnosis is largely
clinical and
experiential
4
More of an art than a science
• Treatment is
pragmatic
• Prevention is about the
politics of health
• “populations,people
pressures, poverty”
5
Mental Health is a worldwide
problem
6
Mental illness is common 6 in 10 women and 4 in 10 men
in Western Europe and North America will have a
significant mental illness during their lifetime
Mental illness can affect any one of us
Mental illness occurs in all societies and cultures
7
We are all vulnerable
8
A Holistic Approach
Arrow of Time
BODY
CULTURE
MIND
SPIRIT
9
Intelligence
IQ = 100
IQ
I.Q. = the Mental Age
x 100
the Chronological age
10
Personality
• Each human being is
unique
• We all have different
personalities
• My personality
reflects genetic
inheritance and
Environment
11
Behaviour
SUPER-EGO
The Parent
EGO
The Adult
ID
The Child
12
The Subconscious Mind
The Conscious
The Subconscious
13
A Classification
• Affective Disorders
•
Anxiety,depression,mania,obsessional
disorders
Substance abuse problems
Drugs, alcohol
Learning disorders
• Schizophrenia
•
Subnormality
Simple,Hebephrenic,Catatonic,paranoid
• Organic states
•
Delirium,dementia
• Personality Disorder
•
Abnormal personality,Psychopathy
14
The Classification of Mental Illness:
The Neuroses
Depression, Anxiety, Mania, Obsessions and compulsions
(usually the patient retains insight and orientation; they
experience deep distress and may commit suicide)
The Psychoses
Schizophrenia, puerperal psychosis
(the patient is disorientated, deluded, and lacking in insight)
The Dementias
Progressive deterioration with loss of recent memory and
deterioration of a normal personality,
They may be primary or more commonly secondary to
another condition e.g. alcohol, stroke
15
Clinical Diagnosis
16
The Classification of Mental Illness
Drug Problems
Addictive drugs, (Heroin, Cocaine, Amphetamines,) alcohol
and drug related illness-psychosis, delirium and dementia
Personality Disorders
A personality and behaviour that is damaging to the individual
and/or to society and which is not tolerated by the dominant
culture
Mental subnormality/learning disorders:
Problems around intelligence and ability to learn on the basis
of teaching and experience
17
Aetiology
Inheritance-Genetics/Intrauterine environment
Schizophrenia,Huntington’s
Drug Abuse
Alcohol,Heroin etc
Upbringing
Neurological diseases
Mothering,education,
parenting
Trauma/head injury
MS,Brain tumour
Biochemistry/metabolic
Porphyria,Diabetes
InfectionsHIV,Syphilis,CJD
Vascular-CVA
Nutrition/PCM
18
Treatment and Care
Hospital Care
Community Care
19
Preventive Networks
Church,Family, Home, Friends,
Work
20
The Mental Health Act
Compulsory Psychiatric
Treatment
Criminal responsibility
Power of attorney
21
Mental Handicap/learning disability
The mind of a young child in the body of an adult
22
Canst thou not minister to a mind diseased,
Pluck from the memory a rooted sorrow,
Raze out the written troubles of the brain,
And with some sweet oblivious antidote
Cleanse the stuff’d bosom of that perilous stuff
Which weighs upon the heart?
Macbeth
23