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Transcript
TOPIC 1-INTRODUCTION TO MENTAL HEALTH
DEFITION OF HEALTH
 WHO (1948) define heath as a state of complete physical, mental and
social wellbeing and not merely the absence of disease and infirmity.
 WHO (1986) in the Ottawa charter for health promotion (OCHP) said
that health is a resource for everyday life, not the objective of living.
 Health acc o the Macmillan dictionary is the condition of your body
whether or not you are ill.
 Health is a positive resource emphasising social and personal
resources as well as physical capacities.
 Overall health is achieved through a combination of physical, mental
emotional and social wellbeing which together is know as the health
triangle.
Overview of mental illness
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An essential criterion for defining behavioural patterns or symptoms of
psychological distress as a mental disorder is that they become significant
enough to be functionally disabling and impose substantial increased risks
ranging from an important loss of freedom to suffering pain, disability, or
death.
Both genetic inheritance and environmental factors influence one's
vulnerability to mental illness. Twin and family studies and genetic research
have demonstrated the former, though specific genes have been difficult to
identify, and there may be multiple genes involved in most psychiatric
disorders.
Traumatic events throughout one's lifetime, including childhood abuse or
neglect, major losses, violence, military combat, and dislocation (as among
the urban homeless or wartime refugees) are known to threaten mental
stability.
Substance abuse contributes significantly to the exacerbation or even
precipitation of other psychiatric illnesses and complicates their treatment.
Poverty and home-lessness are risk factors for many of these problems, but
may also be the outcome of psychiatric illness and the inability to function
independently.
The Carter Commission on mental health recognised that the risk of mental
illness was influenced by a range of socio-economic, inter-personal and
hereditary factors.
Mental, or psychiatric, illnesses are a major public health concern. They
adversely affect functioning, economic productivity, the capacity for healthy
relationships and families, physical health, and the overall quality of life. They
cut across racial, ethnic, and socioeconomic lines to affect a significant
proportion of communities worldwide. They tend to develop and manifest in
the early adult years, often preventing individuals from leading full and
productive lives. The National Comorbidity Survey of 1994 found nearly half of
the individuals in its random U.S. sample had a psychiatric disorder over their
lifetime, and almost 30 percent had one in the past year. The World Health
Organization's World Health Report 1998 lists mood and anxiety disorders
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among the leading causes of morbidity and mood disorders as the leading
cause of severely limited activity. Mental disorders account for a quarter of the
world's disability. Comorbidity (having more than one illness) is common and
even further increases the risk of disability. Suicide is the eighth leading cause
of death in the United States and the third leading cause in the fifteen- to
twenty-four-year-old age group. More people die by suicide than homicide.
The definition of mental health as a positive sense of wellbeing challenges the
idea tat mental health is the opposite of mental illness.eg a person with a
diagnosis of schizophrenia may feel supported, at ease and optimistic-they
may be coping well with life and enjoying a high level of wellbeing. Equally
many people who are not clinically diagnosed may have a poor sense of
wellbeing.
DEFINITION OF MENTAL HEALTH
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Mental health problems are common and widely misunderstood. At any one
time, one adult in six suffers from mental health problems of varying severity.
Other research suggests that one person in four will experience some kind of
mental health problem in the course of a year. A survey of children and young
people’s (aged 5 – 15) mental health found that the proportion of children and
adolescents with any mental disorder was greater among boys than girls
across the age range: 11% compared with 8%. The cost of mental illness in
England adds up to £77.4 billion
MH is a state of emotional and psychological well-being in which an individual
is able to use his or her cognitive and emotional capabilities, function in
society, and meet the ordinary demands of everyday life.
MH is a branch of medicine that deals with the achievement and maintenance
of psychological well-being.
A person's overall emotional and psychological condition: Since witnessing
the accident, his mental health has been poor.
Mental health is a contested concept which is defined in a number of different
ways. There is a deficit model of mental health i.e. the absence of objectively
diagnosable disease. There is a positive holistic model of mental health as a
state of physical, social and mental well-being
There has been a movement away from a focus solely on individual attributes
such as coping skills or resilience, to one which incorporates environmental
and social conditions.
Definitions of mental health are personal and are dependant upon our
individual life experiences and life context. Therefore they can be influenced
by our gender, race, religious beliefs, social class, experience of family life,
aspirations and beliefs etc.
Mental health has been described as multifaceted with six dimensions:
affective, behavioural, cognitive, socio-political, spiritual and psychological .
The Health Education Authority (USA) defined mental health in 1997 as “the
emotional and spiritual resilience which enables us to survive pain,
disappointment and sadness. It is a fundamental belief in our own and others’
dignity and worth”.
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The Mental Health Foundation has defined a mentally healthy individual as
one who can:
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Develop emotionally, creatively, intellectually and spiritually;
Initiate, develop and sustain mutually satisfying personal relationships;
Face problems, resolve them and learn from them;
Be confident and assertive;
Be aware of others and empathise with them;
Use and enjoy solitude;
Play and have fun;
Laugh, both at themselves and at the world.
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These differing models and definitions of mental health illustrate an array of
individual and environmental risk and protective factors. The interaction
between discrete factors and mental health outcomes is however not clearly
delineated. Why a particular risk factor should result in poor mental health
outcomes for one individual and not another is as yet unknown. What all these
models of mental health acknowledge however is the extent to which mental
health is entrenched within social relationships.
Mental health describes either a level of cognitive or emotional well-being or
an absence of a mental disorder. From perspectives of the discipline of
positive psychology or holism mental health may include an individual's ability
to enjoy life and procure a balance between life activities and efforts to
achieve psychological resilience. Mental health is an expression of our
emotions and signifies a successful adaptation to a range of demands.
Dianne Hales and Robert Hales define mental health as
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 the capacity to think rationally and logically, and to cope with the
transitions, stresses, traumas, and losses that occur in all lives, in ways
that allow emotional stability and growth. In general, mentally healthy
individuals value themselves, perceive reality as it is, accept its
limitations and possibilities, respond to its challenges, carry out their
responsibilities, establish and maintain close relationships, deal
reasonably with others, pursue work that suits their talent and training,
and feel a sense of fulfilment that makes the efforts of daily living
worthwhile (p. 34).
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A healthy pregnancy, adequate parenting, secure attachments to caretakers,
regular involvement in groups, and stable intimate relationships all contribute
to the development and maintenance of mental health.
Mental health can therefore be socially constructed and socially defined that is
different professions, communities, societies and cultures have very different
ways of conceptualising its nature and causes.
Definitions from WHO
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The World Health Organization defines mental health as "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, and is able to
make a contribution to his or her community". It was previously stated that
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there was no one "official" definition of mental health. Cultural differences,
subjective assessments, and competing professional theories all affect how
"mental health" is defined.
Mental health is an integral and essential component of health. The WHO
constitution states: "Health is a state of complete physical, mental and social
well-being and not merely the absence of disease or infirmity." An important
consequence of this definition is that mental health is described as more than
the absence of mental disorders or disabilities.
A useful definition of mental health is that used by the World Health
Organisation: “Mental health is a state of well-being in which the individual
realises his or her own abilities, can cope with the normal stresses of life, can
work productively and fruitfully and is able to make a contribution to his or her
community.”
Mental health is a state of well-being in which an individual realizes his or her
own abilities, can cope with the normal stresses of life, can work productively
and is able to make a contribution to his or her community. In this positive
sense, mental health is the foundation for individual well-being and the
effective functioning of a community.
Mental Wellness
When searching the literature on mental health, it is difficult to find a
straightforward definition of mental wellness. Instead, we define its absence.
Although many adults do not fit snugly into descriptions of depression and
anxiety, depressive symptoms and behaviours that identify anxiety are seen in
many people. Unfortunately, even if these adults recognize their depressive
symptoms and feelings of anxiety, and even if low-cost treatment were
available around the corner, the stigma of mental illness inhibits many of them
from seeking help.
Depressive symptoms affect the quality and enjoyment of life. Depressed
people tend to exercise less, smoke more and eat less healthily. Sixty to 90
percent of people who commit suicide suffer from depression.
Mental wellness can be influenced by:
1. Biological factors - changes in the central nervous system, medications,
illnesses and family history
2. Social environment - losses, traumatic events, stress and low economic
status
Mental wellness is promoted through:
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Physical activity
Good nutrition
Adequate rest and sleep
Stress reduction
An optimistic attitude that can include humour, creativity and faith
Optimal medication management
Emotionally enriched environments
For people to survive their later years, maintaining mental wellness is an
essential charge, both for themselves and for those who work with them.
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An example of a wellness model includes one developed by Myers, Sweeney
and Witmer. It includes five life tasks—essence or spirituality, work and
leisure, friendship, love and self-direction—and twelve sub tasks—sense of
worth, sense of control, realistic beliefs, emotional awareness and coping,
problem solving and creativity, sense of humor, nutrition, exercise, self care,
stress management, gender identity, and cultural identity—which are
identified as characteristics of healthy functioning and a major component of
wellness. The components provide a means of responding to the
circumstances of life in a manner that promotes healthy functioning.
Characteristics of mental health
1) The ability to enjoy life-acc to James Taylor the secret to life is enjoying the
passing of time-any fool can do it-there is nothing to it. However we need to
plan for the future. But too often we make ourselves miserable in the present
by worrying about the future.
2) Resilience-the ability to bounce back from adversity. Some people handle
stress better that others-some adults raised in alcoholic families do well while
others have repeated problems in life. resilience can be found among those
who cope well with stress.
3) Balance-we need to balance time spent alone and time spent socially-extreme
social isolation may result in a split with reality-failure to integrate positive and
negative experiences that occur between individuals and other people(rather
than perceiving scolding from parents as love- a person is always negative.
Balance work and play ,rest and exercise.
4) Flexibility-Pple should not have rigid expectations. Emotional flexibility is as
good as cognitive flexibility.
5) Self actualisation-mentally healthy people are those who are in the process of
actualising their potential.
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References
Office for National Statistics (2000) Survey of Psychiatric Morbidity among
Adults Living in Private Households. London: HMSO
Goldberg D (1991) Filters to care in Indicators for Mental Health in the
Population. Jenkins R and Griffiths S (ed). London. The Stationery Office.
Meltzer H, Gatward R, Goodman R and Ford T (2000) The mental health of
children and adolescents in Great Britain: Summary report. London: Office for
National Statistics.
Sainsbury Centre for Mental Health (2003) The Economic and Social Costs of
Mental Illness. London:SCMH.
World Health Organisation (1946) Constitution. New York: World Health
Organisation
World Health Organisation (1986) Ottawa Charter for Health Promotion.
Ottawa: World Health Organisation
Rutter M (1985) Resilience in the face of adversity: protective factors and
resistance to psychiatric disorder. British Journal of Psychiatry. 147: 598-611
Health Education Authority (1997) Mental Health Promotion: A Quality
Framework. London: HEA.
MacDonald G and O’Hara K (1998) Ten Elemen