No Health Without Mental Health Week 7, Lecture 1

Game Plan Announcements? Name that Tune Mental health Review questions Take home messages

Mental Health Overview Mental disorders contribute to the burden of disease worldwide Neuropsychiatric conditions account for of all disability-adjusted life years Unipolar & bipolar, substance-use and alcohol-use, schizophrenia, dimentia

Low Priority Mental health is a low priority in most low-income and middle-income countries Developing countries prioritize control and eradication of infectious diseases and reproductive, maternal, and child health developing countries prioritize non-communicable diseases that cause early death (cancer & heart disease)

Contributions of mental disorders to disability and mortality Mental disorders are important causes of long-term disability and dependency 5 major contributors: unipolar depression… only sad Alcohol-use disorder Schizophrenia Bipolar depression… 2 diff stages, (mania) happy & (depression) sad Dementia… THAT SHIT CRAY… MIND DETERIORATES, cannot appreciate reality. Depression predicts the onset and progression of both physical, social disability, and mortality

Mental Disorder Interact with Other Health Conditions Medically unexplained somatic symptoms Pain, fatigue, and dizziness, irritable bowel syndrome, fibromyalgia, chronic-fatigue syndrome, chronic pelvic pain, and sexual-discharge syndromes Non-communicable diseases Cardiovascular disease and cancer Links between anxiety, depression, and coronary heart disease Diabetes Depression increases the risk of type 2 diabetes

Mental Disorder Interact with Other Health Conditions Communicable diseases HIV/AIDS People with mental disorders are heightened risk for HIV/AIDS, typically related to high risk behavioral issues Tuberculosis Incidents of tuberculosis was high in patients with schizophrenia Malaria Associated with selflimiting psychiatric disorders, including depression, schizophrenia and manic syndromes, anxiety attacks, and confusional episodes

Reproductive & Sexual Health Sexual and other forms of abuse, anxiety, depression, and use of substances and alcohol associated with reproductive health outcomes: dysmenorrhoea, dyspareunia, and non-cyclical pelvic pain

Maternal and Child Health Maternal psychosis affects infant growth and survival Maternal schizophrenia is associated with pre-term delivery and low birth weight

Injuries Mental health is both a cause and a consequence of injury Injury and mental health have many determinants in common, such as , conflict, violence, and alcohol use

Self-Injuries Child abuse is a risk factor for psychiatric disorders and suicidal behaviour Intimate partner violence is risk factor for depression, anxiety, and suicide Sexual violence is risk factor for depression, substance abuse, and suicide

Clip Many have no acess to health care Suffer in silence Mental health disorders receive no treatment 9/10 pple suffered from epilepsy go untreated WHO – defines health as mental well being as well as complete well being Gap needs to be closed through funding/partnerships

Change policy/practice Care/counselling/medication millions can be treated for epilepsy, suicide, depression etc

Canadian Figures Canadian Mental Health Association

Who is affected? Mental illness indirectly affects all Canadians at some time through a family member, friend, or colleague. 20% of Canadians will personally experience a mental illness in their lifetime. Mental illness affects people of all ages, educational and income levels, and cultures. Approximately 8% of adults will experience major depression at some time in their lives. About 1% of Canadians will experience bipolar disorder (or "manic depression").

How common is it? Schizophrenia affects 1% of the Canadian population. Anxiety disorders affect 5% of the household population, causing mild to severe impairment. Suicide accounts for 24% of all deaths among 15-24 year olds and 16% among 25-44 year olds. Suicide is one of the leading causes of death in both men and women from adolescence to middle age. The mortality rate due to suicide among men is four times the rate among women.

What causes it? Complex interplay of genetic, biological, personality and environmental factors causes mental illnesses. Almost one half (49%) of those who feel they have suffered from depression or anxiety have never seen a doctor about this problem. Stigma or discrimination presents a serious barrier, not only to diagnosis and treatment but also to acceptance in the community. Mental illnesses can be treated effectively.

Youth Statistics It is estimated that 10-20% of Canadian youth are affected by a mental illness or disorder - the single most disabling group of disorders worldwide. Today, approximately 5% of male youth and 12% of female youth, age 12 to 19, have experienced a major depressive episode. The total number of 12-19 year olds in Canada at risk for developing depression is a staggering 3.2 million. Once depression is recognized, help can make a difference for 80% of people who are affected, allowing them to get back to their regular activities. Canada's youth suicide rate is the third highest in the industrialized world.

Youth Stats Con’t Suicide is among the leading causes of death in 15-24 year old Canadians, second only to accidents; 4000 people die prematurely each year by suicide. Schizophrenia is youth's greatest disabler as it strikes most often in the 16 to 30 year age group, affecting an estimated one person in 100. Surpassed only by injuries, mental disorders in youth are ranked as the second highesthospital care expenditure in Canada. In Canada, only 1 out of 5 children who need mental health services receives them.

What is the economic cost? The economic cost of mental illnesses in Canada for the health care system was estimated to be at least $7.9 billion in 1998 - $4.7 billion in care, and $3.2 billion in disability and early death. An additional $6.3 billion was spent on uninsured mental health services and time off work for depression and distress that was not treated by the health care system. In 1999, 3.8% of all admissions in general hospitals (1.5 million hospital days) were due to anxiety disorders, bipolar disorders, schizophrenia, major depression, personality disorders, eating disorders and suicidal behaviour.

Suicide Warning Signs Be concerned when someone you know: makes statements about wanting to die/end the pain is depressed and/or withdrawn to die/end pain takes unnecessary risks gives away valuable possessions shows a marked change in behavior, attitude or appearance abuses alcohol and/or drugs has experienced a significant loss, failure or life change

Is Path Warm I – Ideation (suicidal thoughts) S – Substance Abuse P – Purposelessness A – Anxiety T – Trapped H – Hopelessness/Helplessness W – Withdrawal A – Anger R – Recklessness M – Mood changes

Help them by: listening with concern reserving judgment exploring and supporting their feelings asking if they have suicidal thoughts encouraging them to reach out for help Spending time with them

Resources 911 Student Counselling: 613 562-5200 Crisis Line: 613 722-6914 Student Health: 613 564-3950 http://www.sass.uottawa.ca/personal/ http://www.ementalhealth.ca/

Mid-Term Questions? 50 marks 20 mc – pencil 7 def, choose 5 Full sentences SUB SARAHAN AFRICA THAT SHIT CRAY 20 SHORT ANSWER Only write within space provided.

Take Home Messages Take care of yourselves and each other! Exam: Friday!