1. Social Work and Mental Health Week 2 – Incidence and Determinants of Mental Illness

2. Learning Outcomes: 21 October 2015 To establish the determinants of Mental Health To examine the incidence and probability of poor Mental Health

3. List of mental health disorders How many can you think of? Write them down Officially 110 http://www.nhs.uk/Conditions/Pages/bodymap.aspx?Subject=Menta l%20health%20disorders http://www.nhs.uk/Conditions/Pages/bodymap.aspx?Subject=Menta l%20health%20disorders

4. How many people experience MH problems? The Office for National Statistics Psychiatric Morbidity report found that in any one year 1 in 4 British adults experience at least one mental disorder, and 1 in 6 experiences this at any given time.

5. Calculations Some calculations are based on how many people have a mental health problem at any point in time, while others measure the likelihood of someone developing mental health problems in their lifetime. Others measure rates per year. Figures may relate to different populations such as the adult population, a regional population or a nation within the UK (eg. The North West or England), or an international population.

6. Classifying MH problems: Most mental health symptoms have traditionally been divided into groups called either ‘neurotic’ or ‘psychotic’ symptoms. ‘Neurotic’ covers those symptoms which can be regarded as extreme forms of ‘normal’ emotional experiences such as depression, anxiety or panic. Conditions formerly referred to as ‘neuroses’ are now more frequently called ‘common mental health problems,’

7. Less common are ‘psychotic’ symptoms which interfere with a person’s perception of reality and may include hallucinations, delusions or paranoia, with the person seeing, hearing, smelling, feeling or believing things that no one else does. Psychotic symptoms or ‘psychoses’ are often associated with ‘severe mental health problems.’

9. Statistics… In a 2001 survey, 15% of British adults reported experiencing ‘neurotic symptoms’ in the previous week. Mixed anxiety and depression is the most common mental disorder in Britain, with almost 9% of people meeting criteria for diagnosis.

10. Age Related….? Overall, common mental health problems peak in middle age. 20-25% of people in the 45-54 years age group have a ‘neurotic disorder’. As people age, neurotic disorders become less common, with the lowest level recorded in the 70-74 years age group.

11. Depression: Between 8% and 12% of the population experience depression in any year. A depressive episode may be classed as mild, moderate or severe, depending on the number and intensity of associated symptoms, such as sleep disturbance, appetite and weight change, anxiety, poor concentration, irritability and suicidal thoughts.

12. Depression tends to recur in most people. More than half of people who have one episode of depression will have another, while those who have a second episode have a further relapse risk of 70%. After a third episode, the relapse risk is 90%. For about 1 in 5 people, the condition is chronic.

13. Suicide Rates: Scotland has the highest suicide rate in the UK at 20 in 100,000, an increase of 1% over a decade and the only country in the UK to show a rise. In England the suicide rate is 10 per 100,000 people. In both Northern Ireland and Wales the suicide rate is 11 per 100,000. The suicide rate in the EU is 17.5 people in 100,000 and 15.1 in 100,000 worldwide.

14. 4% of people who took their lives were the lone carers of children. Suicide and self- harm are not themselves mental illnesses, but they usually result from mental distress.

15. In around a quarter of suicide inquiry cases in England, Wales and Scotland and nearly a third in Northern Ireland, the person died within three months of discharge from in-patient care, with a peak in the first one to two weeks after discharge. In England and Wales 40% died before the first follow up appointment. In Scotland this was 35% and in Northern Ireland 66%.

16. Suicide and ethnicity In the five years to 2001, 6% of people who took their own lives in England and Wales were from an ethnic minority group. In Scotland this was 2% and in Northern Ireland 1%. The 2001 Census found that 9% of the population in England were from ethnic minorities. In Wales this was 2%, in Scotland 2% and in Northern Ireland 0.75%.

17. BME (Black and Minority Ethnic) - Black Caribbean The National Confidential Inquiry into Suicide and Homicide by People with Mental Illness in the five years to 2001 found that people from ethnic minorities who died by suicide usually had severe mental illness. Three quarters of Black Caribbean people who took their own lives had a diagnosis of schizophrenia.

18. Influences…. Self-harming and suicide may be influenced by the depiction of similar behaviour in the media or taking place in peer groups. For example, one study showed a 17% increase in presentations to hospital from self- poisoning in the week after an overdose was depicted in a TV drama. Similarly, a study of teenagers who self-harmed found that the strongest associated factor was awareness of friends who had also self-harmed.

19. What are the possible causes of Mental Health Problems..? Write down as many possible causes of Mental Health Problems you can think of. Think of some scenarios and examples to share with the group.

20. What influences our Mental Health? Family Relationships Childhood Experiences Friendships Lifestyle Choices Genetics Coping Strategies Addiction Problems Crime Finances Housing Bereavement Sense of Purpose Stress Communication Bullying Workload

21. Give examples of ‘Determinants’ of MH problems Society Community Family Individuals Take one of the topics per group List as many possible determinants as you can think of and present to the class with your explanations.

22. Resources: Office for National Statistics. Health & Social Care – Specialist Health Care – Mental Health Services. http://www.ons.gov.uk/ons/taxonomy/index.html?nscl= Mental+Health+Services The Fundamental Facts (2007) The Latest Facts and Figures on Mental Health http://www.mentalhealth.org.uk/content/assets/PDF/pu blications/fundamental_facts_2007.pdf?view=Standard http://www.ons.gov.uk/ons/taxonomy/index.html?nscl= Mental+Health+Services http://www.mentalhealth.org.uk/content/assets/PDF/pu blications/fundamental_facts_2007.pdf?view=Standard