1. The definition and scope of mental health problems
Mental Health Loss
The definition and scope of mental health problems
Scott Kane
Clinical Academic Lecturer
Abertay University
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2. Session Outline How mental health problems are defined
The historical development of the concept of mental illness and disorder
Stigma
Models of mental illness
Epidemiology of mental health problems
Common mental health problems
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3. WHAT IS MENTAL HEALTH? W.H.O. DEFINITION:
“Mental health is a state of well being resulting from being in CONTROL over one’s own life”
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4. WHAT IS MENTAL HEALTH?
It is usually possible to say definitely whether someone is suffering from a particular physical problem.
An x-ray shows a #
lab tests reveal the presence or absence of bacteria.
i.e. it can be scientifically explained.
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5. WHAT IS MENTAL HEALTH?
For most forms of mental illness it is not possible to obtain physical proof of illness.
How do we therefore identify mental ill health?
Generally it can only be deduced from the way a person: feels, thinks, behaves or sees the world.
We don’t have access to peoples minds in order to confirm a diagnosis.
Point 2 - discussion
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6. WHAT IS MENTAL HEALTH?
Mental illness is then suspected when these aspects of a person’s life are ‘abnormal’.
Just because someone feels depressed doesn’t mean they are mentally ill/disordered.
Similarly, no one leads an anxiety free life.
In addition, what may be seen as eccentric behaviour need not be interpreted as a sign of mental illness.
This in itself however raises another question.
What is ‘normal’?
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7. What Is Normal ? Being like the majority Autonomous functioning
Accurate reality perception
Regulated moods
Adequate interpersonal relationships
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8. Psychological Disorders
A condition in which behaviour is judged :
Atypical (not enough in itself)
Disturbing (varies with time & culture)
Maladaptive (harmful)
Unjustifiable (sometimes there’s a good reason)
What’s wrong with being different?
Point 1. Throughout history some people have always behaved differently e.g. Ghandi, Andy Worhall, William Wallace.
Point 2. What might have been considered to be disturbing in the past may now be acceptable. E.g. Masterbation.
Point3 .what is maladaptive behaviour? Cutting? Smoking?
Point 4. Strirling parents hounding out a paedophille.
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9. Historical Perspective
Perceived Causes :
Movements of sun or moon – lunacy/full moon
Evil spirits
Ancient treatments – exorcism, caged, beaten, burned, castrated, mutilated, trepanned.
What were the treatments?
Greek word used to describe a sign or mark cut or burnt into the body to indicate that a person was a slave, criminal or traitor - a blemished person, ritually polluted, to be avoided, especially in public places.
“The situation of the individual who is disqualified from full social acceptance” Goffman
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10. Stigma
Medieval - Woman who were thought to be promiscuous had the letter A branded on their forehead (A= Adulteress)
16th & 17th centuries - mental illness considered to be a sign of witchcraft or possessed by the devil!
Jews in the 2nd world war had to wear armbands to identify themselves.
These marks/labels set people apart from “normal society” resulting in rejection.
Associating with such individuals increased the risk of being branded “one of them”
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11. Stigma Questions: Why does stigma exist?
Why is it attached to illnesses such as depression, anxiety, schizophrenia?
Why do we need to seclude some members of society?
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12. Stigma Answer - as humans we don’t deal very well with mysteries.
Particularly with things we can’t see, feel, taste or measure.
We need scientific explanations.
If we cannot find these answers we invent myths to explain them.
So why is mental illness different?
There is no simple answer. What does seem certain however is that stigma exists and that it’s irrational.
55% of people with a history of mental ill health are women.
25% of people with a history of mental ill health are turned down by insurance companies.
34% are dismissed or forced to resign by their employers.
26% are forced to move due to harassment.
69% are put off applying for jobs.
(MIND 2001)
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13. See me …. LETS STOP THE STIGMA OF MENTAL ILL HEALTH
Scottish campaign on anti-stigma - see the person not the label.
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14. Psychological Disorders Epidemiology
One in four people will experience a mental health problem this year.
In Scotland over 300 mental health consultations for every 1000 people seen in practice during a year
These are predominantly depression or anxiety
Before point 3 ask what they think are the most common mental health complaints GP’s are faced with
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15. Epidemiology contd.
Depression is the commonest contributing diagnosis for Scots visiting their GP.
Antidepressants were dispensed to 814,181 patients in 2014/15. Since 2009/10, use of antidepressants has increased by 28.5%.
On discharge from psychiatric inpatient stay, main diagnosis for women was mood disorders, for men was behavioural disorders due to alcohol/drug use.
Point 1
WHY?
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16. Needs of People with Mental Illness
Day care
Long term care
Community :
Avoidance of stigma & discrimination
Full social participation
Human rights
Medical:
Early recognition
Information about illness & treatment
Medical care
Psychological support
Hospitalisation
Rehabilitation :
Social support
Education
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17. WISE UP TO MENTAL HEALTH
1.What % of employers would consider employing someone with a mental health problem?
A. 25%.
B. 37%.
C. 52%.
D. 4%.
2. In the last 50 years, the % of murders committed by people with mental health problems has:
A. Fallen steadily.
B. Stayed the same.
C. Risen slightly.
D. Risen a lot.
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18. WISE UP TO MENTAL HEALTH
3. How many people will experience some kind of mental health problem in the course of a year?
A. One person per 100.
B. One person in 50.
C. One person in 10.
D. One person in 4.
4. What % of people with mental health problems recover and get on with their lives?
A. 99%.
B. 5%
C. 70%.
D. 33%.
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19. WISE UP TO MENTAL HEALTH
5. What % of people with mental health problems identified stigma as a barrier to employment?
A. 55%
b. 67%
c. 27%
d. 47%
6. In 2016, The highest suicide rate in the UK was for:
A. men aged 40–44.
B. Women aged
C. Both men and women aged 60+.
D. Men aged 25 and under.
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20. WISE UP TO MENTAL HEALTH
7. What % of people with a mental health problem would be embarrassed to disclose to a prospective employer?
A. 49%.
B. 64%.
C. 98%.
D. 19%
8. What % of homicides are committed by people who have not been diagnosed with a mental health problem.
A. 46%.
B. 86%
C. 95%
D. 26%
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21. WISE UP TO MENTAL HEALTH
9. Which group of people is most likely to be a danger to the public?
A. People with mental health problems.
B. Young women under the influence of alcohol.
C. Young men under the influence of alcohol.
D. Students on SWAP Access to Nursing programmes?
10. Which of these groups is unlikely to experience mental health problems?
A. Doctors.
B. People under the age of 25.
C. People who live in rural areas.
People with high incomes.
ANSWERS:
1. = B
2. = B
3. = D
4. = C
5. = B
6. = A
7. = B
8. = C
9. = A
10. = ALL.
ANYNONE CAN EXPERIENCE MENTAL HEALTH PROBLEMS
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22. What Do We Mean By Abnormal Behaviour ?
Five components of abnormal behaviour have been identified :
Statistical Infrequency
Violation of norms
Personal distress
Maladaptive
Medical Disorder.
Today there are many definitions to define what abnormal behaviour is.
Point 1. Or Statistical Deviation with the defining character for this being ‘uncommon behaviour’. Bell shaped curve - height 5’ 8” is the average with some deviation up or down. Or normally distributed. - still difficult to define because someone who is 6 ft 8’’ is not abnormal in the true sense of the word.
Point 2. Most of our behavior is shaped by social norms and cultural expectations. Examples of norms are - dress, how to eat, behaviour on a first date. Frequently violating these norms is seen as abnormal..
Point 3 . Put simply, if the person is distressed, anxious or depressed - we consider these thoughts, feelings and behaviours to be abnormal.
Point 4. 2 types - 1. Self- inability to meet goals or demands of life. 2. Interferes/disrupts social group functioning e.g. alcohol misuse.
Point 5. Abnormality exists when there is a physical disease e.g.alzheimers.
Using a definition is sometimes unavoidable but we need to be sure what we mean when we define behaviour as being abnormal.
So hw far back does the concept of abnormal behaviour go?
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23. Epidemiology contd.
Schizophrenia : Tayside - being cared for by NHS Tayside = 559 people between ages years.
Population around 450,000
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24. Needs of People with Mental Illness (contd)
Family :
Skills for care
Networking with families
Crisis support
Financial support
Respite care.
Alzheimers / depression
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