Mental health problems , epidemiology, prevention and control

Mental Health– Mental health means a harmonious working of

the mind, which results in a well adjusted personality.

– Mental health is one of the three important aspects of health (others being physical and social) incorporated in the WHO definition of health.

– Mental health is not exclusively relation b/w persons; it is also a matter of relation of an individual

– 1. towards the community he lives in

– 2. towards the society of which the community is a part

– 3. towards the social institution which for a large part guide his life, determine his way of living, working, leisure and the way he earns and spends his money.

–  Epidemiological studies report prevalence rates for psychiatric disorders varying from 9.5 to 370/1000 population in India.

Types of mental illnessas classified by International classification of Disease (ICD):

– Organic, including symptomatic, mental disorders (dementia, delirium)

– Mental and behavioural disorders due to psychoactive substance use

– Schizophrenia, schizotypal and delusional disorders– Mood (affective) disorders– Neurotic, stress related, and somatoform disorders (anxiety,

OCD)– Behavioural syndromes– Disorder of adult personality and behaviour (paranoia)– Mental retardation – Disorders of psychological development– Unspecified mental disorder

Some well known and most prevalent mental disorders are

– 1.UNIPOLAR DEPRESSIVE DISORDER-

A mental disorder characterized by persistent low mood that is accompanied by low self-esteem and by a loss of interest in normally enjoyable activities.

The report on Global Burden of Disease estimates the point prevalence of unipolar depressive episodes to be 1.9% for men and 3.2% for women, and the one-year prevalence has been estimated to be 5.8% for men and 9.5% for women.

2.BIPOLAR AFFECTIVE DISORDER-

– It is characterized by periods of elevated mood and periods of depression.

– 3.SCHIZOPHRENIA-

It is often characterized by abnormal social behaviour and failure to recognize what is real.

4.EPILEPSY-

– It is a group of neurological disorders characterized by epileptic seizures.

prevalence is about 1% in our population. The prevalence is higher in the rural (1.9%) compared to urban population (0.6%)

5.ALZHEIMER’S DISEASE-

– It is the most common form of dementia. The most common early symptom is short term memory loss.

6.PARKINSON’S DISEASE-

– It is a degenerative disorder of central nervous system. Symptoms of this disease are movement related like shaking, rigidity, slowness of movement, gait, etc.

7. MULTIPLE SCLEROSIS-– An inflammatory disease in which the insulating covers of

nerve cells in the brain and spinal cord are damaged.

8.DRUG USE DISORDER-– It refers to the overuse of or dependence on a drug leading

to effects that are detrimental to the individual’s physical and mental health.

9. POST TRAUMATIC DISORDER-

– It may develop after a person is exposed to one or more traumatic events, such as sexual assault, warfare, serious injury, etc.

10.OBSESSIVE COMPULSIVE DISORDER-

– An anxiety disorder characterized by intrusive thoughts that produce obsessions, repetitive behaviours aimed at reducing the associated anxiety(compulsions),or both.

11.INSOMNIA-– Insomnia, or sleeplessness, is a sleep disorder in which

there is an inability to fall asleep or to stay asleep as long as desired.

12. MIGRAINE-– Chronic neurological disease characterized by recurrent

moderate to severe headaches.

TYPES OF MENTAL ILLNESSES

– 1.MAJOR ILLNESS-PSYCHOSIS (insane, out of touch with reality)

– 2.MINOR ILLNESS

Major illness(1) Schizophrenia (split personality) - 1) Schizophrenia (split personality) - person lives in dream world

of his own.

(2) Manic depressive psychosis - 2) Manic depressive psychosis - symptoms vary from heights of excitement to depths of depression

(3) Paranoia (3) Paranoia – a tendency to regard the whole world in a frame work of delusion.

Minor illnessTwo groups-Two groups-

(1) Neurosis & 1) Neurosis & psychoneurosispsychoneurosis– In this the person is unable to react normally to life situations.

(2) Personality and character 2) Personality and character disorder- disorder- This group of disorders are the legacy of unfortunate childhood experiences and perception.

CAUSES OF MENTAL ILLNESS– Mental illnesses are due to multiple causes. There are many factors

affecting mental health like-

1- ORGANIC CONDITION-mental illnesses may have 1- ORGANIC CONDITION-mental illnesses may have their origin in organic conditions such as their origin in organic conditions such as

cerebral arteriosclerosis neoplasm metabolic diseases neurological disease endocrine disease tuberculosis leprosy epilepsy

2-2- HEREDITY- HEREDITY- For example, the child of two schizophrenic patients is 40 times more likely to develop schizophrenia than is the child of two healthy persons.

3- SOCIAL PATHOLOGICAL CAUSES-3- SOCIAL PATHOLOGICAL CAUSES- worries anxieties emotional stress tension frustration unhappy marriage broken homes economical insecurities

Characteristics of mentally healthy persons

– A mentally healthy person has 3 main characteristics-

1.He feels comfortable about himself i.e.

-he neither underestimates nor overestimates his own abilities

-he accepts his shortcomings

2.The mentally healthy person feels right towards others i.e.

-he is able to be interested in others and to love them.

-he has friendships that is satisfying and lasting

-he is able to like and trust others

3-The mentally healthy person is able to meet the demands of life i.e.-

-he sets reasonable goal for himself

-he is not bowled over by his emotions of fear, anger, love & guilt.

Some warning signals of poor health

There are some Questions by which we define person is mentally healthy or ill

Are you always worrying?Are you unable to concentrate b/c of unrecognised reason?Are you continuously unhappy?Do you lose your temper easily &often?Are you troubled by regular insomnia?Do you continuously dislike to be with people?Are you upset if the routine of your life is disturbed?

Are you afraid without real cause?

Are you always right and the other person is always wrong?

If the answer to any of the above questions is ‘yes’ then help is necessary.

Prevention– 3 LEVELS OF PREVENTION …..

Primary preventionIt operates on a community basis . This consist of “improving the social environment” and promotion of social, emotional, & physical well being of all people. Secondary preventionIt consists of early diagnosis of mental illness & of social & emotional disturbance through screening programmes in schools, universities, etc. & provision of treatment facilities and effective community resources.

– In secondary prevention ‘family based’ help services have much role to play.

Family counselling is one method of treatment intervention for helping the mentally ill.

Tertiary preventionIt seeks to reduce the duration of mental

illness & thus reduce the stress they create for family & the community. In short, the goal at this level is to prevent further break down & disruption.

Mental health services

Mental health services in a community comprise-

1- early diagnosis and treatment

2- rehabilitation

3- group and individual psychotherapy

4- mental health education

5- use of modern psychoactive drugs

6- after care services.

10 COMMANDMENTS OF MENTAL HEALTH

1. Think positively; it’s easier

2. Cherish the ones you love

3. Continue learning as long as you live

4. Learn from your mistakes

5. Exercise daily; it enhances your well-being

6. Do not complicate your life unnecessarily

7. Try to understand and encourage those around you

8. Do not give up; success in life is a marathon

9. Discover and nurture your talents

10. Set goals for yourself and pursue your dreams

THANK YOU.