This document provides an overview of a paper on the social determinants of mental health produced by the World Health Organization and Calouste Gulbenkian Foundation. It discusses the background, methods, findings, and key concepts around how social, economic, and environmental factors impact mental health across the lifespan. The paper takes a life course approach and finds that factors like socioeconomic status, gender, education level, employment conditions, and community support influence mental health outcomes. It provides a framework for understanding these determinants and pursuing multi-sectoral actions and policies to promote mental well-being at all stages of life.
the social determinants of mental illnessGreg Fell
This document discusses addressing the social determinants of mental illness and flipping the approach to mental health on its head. It makes four key points: (1) Most factors influencing mental well-being are outside the traditional health system; (2) Upstream social and economic factors matter more than downstream interventions; (3) All the proposed determinants are complex systems that interact; and (4) The default is to focus on symptoms over addressing root causes. It argues for a holistic, multi-sector approach to mental health that tackles issues like debt, employment, housing, and education.
This ppt presentation discusses about the various models of mental illness. I found it useful to download as it gives a fair idea about various models which are generally not found in books.
The document discusses models of health psychology, focusing on the biopsychosocial model. The biopsychosocial model views health and illness as influenced by biological, psychological, and social factors. It was first proposed by George Engel in 1977 as an alternative to purely biomedical models. The model examines the interconnections between biology, psychology, and socio-environmental factors in topics like health, disease, and human development. Strengths include improved patient outcomes, while limitations include being time-consuming and lacking a strong theoretical basis.
This document provides information on counseling older adults. It discusses trends in the aging US and Wisconsin populations. Issues addressed include ageism, elder abuse/neglect, vocational transitions, mental deterioration, sexuality, substance abuse, depression, and resources. Statistics and research are presented on each topic. Implications for counseling are discussed, such as being aware of physical and cognitive limitations, addressing stereotypes, and recognizing depression is not a normal part of aging. The document aims to educate counselors working with older adult clients.
- Women experience higher rates of depression, anxiety, and somatic symptoms than men. Certain life events that disproportionately affect women, such as gender-based violence and low socioeconomic status, are risk factors for these common mental disorders.
- Throughout a woman's life, hormonal changes during the menstrual cycle, pregnancy, and menopause can impact mental health and susceptibility to mental illness. Conditions like premenstrual dysphoric disorder and postpartum depression are more prevalent in women.
- Women are also more likely to be affected by disorders like PTSD due to higher rates of sexual violence and trauma. While research on gender differences in mental health is growing, more work is still needed to improve identification and treatment
Psychosocial rehabilitation is the process that facilitates opportunities for persons with chronic mental illness to reach their optimal level of independent functioning in society and for improving their quality of life.
Negative symptoms in schizophrenia can be primary or secondary. Primary negative symptoms are intrinsic to schizophrenia while secondary symptoms are caused by other factors like positive symptoms or medication side effects. Persistent primary negative symptoms present for over 6 months may indicate the deficit syndrome. Several rating scales exist to measure negative symptoms, including the Scale for Assessment of Negative Symptoms (SANS) and Positive and Negative Syndrome Scale (PANSS). Treatment involves addressing secondary causes and then using second generation antipsychotics like low-dose amisulpride or adjunctive antidepressants for primary symptoms.
A presentation on the newly introduced cross-cutting symptom measures in DSM5. I'd made this as part of my psychiatry residency, and the article describes why the need came about, the process of formulating and testing the new cross-cutting system and the repercussions this will have on psychiatric practice
the social determinants of mental illnessGreg Fell
This document discusses addressing the social determinants of mental illness and flipping the approach to mental health on its head. It makes four key points: (1) Most factors influencing mental well-being are outside the traditional health system; (2) Upstream social and economic factors matter more than downstream interventions; (3) All the proposed determinants are complex systems that interact; and (4) The default is to focus on symptoms over addressing root causes. It argues for a holistic, multi-sector approach to mental health that tackles issues like debt, employment, housing, and education.
This ppt presentation discusses about the various models of mental illness. I found it useful to download as it gives a fair idea about various models which are generally not found in books.
The document discusses models of health psychology, focusing on the biopsychosocial model. The biopsychosocial model views health and illness as influenced by biological, psychological, and social factors. It was first proposed by George Engel in 1977 as an alternative to purely biomedical models. The model examines the interconnections between biology, psychology, and socio-environmental factors in topics like health, disease, and human development. Strengths include improved patient outcomes, while limitations include being time-consuming and lacking a strong theoretical basis.
This document provides information on counseling older adults. It discusses trends in the aging US and Wisconsin populations. Issues addressed include ageism, elder abuse/neglect, vocational transitions, mental deterioration, sexuality, substance abuse, depression, and resources. Statistics and research are presented on each topic. Implications for counseling are discussed, such as being aware of physical and cognitive limitations, addressing stereotypes, and recognizing depression is not a normal part of aging. The document aims to educate counselors working with older adult clients.
- Women experience higher rates of depression, anxiety, and somatic symptoms than men. Certain life events that disproportionately affect women, such as gender-based violence and low socioeconomic status, are risk factors for these common mental disorders.
- Throughout a woman's life, hormonal changes during the menstrual cycle, pregnancy, and menopause can impact mental health and susceptibility to mental illness. Conditions like premenstrual dysphoric disorder and postpartum depression are more prevalent in women.
- Women are also more likely to be affected by disorders like PTSD due to higher rates of sexual violence and trauma. While research on gender differences in mental health is growing, more work is still needed to improve identification and treatment
Psychosocial rehabilitation is the process that facilitates opportunities for persons with chronic mental illness to reach their optimal level of independent functioning in society and for improving their quality of life.
Negative symptoms in schizophrenia can be primary or secondary. Primary negative symptoms are intrinsic to schizophrenia while secondary symptoms are caused by other factors like positive symptoms or medication side effects. Persistent primary negative symptoms present for over 6 months may indicate the deficit syndrome. Several rating scales exist to measure negative symptoms, including the Scale for Assessment of Negative Symptoms (SANS) and Positive and Negative Syndrome Scale (PANSS). Treatment involves addressing secondary causes and then using second generation antipsychotics like low-dose amisulpride or adjunctive antidepressants for primary symptoms.
A presentation on the newly introduced cross-cutting symptom measures in DSM5. I'd made this as part of my psychiatry residency, and the article describes why the need came about, the process of formulating and testing the new cross-cutting system and the repercussions this will have on psychiatric practice
Bipolar disorder is a mental illness characterized by periods of depression and periods of abnormally elevated mood. During manic episodes, individuals may feel excessively happy or irritable with less need for sleep, racing thoughts, and increased energy. Depressive episodes involve symptoms like sadness, loss of energy, increased need for sleep, changes in appetite, and thoughts of death or suicide. The causes of bipolar disorder are thought to involve biological factors like changes in neurotransmitter levels, genetic predispositions, and environmental triggers that disrupt one's self-concept or ability to achieve their potential. The disorder is typically diagnosed based on a person's symptom history and impacts individuals worldwide regardless of gender, ethnicity, or socioeconomic status.
Motivation and motivational enhancement therapydeveshwaralladi
This document provides an overview of motivation and motivational enhancement therapy (MET). It defines motivation and discusses theories of motivation including need and drive reduction theory, instinct theory, social urges theory, and goal orientation theory. It also summarizes Maslow's hierarchy of needs and characteristics of self-actualized people. The document then discusses motivational treatment approaches like brief motivational intervention, motivational interviewing, and motivational enhancement therapy. It provides details on the stages and processes of MET, including the EARS principles and three phases of building and strengthening motivation for change.
Dynamic psychotherapy aims to reveal unconscious content to alleviate psychic tension. It relies on the client-therapist relationship. Past experiences shape personality and perceptions through implicit memory. Transference and countertransference influence current relationships. Repeated self-defeating behaviors are an attempt to resolve past conflicts. The therapeutic relationship provides a safe space to examine feelings, distortions, and patterns promoting behavioral change.
Psychoeducation involves educating patients and families about mental health conditions to help them better understand and manage the illness. It has roots in movements from the early 20th century and has been shown to improve outcomes. Psychoeducation can be delivered individually, to families, or in groups. It covers topics like the nature of the illness, treatment, and how to prevent relapse. Various models exist including providing information, teaching skills, and being supportive. Psychoeducation has benefits for conditions like schizophrenia, depression, and eating disorders.
The document discusses the biopsychosocial model, an approach to health that considers the interaction between biological, psychological, and social factors. It addresses how these three factors can influence a person's health and aims to provide a holistic view of an individual. Key aspects of the biological, psychological, and social domains are defined, and learning activities are outlined to help students understand and apply the biopsychosocial model.
Mood disorders are a category of mental illnesses that involve serious changes in mood. There are several types of mood disorders including major depressive disorder, dysthymic disorder, bipolar I, bipolar II, and cyclothymic disorder. Mood disorders are among the most common mental illnesses and have a lifetime prevalence of 5-20%. Females are twice as likely as males to experience a mood disorder. The highest incidence rates occur between the ages of 20-40 years old. Mood disorders are a major cause of disability and suicide worldwide. Biological, psychological, and environmental factors all contribute to the development of mood disorders.
Psychiatry history taking and mental state examination [autosaved]Ravi Paul
The document discusses the importance of obtaining a thorough psychiatric history from patients. It outlines the key components of a psychiatric history, including identifying data, chief complaint, history of present illness, past psychiatric history, medical history, family history, developmental history, and mental status examination. The psychiatric history allows psychiatrists to understand who the patient is, where they have come from, and where they are likely to go in the future by gathering details about their life experiences, current issues, and mental state.
This document provides an overview of psychiatry case taking and examination, including history taking and mental status examination (MSE). It discusses the purpose and general principles of history taking, as well as how to structure the interview room and questions. It then describes how to obtain information on a patient's identifying data, chief complaints, history of present illness, past history, family history, personal history, and pre-morbid personality. Finally, it outlines the components of the MSE including general appearance, psychomotor activity, speech, mood, thought, perception, and cognitive functions.
This document discusses case formulation, which involves developing a hypothesis about the factors that cause and maintain a client's problems. It outlines the key components of case formulation using the DSM-5, including the presenting problem, predisposing factors, precipitating factors, perpetuating factors, and protective factors. The document provides an example case formulation for a client named Nasira who is experiencing depression. It analyzes the precipitant, predisposing factors, and perpetuating factors for Nasira based on her history and symptoms. The case formulation would then inform the treatment plan.
Impact of culture on mental illness/ Transcultural Psychiatry Dr. Amit Chougule
This document discusses the impact of culture on mental illness and psychiatry. It begins by defining culture and the components of culture. It then discusses how culture shapes psychopathology in various ways such as pathogenic, pathoplastic, and pathofacilitative effects. Culture also impacts psychodynamics through variables like dependency versus autonomy, linguistic competence, cognitive styles, and social support systems. Overall, the document examines how culture influences the expression and experience of mental illness as well as psychiatric diagnosis and treatment across different cultures.
The document provides information about World Mental Health Day, including:
1) It was established in 1992 by the World Federation for Mental Health to raise awareness about mental health issues around the world.
2) Each year it has a different theme such as depression, schizophrenia, mental health of older adults, and youth mental health.
3) The 2020 theme is "Mental Health for All" with a focus on increasing investment and access to mental health services globally.
Schizophrenia and other psychotic disorders involve positive, negative, and disorganized symptoms that distort thinking, perception, and behavior. Schizophrenia is a chronic condition defined by fundamental distortions in thought, perception, emotion, and behavior. It affects about 1% of the population and typically emerges in early adulthood. Treatment involves antipsychotic medications to reduce positive symptoms as well as psychosocial support. The causes are complex and involve genetic, neurological, developmental, and environmental factors.
The document provides an overview of community psychiatry, including definitions, services, and developments in various countries. It focuses on the development of community psychiatry in India. Key points include:
- Community psychiatry aims to provide mental healthcare in community settings rather than institutions.
- It originated in the US and Italy in the mid-20th century with deinstitutionalization and a shift toward community-based care.
- In India, community psychiatry developed through initiatives like the National Mental Health Programme in 1982, which integrated mental healthcare into primary care.
- Notable experiments included training general physicians in Ranchi and community programs run by NGOs. The Indian Mental Healthcare Act of 1987 also supported
This document provides an overview of motivational interviewing (MI). It discusses key concepts in MI including developing motivation for change, the stages of change model, and strategies used in MI. The strategies focus on expressing empathy, developing discrepancy, avoiding argumentation, rolling with resistance, and supporting self-efficacy. MI is a collaborative, goal-oriented style of communication designed to strengthen personal motivation for change.
Dr. Chandramukhi discusses abnormal illness behavior, where psychological distress manifests physically. Unconscious processes can cause people to generate or prolong physical symptoms to get attention and reassurance or avoid mental stress. Other contributing factors include stress magnifying physical sensations and a preoccupation with finding the root cause of problems. Management involves reassuring patients that serious medical conditions have been ruled out, helping them understand symptoms may not indicate illness, exploring psychosocial conflicts, and potentially using pharmacotherapy to treat underlying conditions.
This document provides an overview of transcultural psychiatry and cultural factors that are relevant to mental illness. It discusses what culture is, how culture can influence psychopathology in different ways such as pathogenic effects, pathoplastic effects, and pathofacilitative effects. It also examines cultural psychodynamics and how cultural variables like dependency versus autonomy, linguistic competence, and social support systems can impact mental health. The document provides examples of culture-bound syndromes and discusses the importance of considering culture in clinical practice and research in psychiatry.
DSM 5 Changes: Schizophrenia & Psychotic Disorders Asit Kumar Maurya
The DSM-5 made several changes to the diagnosis of schizophrenia and other psychotic disorders. For schizophrenia, it eliminated the special status of bizarre delusions and auditory hallucinations, and now requires one of three positive symptoms. It also removed schizophrenia subtypes due to low reliability and validity. For schizoaffective disorder, a mood episode must now be present for most of the time. The DSM-5 no longer distinguishes between bizarre and non-bizarre delusions for delusional disorder. It also consolidated catatonia criteria across disorders.
Expressed emotions refer to the amount and type of emotions that relatives express towards a family member with a psychological disorder when they are not present. There are two types - high expressed emotions, which are hostile, critical, or overly involved, and low expressed emotions, which are reserved and accepting. High expressed emotions can lead to increased relapse in the patient's disorder due to feelings of being trapped or dependent. Cultural and social factors can influence the level of expressed emotions.
The document discusses the history and evolution of somatic symptom and related disorders. It describes how concepts like hysteria, hypochondriasis, and psychosomatic disorders developed before being categorized under somatic symptom disorder, illness anxiety disorder, conversion disorder, and other diagnoses in DSM-5. It provides details on the characteristic symptoms, thresholds, and specifiers for each DSM-5 disorder category. Theories on the causes of related conditions like pseudocyesis are also summarized.
The document discusses global initiatives for adolescent mental health. It outlines key facts such as half of all mental health conditions starting by age 14 and depression being a leading cause of illness in 10-19 year olds. The WHO Director-General described a new action plan from 2013-2020 to address this long-neglected issue through strategies like promoting mental well-being during adolescence, a crucial period for social-emotional development. The plan also calls for changing stigma and expanding services.
One in five adolescents experience significant symptoms of emotional distress and nearly one in ten are emotionally impaired. The most common mental health disorders among adolescents include depression, anxiety disorders, attention-deficit/hyperactivity disorder, and substance use disorder. Depression is one of the most widely studied conditions, with over a quarter of adolescents affected by at least mild depressive symptoms. National data show that 36.7% of female and 20.4% of male high school students have experienced sadness or hopelessness that prevented usual activities for two or more weeks.
Bipolar disorder is a mental illness characterized by periods of depression and periods of abnormally elevated mood. During manic episodes, individuals may feel excessively happy or irritable with less need for sleep, racing thoughts, and increased energy. Depressive episodes involve symptoms like sadness, loss of energy, increased need for sleep, changes in appetite, and thoughts of death or suicide. The causes of bipolar disorder are thought to involve biological factors like changes in neurotransmitter levels, genetic predispositions, and environmental triggers that disrupt one's self-concept or ability to achieve their potential. The disorder is typically diagnosed based on a person's symptom history and impacts individuals worldwide regardless of gender, ethnicity, or socioeconomic status.
Motivation and motivational enhancement therapydeveshwaralladi
This document provides an overview of motivation and motivational enhancement therapy (MET). It defines motivation and discusses theories of motivation including need and drive reduction theory, instinct theory, social urges theory, and goal orientation theory. It also summarizes Maslow's hierarchy of needs and characteristics of self-actualized people. The document then discusses motivational treatment approaches like brief motivational intervention, motivational interviewing, and motivational enhancement therapy. It provides details on the stages and processes of MET, including the EARS principles and three phases of building and strengthening motivation for change.
Dynamic psychotherapy aims to reveal unconscious content to alleviate psychic tension. It relies on the client-therapist relationship. Past experiences shape personality and perceptions through implicit memory. Transference and countertransference influence current relationships. Repeated self-defeating behaviors are an attempt to resolve past conflicts. The therapeutic relationship provides a safe space to examine feelings, distortions, and patterns promoting behavioral change.
Psychoeducation involves educating patients and families about mental health conditions to help them better understand and manage the illness. It has roots in movements from the early 20th century and has been shown to improve outcomes. Psychoeducation can be delivered individually, to families, or in groups. It covers topics like the nature of the illness, treatment, and how to prevent relapse. Various models exist including providing information, teaching skills, and being supportive. Psychoeducation has benefits for conditions like schizophrenia, depression, and eating disorders.
The document discusses the biopsychosocial model, an approach to health that considers the interaction between biological, psychological, and social factors. It addresses how these three factors can influence a person's health and aims to provide a holistic view of an individual. Key aspects of the biological, psychological, and social domains are defined, and learning activities are outlined to help students understand and apply the biopsychosocial model.
Mood disorders are a category of mental illnesses that involve serious changes in mood. There are several types of mood disorders including major depressive disorder, dysthymic disorder, bipolar I, bipolar II, and cyclothymic disorder. Mood disorders are among the most common mental illnesses and have a lifetime prevalence of 5-20%. Females are twice as likely as males to experience a mood disorder. The highest incidence rates occur between the ages of 20-40 years old. Mood disorders are a major cause of disability and suicide worldwide. Biological, psychological, and environmental factors all contribute to the development of mood disorders.
Psychiatry history taking and mental state examination [autosaved]Ravi Paul
The document discusses the importance of obtaining a thorough psychiatric history from patients. It outlines the key components of a psychiatric history, including identifying data, chief complaint, history of present illness, past psychiatric history, medical history, family history, developmental history, and mental status examination. The psychiatric history allows psychiatrists to understand who the patient is, where they have come from, and where they are likely to go in the future by gathering details about their life experiences, current issues, and mental state.
This document provides an overview of psychiatry case taking and examination, including history taking and mental status examination (MSE). It discusses the purpose and general principles of history taking, as well as how to structure the interview room and questions. It then describes how to obtain information on a patient's identifying data, chief complaints, history of present illness, past history, family history, personal history, and pre-morbid personality. Finally, it outlines the components of the MSE including general appearance, psychomotor activity, speech, mood, thought, perception, and cognitive functions.
This document discusses case formulation, which involves developing a hypothesis about the factors that cause and maintain a client's problems. It outlines the key components of case formulation using the DSM-5, including the presenting problem, predisposing factors, precipitating factors, perpetuating factors, and protective factors. The document provides an example case formulation for a client named Nasira who is experiencing depression. It analyzes the precipitant, predisposing factors, and perpetuating factors for Nasira based on her history and symptoms. The case formulation would then inform the treatment plan.
Impact of culture on mental illness/ Transcultural Psychiatry Dr. Amit Chougule
This document discusses the impact of culture on mental illness and psychiatry. It begins by defining culture and the components of culture. It then discusses how culture shapes psychopathology in various ways such as pathogenic, pathoplastic, and pathofacilitative effects. Culture also impacts psychodynamics through variables like dependency versus autonomy, linguistic competence, cognitive styles, and social support systems. Overall, the document examines how culture influences the expression and experience of mental illness as well as psychiatric diagnosis and treatment across different cultures.
The document provides information about World Mental Health Day, including:
1) It was established in 1992 by the World Federation for Mental Health to raise awareness about mental health issues around the world.
2) Each year it has a different theme such as depression, schizophrenia, mental health of older adults, and youth mental health.
3) The 2020 theme is "Mental Health for All" with a focus on increasing investment and access to mental health services globally.
Schizophrenia and other psychotic disorders involve positive, negative, and disorganized symptoms that distort thinking, perception, and behavior. Schizophrenia is a chronic condition defined by fundamental distortions in thought, perception, emotion, and behavior. It affects about 1% of the population and typically emerges in early adulthood. Treatment involves antipsychotic medications to reduce positive symptoms as well as psychosocial support. The causes are complex and involve genetic, neurological, developmental, and environmental factors.
The document provides an overview of community psychiatry, including definitions, services, and developments in various countries. It focuses on the development of community psychiatry in India. Key points include:
- Community psychiatry aims to provide mental healthcare in community settings rather than institutions.
- It originated in the US and Italy in the mid-20th century with deinstitutionalization and a shift toward community-based care.
- In India, community psychiatry developed through initiatives like the National Mental Health Programme in 1982, which integrated mental healthcare into primary care.
- Notable experiments included training general physicians in Ranchi and community programs run by NGOs. The Indian Mental Healthcare Act of 1987 also supported
This document provides an overview of motivational interviewing (MI). It discusses key concepts in MI including developing motivation for change, the stages of change model, and strategies used in MI. The strategies focus on expressing empathy, developing discrepancy, avoiding argumentation, rolling with resistance, and supporting self-efficacy. MI is a collaborative, goal-oriented style of communication designed to strengthen personal motivation for change.
Dr. Chandramukhi discusses abnormal illness behavior, where psychological distress manifests physically. Unconscious processes can cause people to generate or prolong physical symptoms to get attention and reassurance or avoid mental stress. Other contributing factors include stress magnifying physical sensations and a preoccupation with finding the root cause of problems. Management involves reassuring patients that serious medical conditions have been ruled out, helping them understand symptoms may not indicate illness, exploring psychosocial conflicts, and potentially using pharmacotherapy to treat underlying conditions.
This document provides an overview of transcultural psychiatry and cultural factors that are relevant to mental illness. It discusses what culture is, how culture can influence psychopathology in different ways such as pathogenic effects, pathoplastic effects, and pathofacilitative effects. It also examines cultural psychodynamics and how cultural variables like dependency versus autonomy, linguistic competence, and social support systems can impact mental health. The document provides examples of culture-bound syndromes and discusses the importance of considering culture in clinical practice and research in psychiatry.
DSM 5 Changes: Schizophrenia & Psychotic Disorders Asit Kumar Maurya
The DSM-5 made several changes to the diagnosis of schizophrenia and other psychotic disorders. For schizophrenia, it eliminated the special status of bizarre delusions and auditory hallucinations, and now requires one of three positive symptoms. It also removed schizophrenia subtypes due to low reliability and validity. For schizoaffective disorder, a mood episode must now be present for most of the time. The DSM-5 no longer distinguishes between bizarre and non-bizarre delusions for delusional disorder. It also consolidated catatonia criteria across disorders.
Expressed emotions refer to the amount and type of emotions that relatives express towards a family member with a psychological disorder when they are not present. There are two types - high expressed emotions, which are hostile, critical, or overly involved, and low expressed emotions, which are reserved and accepting. High expressed emotions can lead to increased relapse in the patient's disorder due to feelings of being trapped or dependent. Cultural and social factors can influence the level of expressed emotions.
The document discusses the history and evolution of somatic symptom and related disorders. It describes how concepts like hysteria, hypochondriasis, and psychosomatic disorders developed before being categorized under somatic symptom disorder, illness anxiety disorder, conversion disorder, and other diagnoses in DSM-5. It provides details on the characteristic symptoms, thresholds, and specifiers for each DSM-5 disorder category. Theories on the causes of related conditions like pseudocyesis are also summarized.
The document discusses global initiatives for adolescent mental health. It outlines key facts such as half of all mental health conditions starting by age 14 and depression being a leading cause of illness in 10-19 year olds. The WHO Director-General described a new action plan from 2013-2020 to address this long-neglected issue through strategies like promoting mental well-being during adolescence, a crucial period for social-emotional development. The plan also calls for changing stigma and expanding services.
One in five adolescents experience significant symptoms of emotional distress and nearly one in ten are emotionally impaired. The most common mental health disorders among adolescents include depression, anxiety disorders, attention-deficit/hyperactivity disorder, and substance use disorder. Depression is one of the most widely studied conditions, with over a quarter of adolescents affected by at least mild depressive symptoms. National data show that 36.7% of female and 20.4% of male high school students have experienced sadness or hopelessness that prevented usual activities for two or more weeks.
This document discusses mental health in primary care. It notes that half of all mental illnesses begin by age 14 but often go undetected and untreated. Mental disorders represent a significant proportion of health issues in primary care and have a high degree of co-morbidity with other non-communicable diseases. While mental disorders are treatable, the treatment gap remains large due to low detection rates and prioritization of these issues. The document advocates for integrating mental health services into primary care to improve accessibility, affordability, and acceptance of care for those suffering from mental health problems.
Mental health includes our emotional, psychological, and social well-being. I...AkashBhagatsingYadav
This document discusses mental health, including its definition by the World Health Organization, its history of treatment, characteristics of mentally healthy individuals, types of mental illnesses, causes of mental illness, and methods of prevention. It notes that historically, mentally ill individuals were considered possessed and locked away without treatment. Today, psychiatry takes a more scientific approach. The document also outlines some early warning signs of poor mental health and stresses the importance of upholding human rights for those with mental illness.
For each of the learning objectives, provide an analysis of how thShainaBoling829
For each of the learning objectives, provide an analysis of how the course supported each objective.
1. Discriminate among the mechanisms of action for the major classes of drugs/medications
2. Critique evidence that supports proposed pharmacotherapeutic protocols for appropriateness of application across the lifespan
3. Integrate the teaching-learning needs of clients across the lifespan when proposing pharmacotherapies
4. Propose prescriptive therapies for selected clients evaluating safety factors while utilizing knowledge of how current health status, age, gender, culture, genetic factors, ethical concerns and prescriptive authority impact decision making
Explain how the material learned in this course, based upon the objectives, will be applicable to professional application.
Provide evidence (citations and references) to support your statements and opinions.
All references and citations should in APA format.
14
Mental Health and Social Work
Shanae Hampton
Cal Baptist University
Introduction
How well a person is able to live a full life, build and maintain relationships and pursue their education, profession or other pursuits requires them to maintain their well-being ranging from physical to mental health. When assisting others to achieve good and self-motivated changes, social workers draw on their relationship-based abilities and emphasize personalization and rehabilitation. A key issue is, "What components and obstacles of an assessment are there in order to reach these outcomes?" When it comes to health promotion and public involvement, social workers are well-suited for this role since primary care is all about these things. Social workers who deal with mental health have unique challenges in assessment, which necessitates them learning and using psychiatric principles. Identifying the need for mental health care requires an understanding of assessment principles.
For this research, the focus is on urban youth's increase in mental health cases which is more influenced by lack of access to mental health care as a result of poverty that affects many children and families in the US. Young people are the most impacted by poverty, accounting for 33% of the total number of individuals in poverty. Children who live in "high risk neighborhoods" are more likely to lack access to the mental health supports they need to manage their symptoms. Stabilization, individual treatment, and symptom management are all important aspects of aftercare for children who have been hospitalized for behavioral difficulties by the time they are six years old (Hodgkinson, 2017).
Literature Review
Inequality based on race and class has been shown to be associated with a variety of negative health outcomes, including poor mental health. Increased financial disparity is associated with an increase in the prevalence of mental illness along a social gradient in mental health. However, psychiatric and psychological approaches have dominated ment ...
the importance of epidemiological studies, important historical research on mental health, techniques and processes, and epidemiological research findings on mental health during covid 19 are included.
This program is part of a comprehensive School Mental Health and High School Curriculum Guide.
Find out more about the guide by visiting:
teenmentalhealth.org
ADVANCED NURSING RESEARCH
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ADVANCED NURSING RESEARCH 2
Evidence Based Practice Grant Proposal
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Grant Proposal-Assessing the role of stigma towards mental health patients in help seeking
Study problem
There are several studies that have shown that stigmatization towards mental health patients have been present throughout history and even despite the evolution in modern medicine and advanced treatment. For example, Verhaeghe et al., (2014), captures in a publication in reference to a study that he conducted that stigmatization towards mental health patients has been there even as early is in the 18th Century. People were hesitant to interact with people termed or perceived to have mental health conditions.
Stigmatization has resulted from the belief that those with mental problem are aggressive and dangerous creating a social distance (Szeto et al., 2017). Also, mental health-related stigma has become of major concern as it creates crucial barriers to access treatment and quality care since it not only influences the behaviour of the patients but also the attitude of the providers hence impacting help-seeking. Timmermann, Uhrenfeldt and Birkelund (2014), have identified stigma as a barrier that is of significance to care or help seeking while the extent to which it still remains a barrier have not been reviewed deeply. Therefore, this study will assess the role contributed by stigma in help seeking in depth. 1. Purpose
The intention of the research study is to review the association between stigma, mental illness and help seeking in order to formulate ways in which the stigma that is around mental health is done away with to enable as many people suffering from mental health complications to seek medical help.2. Background
Mental health is crucial in every stage of life. It is defined as the state of psychological well-being whereby the individual realizes a satisfactory integration instinctual drive acceptable to both oneself and his or her social setting (Ritchie & Roser, 2018). The status of mental health influences physical health, relationships, and most importantly day-to-day life. Mental health problems arise when there is a disruption in mental well-being.
The risk factors to mental health problems are not limited and therefore everyone is entitled to the problem irrespective of gender, economic status, and ethnic group. For example, data shows that in America one out of five individuals experience mental health problems annually; with mental disorders being recognized as the leading cause of disability not only in the United States but also globally (Ritchie & Roser, 2018). Mental health disorders are seen to be complex and of many forms such as anxiety, mood, and schizophren.
This document provides an overview of community mental health. It discusses the magnitude of mental illness worldwide and classifications of disorders like psychoneurosis, psychosis, addictions and mental retardation. The etiology and risk factors of mental illness are explained. Prevention and control of mental illness involves primary prevention through reducing risks and promoting protective factors. Integration of mental health services into primary healthcare is discussed as being affordable and improving outcomes. The status of mental health facilities and services available in KSA is summarized.
ental health has been hidden behind a curtain of stigma and discrimination for too long. It is time to bring it out into
the open. The magnitude, suffering and burden in terms of disability and costs for individuals, families and societies
are staggering. In the last few years, the world has become more aware of this enormous burden and the potential
for mental health gains. We can make a difference using existing knowledge ready to be applied.
We need to enhance our investment in mental health substantially and we need to do it now.
This document provides information about a Mental Health and Office Administration course taught by Dr. George Boghozian. It includes his education background and teaching experience. The document then summarizes key topics from the course, including definitions of mental health, models of psychopathology, and strategies for promoting positive mental health. Mental health is defined as emotional well-being and the ability to cope with life's stresses. The document discusses biological, environmental, and social factors that influence mental illnesses and notes that many such illnesses can be effectively treated.
This document proposes an internship to develop an arts-based program to address mental health among college students at CUNY. It provides background on the need to address mental health through innovative approaches. A conceptual model is presented showing factors that contribute to student stress, including cultural, social, and environmental factors. The internship aims to create a curriculum using art to help alleviate stress. Short and long-term outcomes are outlined, showing how the program could benefit students' daily lives and provide evidence to support future mental health legislation. Careful evaluation of program activities and their ability to achieve outcomes is discussed. The goal is to explore how art can fit into traditional mental health interventions and expand knowledge in the field.
Health psychology;Definition, areas,Aims, Need & Significance|Aboutpsy.comAboutPsy
Definition of health psychology
Definition of Health
Areas of health psychology
Aims of health psychology
Need and significance of health psychology
Health psychology is devoted to understanding psychological influences on how people stay healthy, why they become ill, and how they respond when they do get ill.
Health psychologists both study such issues and develop interventions to help people stay well or recover from illness.
..........aboutpsy.com
ADVANCED NURSING RESEARCH
1
ADVANCED NURSING RESEARCH 2
Evidence Based Practice Grant Proposal
Table of Contents
31.Purpose
42.Background
5Research objectives
6Theoretical framework
63.EBP Model
74.Proposed Change
85.Outcomes
86.Evaluation Plan
97.Dissemination Plan
9Tools to be Used
9Peer review tools for the proposal
11Grant Request
11Proposed Tasks
11Task 1: Case study- Reviewing existing literature on stigma around mental health complications
11Task 2: Interviewing clinicians that have dealt with the study topic
12Task 3: Interviewing patients of mental health
12Schedule
13Budget
148.Appendices
14a.Informed Consent
19Certificate of Consent
19Signature or Date
21b.Literature Matrix
32c.Tools and equipment to be used
34References
Grant Proposal-Assessing the role of stigma towards mental health patients in help seeking
Study problem
There are several studies that have shown that stigmatization towards mental health patients have been present throughout history and even despite the evolution in modern medicine and advanced treatment. For example, Verhaeghe et al., (2014), captures in a publication in reference to a study that he conducted that stigmatization towards mental health patients has been there even as early is in the 18th Century. People were hesitant to interact with people termed or perceived to have mental health conditions.
Stigmatization has resulted from the belief that those with mental problem are aggressive and dangerous creating a social distance (Szeto et al., 2017). Also, mental health-related stigma has become of major concern as it creates crucial barriers to access treatment and quality care since it not only influences the behaviour of the patients but also the attitude of the providers hence impacting help-seeking. Timmermann, Uhrenfeldt and Birkelund (2014), have identified stigma as a barrier that is of significance to care or help seeking while the extent to which it still remains a barrier have not been reviewed deeply. Therefore, this study will assess the role contributed by stigma in help seeking in depth. 1. Purpose
The intention of the research study is to review the association between stigma, mental illness and help seeking in order to formulate ways in which the stigma that is around mental health is done away with to enable as many people suffering from mental health complications to seek medical help.2. Background
Mental health is crucial in every stage of life. It is defined as the state of psychological well-being whereby the individual realizes a satisfactory integration instinctual drive acceptable to both oneself and his or her social setting (Ritchie & Roser, 2018). The status of mental health influences physical health, relationships, and most importantly day-to-day life. Mental health problems arise when there is a ...
This document discusses mental health awareness in India. It provides statistics on the prevalence of mental illness in India and notes that mental health issues account for 14% of India's disease burden. The document outlines some of the major mental health disorders seen in India by gender and discusses causes of mental health problems like childhood trauma, social isolation, and physical health conditions. It proposes a roadmap for improving mental health awareness through six platforms and emphasizes the importance of recognizing signs of mental illness. The document also provides recommendations for maintaining good mental health through self-care practices.
1) The document discusses the results of an online survey conducted in India to examine the psychological impact of the COVID-19 lockdown on mental health. It found that over two-fifths of respondents reported increased anxiety and depression.
2) Health care workers reported slightly better mental well-being compared to non-health care workers. Higher stress, anxiety and depression correlated with longer lockdown duration.
3) About one-third of participants reported increased negative emotions like sadness, anxiety and irritability due to the lockdown, though most reported no change in these areas.
Snigdhaseminar 140209025729-phpapp02 (1)Anjana Sen
This document discusses psychosocial rehabilitation of psychiatric patients with a focus on family and community. It provides an overview of psychosocial rehabilitation, outlines its benefits, and discusses evidence that family-based and community-based interventions can improve outcomes. Numerous studies have shown psychosocial rehabilitation improves social functioning, employment, independent living, and decreases hospitalization and health costs when combined with medication and case management. Involving family in treatment also facilitates better illness management and outcomes.
psychosocial rehabilitation of psychiatric patientsSnigdha Samantray
The document discusses psychosocial rehabilitation of psychiatric patients with a focus on family and community. It begins with an introduction on what psychosocial rehabilitation is and how it differs from psychiatric treatment by focusing on improving role functioning rather than just symptom relief. It then discusses the need for psychosocial rehabilitation given the increasing prevalence of mental illness worldwide and high rates of disability. It provides an example case study of a patient named Simon who is in urgent need of psychosocial rehabilitation services to regain his confidence and skills. The document also reviews evidence that psychosocial rehabilitation can improve outcomes for patients, citing a long-term study finding much stronger community and work functioning in patients who received rehabilitation services compared to traditional care.
The document discusses the need for behavioral health services in Nueces County, Texas. It provides statistics on mental illnesses like bipolar disorder and major depressive disorder treated in the county. Suicide rates are also discussed both locally and nationally. The nursing implications are early detection, education on risk factors, and management of disorders. Nurses play a role in comprehensive assessment, advocacy, and linking patients to support services. Barriers to mental healthcare include stigma, lack of perceived need, and cost of treatment. Community education and support can help address these barriers.
Mental illness is a major health issue affecting 1 in 5 Canadians. It encompasses a variety of conditions that interrupt mood and behavior and can make daily life difficult. While mental illnesses have many contributing factors like stress, abuse, and poverty, there are also many myths surrounding mental illness. In reality, it can affect anyone regardless of age, gender, or background. Further efforts are needed to improve access to mental healthcare and increase awareness and education to combat the stigma around mental illness.
Similar to Social Determinants of Mental Health (1).pptx (20)
Breast cancer :Receptor (ER/PR/HER2 NEU) Discordance.pptxDr. Sumit KUMAR
Receptor Discordance in Breast Carcinoma During the Course of Life
Definition:
Receptor discordance refers to changes in the status of hormone receptors (estrogen receptor ERα, progesterone receptor PgR, and HER2) in breast cancer tumors over time or between primary and metastatic sites.
Causes:
Tumor Evolution:
Genetic and epigenetic changes during tumor progression can lead to alterations in receptor status.
Treatment Effects:
Therapies, especially endocrine and targeted therapies, can selectively pressure tumor cells, causing shifts in receptor expression.
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Therapeutic Resistance:
Loss of ERα or PgR can lead to resistance to endocrine therapies.
HER2 discordance affects the efficacy of HER2-targeted treatments.
Treatment Adjustment:
Regular reassessment of receptor status may be necessary to adjust treatment strategies appropriately.
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Receptor discordance is often associated with a poorer prognosis.
Biopsies:
Obtaining biopsies from metastatic sites is crucial for accurate receptor status assessment and effective treatment planning.
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Continuous monitoring of receptor status throughout the disease course can guide personalized therapy adjustments.
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Part III - Cumulative Grief: Learning how to honor the many losses that occur...bkling
Cumulative grief, also known as compounded grief, is grief that occurs more than once in a brief period of time. As a person with cancer, a caregiver or professional in this world, we are often met with confronting grief on a frequent basis. Learn about cumulative grief and ways to cope with it. We will also explore methods to heal from this challenging experience.
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Selective alpha1 blockers are Prazosin, Terazosin, Doxazosin, Tamsulosin and Silodosin majorly used to treat BPH, also hypertension, PTSD, Raynaud's phenomenon, CHF
Congestive Heart failure is caused by low cardiac output and high sympathetic discharge. Diuretics reduce preload, ACE inhibitors lower afterload, beta blockers reduce sympathetic activity, and digitalis has inotropic effects. Newer medications target vasodilation and myosin activation to improve heart efficiency while lowering energy requirements. Combination therapy, following an assessment of cardiac function and volume status, is the most effective strategy to heart failure care.
CLASSIFICATION OF H1 ANTIHISTAMINICS-
FIRST GENERATION ANTIHISTAMINICS-
1)HIGHLY SEDATIVE-DIPHENHYDRAMINE,DIMENHYDRINATE,PROMETHAZINE,HYDROXYZINE 2)MODERATELY SEDATIVE- PHENARIMINE,CYPROHEPTADINE, MECLIZINE,CINNARIZINE
3)MILD SEDATIVE-CHLORPHENIRAMINE,DEXCHLORPHENIRAMINE
TRIPROLIDINE,CLEMASTINE
SECOND GENERATION ANTIHISTAMINICS-FEXOFENADINE,
LORATADINE,DESLORATADINE,CETIRIZINE,LEVOCETIRIZINE,
AZELASTINE,MIZOLASTINE,EBASTINE,RUPATADINE. Mechanism of action of 2nd generation antihistaminics-
These drugs competitively antagonize actions of
histamine at the H1 receptors.
Pharmacological actions-
Antagonism of histamine-The H1 antagonists effectively block histamine induced bronchoconstriction, contraction of intestinal and other smooth muscle and triple response especially wheal, flare and itch. Constriction of larger blood vessel by histamine is also antagonized.
2) Antiallergic actions-Many manifestations of immediate hypersensitivity (type I reactions)are suppressed. Urticaria, itching and angioedema are well controlled.3) CNS action-The older antihistamines produce variable degree of CNS depression.But in case of 2nd gen antihistaminics there is less CNS depressant property as these cross BBB to significantly lesser extent.
4) Anticholinergic action- many H1 blockers
in addition antagonize muscarinic actions of ACh. BUT IN 2ND gen histaminics there is Higher H1 selectivitiy : no anticholinergic side effects
Applications of NMR in Protein Structure Prediction.pptxAnagha R Anil
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Phosphorus, is intensely sensitive to ‘other worlds’ and lacks the personal boundaries at every level. A Phosphorus personality is susceptible to all external impressions; light, sound, odour, touch, electrical changes, etc. Just like a match, he is easily excitable, anxious, fears being alone at twilight, ghosts, about future. Desires sympathy and has the tendency to kiss everyone who comes near him. An insane person with the exaggerated idea of one’s own importance.
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Skin is the largest organ of the human body, serving crucial functions that include protection, sensation, regulation, and synthesis. Structurally, it consists of three main layers: the epidermis, dermis, and hypodermis (subcutaneous layer).
1. **Epidermis**: The outermost layer primarily composed of epithelial cells called keratinocytes. It provides a protective barrier against environmental factors, pathogens, and UV radiation.
2. **Dermis**: Located beneath the epidermis, the dermis contains connective tissue, blood vessels, hair follicles, and sweat glands. It plays a vital role in supporting and nourishing the epidermis, regulating body temperature, and housing sensory receptors for touch, pressure, temperature, and pain.
3. **Hypodermis**: Also known as the subcutaneous layer, it consists of fat and connective tissue that anchors the skin to underlying structures like muscles and bones. It provides insulation, cushioning, and energy storage.
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**Causes:**
1. **Excess Oil Production:** Hormonal changes during adolescence or certain times in adulthood can increase sebum (oil) production, leading to clogged pores.
2. **Clogged Pores:** When dead skin cells and oil block hair follicles, bacteria (usually Propionibacterium acnes) can thrive, causing inflammation and acne lesions.
3. **Hormonal Factors:** Fluctuations in hormone levels, such as during puberty, menstrual cycles, pregnancy, or certain medical conditions, can contribute to acne.
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**Types of Acne:**
- **Whiteheads:** Closed plugged pores.
- **Blackheads:** Open plugged pores with a dark surface.
- **Papules:** Small red, tender bumps.
- **Pustules:** Pimples with pus at their tips.
- **Nodules:** Large, solid, painful lumps beneath the surface.
- **Cysts:** Painful, pus-filled lumps beneath the surface that can cause scarring.
**Treatment:**
Treatment depends on the severity and type of acne but may include:
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- **Oral Medications:** Antibiotics or oral contraceptives for hormonal acne.
- **Procedures:** Such as chemical peels, extraction of comedones, or light therapy for more severe cases.
**Prevention and Management:**
- **Cleanse:** Regularly wash skin with a gentle cleanser.
- **Moisturize:** Use non-comedogenic moisturizers to keep skin hydrated without clogging pores.
- **Avoid Irritants:** Such as harsh cosmetics or excessive scrubbing.
- **Sun Protection:** Use sunscreen to prevent exacerbation of acne scars and inflammation.
Acne treatment can take time, and consistency in skincare routines and treatments is crucial. Consulting a dermatologist can help tailor a treatment plan that suits individual needs and reduces the risk of scarring or long-term skin damage.
2. PRESENTATION OUTLINE
General overview of paper
Background and context
Methods
Main findings and discussion
Principles and actions
Conclusion
Key Messages
3. Co-produced by the World Health Organization and the Calouste
Gulbenkian Foundation’s Global Mental Health Platform, 2014
This publication is part of a broader series of thematic papers.
The series consists of four publications.
4. All thematic papers were produced under the overall guidance
of the Gulbenkian Global Mental Health Platform’s
Advisory and Steering Committees
Advisory Committee: Paulo Ernani Gadelha Vieira (Fiocruz, Brazil); Marian
Jacobs (University of Cape Town, South Africa); Arthur Kleinman (Harvard
University, USA); Sir Michael Marmot (University College London, United
Kingdom); Mirta Roses Periago (Former Director, Pan American Health
Organization); P. Satishchandra (National Institute of Mental Health &
Neurosciences (NIMHANS), India); Tazeen H. Jafar (The Aga Khan University,
Pakistan); and Observer to the Advisory Committee, Shekhar Saxena (WHO
Department of Mental Health and Substance Abuse).
Steering Committee: Benedetto Saraceno (NOVA University of Lisbon,
Portugal; Head and Scientific Coordinator of the Platform), José Miguel Caldas
de Almeida (NOVA University of Lisbon, Portugal), Sérgio Gulbenkian (Calouste
Gulbenkian Foundation), Jorge Soares (Calouste Gulbenkian Foundation)
5. This paper was written by
Team from UCL Institute of Health Equity comprising Jessica
Allen, Reuben Balfour, Ruth Bell, and Michael Marmot.
In collaboration with staff members of the WHO’s Department of
Mental Health and Substance Abuse: Dan Chisholm and
Shekhar Saxena, and with advice from an international panel of
experts: Margaret Barry, Thomas Bornemann, Jonathan Campion,
Somnath Chatterji, Lynne Friedli, Crick Lund, Atif Rahman,
Eugenio Villar, who generously contributed their wisdom.
6. This paper, Social determinants of mental health, enhance
our knowledge about the many interacting forces that
between them shape individual and collective levels of
mental health and well-being, and set out actions that can
be pursued to promote and protect good mental health.
The paper provides a framework that employs a life course
approach for assessing the social determinants of mental
health.
Taking a life-course perspective usefully demonstrates,
how risk exposures in the formative stages of life can
affect mental well-being or predispose towards mental
disorder many years or even decades later.
WHY IS THIS PAPER IMPORTANT?
7. This paper points out a prominent message that actions and
public policies to address existing health inequalities need to
be universal and inclusive, yet proportionate to need.
A further clear message is that since risk and protective
factors for mental health act at several different levels,
responses to them need to be multi-layered and multi-sectoral.
Health, education, welfare, transport, and housing sectors all
need to be concerned and involved, and contribute to a ‘health
in all policies’ approach.
CONT..
8. BACKGROUND AND CONTEXT
Considerable and growing evidence shows that mental health
and many common mental disorders are shaped to a great
extent by social, economic and environmental factors.
A review of global evidence by Vikram Patel and colleagues
for the WHO Commission on Social Determinants of Health
reported convincing evidence that:
low socioeconomic position is systematically associated with
increased rates of depression.
Gender is also important- mental disorders are more common in
women, they frequently experience social, economic and
environmental factors in different ways to men.
9. CONT…
Taking action in order to improve the conditions of daily
life from before birth, during early childhood, at school age,
during family building and working ages, and at older ages
provides opportunities both to improve population mental
health and reduce the risk of those mental disorders that
are associated with social inequalities.
While comprehensive action across the life course is needed,
scientific consensus is considerable that giving every child
with the best possible start will generate the greatest
societal and mental health benefits.
10. CONT…
The prevalence and social distribution of mental disorders has
been reasonably well documented in high-income countries.
While there is growing recognition of the problem in low- and
middle-income countries, a significant gap still exists in
research to measure and describe the problem, and in
strategies, policies and programs to prevent mental disorders.
There is a considerable need to raise the political, and
strategic priority given to the prevention of mental disorders
and to the promotion of mental health through action on the
social determinants of health.
11. MAJOR CONCEPTS AND DEFINITIONS
MENTAL HEALTH
The World Health Organization defines mental health as “a state
of well-being in which every individual realizes his or her own
potential, can cope with the normal stresses of life, can work
productively and fruitfully, and is able to make a contribution
to her or his community”
In this, the absence of mental disorder does not necessarily
mean the presence of good mental health.
Looked at in another way, people living with mental disorder
can also achieve good levels of well being – living a satisfying,
meaningful, contributing life within the constraints of painful,
distressing, or debilitating symptoms.
12. MENTAL DISORDER
Mental disorders include anxiety, depression, schizophrenia,
and alcohol and drug dependency.
Common mental disorders can result from stressful experiences,
but also occur in the absence of such experiences; stressful
experiences do not always lead to mental disorders.
Many people experience sub-threshold mental disorders,
which means poor mental health that does not reach the
threshold for diagnosis as a mental disorder. Mental disorders
and sub-threshold mental disorders affect a large proportion of
populations.
13. CONT…
Mental illness, refers to depression and anxiety (also referred
to as common mental disorders) as well as schizophrenia
and bipolar disorder (also referred to as severe mental illness).
In countries around the world, a shift of emphasis is needed
towards preventing common mental disorders such as anxiety
and depression by action on the social determinants of health,
as well as improving treatment of existing conditions.
Action is needed as many of the causes and triggers of mental
disorder lie in social, economic, and political spheres – in the
conditions of daily life.
14. METHODS
Building on analyses completed by the WHO Commission of Social
Determinants of Health, the Marmot Review in England, the WHO
Review of Social Determinants of Health and the Health Divide, as
well as pioneering WHO reports on mental health promotion and
prevention of mental health and a number of recent, well-
researched resources by experts in mental health, researchers at
the Institute of Health Equity examined two key issues:
1) the social determinants of common mental disorders; and
2) action on social determinants that can prevent mental health disorders and/or
improve population mental health.
The work was undertaken in collaboration with staff members of the
WHO’s Department of Mental Health and Substance Abuse and
with advice from an international panel of experts.
15. MAIN FINDINGS AND DISCUSSION
SOCIAL DETERMINANTS, SOCIAL
INEQUALITIES, AND COMMON MENTAL
DISORDERS
Tackling societal determinants of common mental disorders
and sub-threshold common mental disorders is the major
focus of this paper.
Comprehensive strategies at the population level to address
these societal determinants are likely to improve mental health
in the population and reduce inequities, because such
strategies focus on improving the conditions in which people
are born, grow live, work, and age.
16. Systematic inequalities between social groups that are judged
to be avoidable are inequitable and unfair, so systematic
differences in mental health by gender, age, ethnicity, income,
education, or geographic area of residence are inequitable and
can be reduced by action on the social determinants.
A systematic review of the epidemiological literature on
common mental disorders and poverty in lowand middle-
income countries found that of the 115 studies reviewed over
70% reported positive associations between a variety of
poverty measures and common mental disorders
17. The association between low income and mental disorders is
accounted for by debt
Surveys in European countries found that higher frequencies
of common mental disorders (depression and anxiety) are
associated with low educational attainment, material
disadvantage and unemployment, and for older people, social
isolation.
A two-way relationship exists between mental disorders and
socioeconomic status.
A review of population surveys in European countries found
that higher frequencies of common mental disorders
(depression and anxiety) are associated with low educational
attainment, material disadvantage and unemployment, and for
older people, social isolation.
18. Results from the Eurobarometer survey in 2002 showed
significant variation in population mental health between
countries, and between men and women within countries20.
Poorer mental health was found in women, poorer groups, and
among those who reported weak social support
Patterns of inequity in social distribution emerge before
adulthood. A systematic review of the literature found that the
prevalence of depressed mood or anxiety was 2.5 times higher
among young people aged 10 to 15 years with low
socioeconomic status than among youths with high
socioeconomic status21
19. PREVALENCE OF ANY COMMON MENTAL DISORDER BY
HOUSEHOLD INCOME, ENGLAND 2007
Key: Pale bars: women; dark bars: men.
20. Those lower on the social hierarchy are more likely to
experience less favourable economic, social, and
environmental conditions throughout life and have access to
fewer buffers and supports.
These disadvantages start before birth and tend to accumulate
throughout life, although not all individuals with similar
exposures have the same vulnerabilities; some are more
resilient or have access to buffers and supports to mitigate the
potential mental health effects of disadvantage and poverty.
Multilevel framework for understanding social determinants of
mental disorders can be applied to strategies and interventions
to reduce mental disorders and promote mental well being.
21. LIFE COURSE
Life-course: Prenatal, Pregnancy and perinatal periods, early
childhood, adolescence, working and family building years,
older ages all related also to gender;
Parents, families, and households: parenting
behaviors/attitudes; material conditions (income, access to
resources, food/nutrition, water, sanitation, housing,
employment), employment conditions and unemployment,
parental physical and mental health, pregnancy and maternal
care, social support;
Community: neighborhood trust and safety, community based
participation, violence/crime, attributes of the natural and built
environment, neighborhood deprivation;
22. Local services: early years care and education provision,
schools, youth/adolescent services, health care, social
services, clean water and sanitation;
Country level factors: poverty reduction, inequality,
discrimination, governance, human rights, armed conflict,
national policies to promote access to education, employment,
health care, housing and services proportionate to need, social
protection policies that are universal and proportionate to
need.
23.
24. The experience and impact of social determinants varies
across life, and influence people at different ages, gender and
stages of life in particular ways.
The Commission on the Social Determinants of Health,
Marmot Review, WHO European Review, and others
emphasize the need for a life-course approach to
understanding and tackling mental and physical health
inequalities that accounts for the differential experience and
impact of social determinants throughout life
25. Strong evidence shows that many mental and physical health
conditions emerge in later life but originate in early life
Early childhood affect biological stress regulatory systems,
neural mechanisms by which stress responses are regulated
in the brain, and the expression of genes related to stress
responses.
The effects of stressors on these systems are buffered by
social support provided by loving, responsive and stable
relationships with a caring adult. Such relationships build
secure attachment between child and caregiver, which is
essential for healthy social and emotional development
Stress-related behavioural responses include alcohol and drug
abuse, which are classified as mental disorders when then
lead to alcohol or drug dependency.
26. PRE-NATAL EXPERIENCE AND MENTAL HEALTH
The prenatal period has a significant impact on physical, mental,
and cognitive outcomes in early life and throughout life.
A mother’s maternal health is particularly important and poor
environmental conditions, poor health and nutrition, smoking,
alcohol and drug misuse, stress, and highly demanding physical
labour can all have a negative effect on the development of the
foetus and later life outcomes
A systematic review and meta-analysis of 17 studies on maternal
depression or depressive symptoms and early childhood growth
in developing countries showed that children of depressed
mothers were a greater risk of being underweight and stunted,
low birth weight is itself an increased risk factor for depression in
later life32. Analysis of data from four longitudinal studies showed
that among children of depressed mothers the risk of underweight
and stunting was approximately doubled
27. THE EARLY YEARS
Family conditions and quality of parenting have a significant
impact on risk of mental and physical health.
lack of secure attachment, neglect, lack of quality stimulation,
and conflict, negatively impact on future social behavior,
educational outcomes, employment status and mental and
physical health”.
Children’s exposure to neglect, direct physical and
psychological abuse, and growing up in families with domestic
violence was particularly damaging
28. ACTIONS TO SUPPORT MENTAL HEALTH IN THE EARLY
YEARS
A systematic review of interventions to address common
perinatal mental disorders (CPMDs) in low- and middle-
income countries found that with the correct training and
supervision of primary and community health-care workers,
while ensuring that interventions were culturally adjusted,
interventions implemented within this setting can improve the
mental health of mothers.
The Triple P-Positive Parenting Program is a behavioral family
intervention that aims to improve child behavior and
development by altering the family environment to one that
enables the child to realize its potential; thus, increasing the
child’s life chances and reducing the risks associated with poor
mental health.
29. The Mother2Mothers programme is an early years intervention
implemented in the Kwa-Zulu-Natal region of South Africa that
helps communities develop peer support groups to provide
education and psychosocial support to pregnant women and
new mothers with HIV/ AIDS, particularly with support in
accessing existing health-care services.
30. LATER CHILDHOOD
While the early years of brain development are highly
significant for later life outcomes, continued and appropriate
forms of support are needed throughout childhood and
adolescence.
Education is important in building emotional resilience and
affecting a range of later life outcomes that raise the risks of
mental disorders – such as employment, income, and
community participation
As children grow into adolescents, they become more
interested in taking risks, including substance misuse.
31. It is important to ensure that adolescents have the knowledge
to make informed decisions, and that they have protective
factors including social and emotional support and positive
interactions with peers, family, and the wider community.
Depressive symptoms among adolescents are associated with
their history of adverse childhood experiences as well as their
current experiences
32. ACTIONS TO SUPPORT MENTAL HEALTH AMONG CHILDREN
AND ADOLESCENTS
The Social and Emotional Learning program, implemented in a
number of States across the USA, is a good example of a
school-based intervention. The program promotes supportive
relationships that make learning challenging, engaging, and
meaningful, developing children’s social and emotional skills;
in order to reduce risky behaviors
33. WORKING AGE
The Global Burden of Disease project indicates there are
significant and increasing levels of mental disorders among
the global adult population. Among women, major depression
is the leading cause of years lived with disability, while anxiety
ranks 6th in this list
In England, one in four people experience a mental disorder
during their lifetime and 17.6% of adults experience at least
one common mental disorder. Seventeen percent of adults
have a subthreshold common mental disorder, while 5% of
adults experience subthreshold psychosis and 24% of adults
drink more than the safe upper limit of alcohol
34. POLICIES TO REDUCE ALCOHOL CONSUMPTION
There has been growing political debate and policy movement in a
number of countries, including England, Australia, Malawi, Zambia
and Scotland, that has focused on measures to reduce the
consumption of alcohol
35. As previous sections have described, adult mental disorders
have impacts beyond the individuals concerned: they also
influence children, partners and wider family, communities,
economic development, and subsequent generations.
Unemployment and poor quality employment are particularly
strong risk factors for mental disorders and are a particularly
significant cause of inequalities in mental disorders, as risk of
unemployment and poor quality employment closely relates to
social class and skill levels.
Poor quality employment, such as employment with no or
short-term contracts, and jobs with low reward and control at
work, have significant harmful impacts on mental health.
36. ACTIONS TO SUPPORT MENTAL HEALTH AMONG ADULTS
Microfinance program help the poorest earn a living, improve their
businesses and provide a means for entire communities to work their
way out of poverty.
37. FAMILY BUILDING
Family building and parenting influences children’s mental and
physical health and a range of other outcomes throughout their
lives; in addition adult mental health can be profoundly
affected during family building.
Good, accessible maternal services, information and advice
about parenting strategies, and helping manage transitions to
parenthood are protective of adult and child mental health24.
Support should be maintained throughout childhood and into
adolescence. In addition, support must be appropriate to
parental circumstances and to that of the child’s
developmental stage
38. The Sure Start initiative in England is a good example of a
scaled-up approach to early years intervention. Implemented
by the government, the initiative seeks to engage with parents,
pregnant mothers, infants and pre-school age children to
reduce the rates of low birth weight, cognitive delay and
promote child development, as well as work with parents and
families to improve relationships, child attachment and reduce
social disadvantage while ensuring that these services are
available and easily accessible to the most disadvantaged and
deprived
39. OLDER PEOPLE
Older people’s mental health relates both to earlier life
experiences and also to particular experiences, conditions,
and contexts specific to ageing and the post-retirement period.
Experiences of mental and physical health differ throughout
the older age period. Evidence from England, for example,
shows risks of depression increasing markedly beyond 80
years of age.
Some evidence from analysis of studies across Europe shows
that for men, depressive mood relates to chronic ill-health and
somewhat to exercise; for women, the differences are more
closely related to social factors, such as levels of isolation,
contact with family, and belonging to faith or other community
groups100. Many studies show worse outcomes for older
women than men across a range of mental disorders
40. The Scandinavian countries seem to have lowest levels,
followed by Western European countries, while older people in
Italy, Greece and Spain have the highest levels of mental
disorders
41. ACTIONS TO SUPPORT MENTAL HEALTH AMONG OLDER
PEOPLE
The Upstream Healthy Living Centre, based in England, was
introduced as an innovative approach to identifying and engaging
with older people in rural areas who may experience significant
isolation.
The Centre uses mentors to deliver specially-tailored activities and
support, to improve social networks and get people involved in
creative activities. An evaluation indicated that participants benefited
from attending the centre, reporting improved psychological well-
being and reduced depression
42. INTERGENERATIONAL TRANSFER OF
DISADVANTAGE
Social and economic inequities, perpetuated across
generations, result in the entrenchment of mental health
inequities over time. Taking a social determinants approach
across the life-course means also addressing the
intergenerational transfer of inequity.
The concept of intergenerational transfer of risk, which has
been developed and developed by climate change mitigation
approaches, has relevance to analysis of transmission of
social and economic factors between generations and in
developing policy responses to tackling these
Intergenerational transfers of inequity occur directly, for
instance, prenatally and throughout life from parents to
children, as discussed above. Intergenerational transfers of
inequity are also at community level and nationally.
43. COMMUNITY LEVEL CONTEXT
Provides a platform to develop and improve social norms, values and
practices, while encouraging community empowerment and
participation.
Central to a number of community-based approaches is the
realization that change within a community is best achieved through
engaging people of the community.
This change is brought about by efforts to improve key determinants
of mental health, including a social inclusive community, freedom
from discrimination and violence, and access to economic resources
44. The Basic Needs Mental Health and Development
programme is one example of an intervention in Ghana where
no psychiatric facilities exist.
Comprehensive Rural Health Project (CRHP) in Maharastra,
India
45. ACTIONS IN PRIMARY CARE
“essential health care made universally accessible to
individuals and families in the community by means
acceptable to them, through their full participation and at a
cost the community and country can afford”
important role in addressing mental health needs and
promoting positive mental health
In majority of countries, it is the first point of contact between
the people and health care services, helping to achieve early
identification of mental disorders and prevent future episodes,
but also promoting good mental health through direct provision
and referrals to other more specialized services
46. MENTAL HEALTH GAP ACTION PROGRAM (MHGAP)
Introduced by WHO in 2008 in response to the wide gap
between the resources available and the resources urgently
needed to address the large burden of mental, neurological,
and substance use disorders globally
Aims to provide policy-makers, health planners, and other
stakeholders with clear guidance on how to scale up mental
health care
47. ACTIONS IN HUMANITARIAN SETTINGS
People who experience humanitarian crises or an emergency
situation, such as war, armed conflict, and natural or industrial
disasters, are likely to be at risk of developing mental disorders.
It also affect communities and social institutions, which can lead to
the breakdown of families, social networks, and community bonds
– exacerbating the negative impact of the situation
In Rwanda, socio-therapeutic technique is applied after high level
of violence and conflict during the 1994 genocide.
Socio-therapeutic technique uses interactions between individuals
and their social environment to facilitate the re-establishment of
values, norms, and relationships, as well as facilitating potential
collaborations.
48. ACTIONS TARGETING THE NATURAL AND BUILT
ENVIRONMENT
The built environment is important for both mental and physical
health and can often reduce the risks associated with
communicable diseases, mental disorders, and poor mental
health
A systematic review of slum upgrading programs in low and
middle-income countries showed that a number of interventions
can positively influence mental (and physical) health by reducing
risks of stressors, injury and transmission of disease.
49. Access to the natural environment and outdoor spaces is also
vitally important for good mental health.
Living close to natural environments and engaging in outdoor
activities such as walking, running, cycling, horse riding, and
gardening have known benefits for mental health.
50. COUNTRY LEVEL CONTEXTS: SOCIOECONOMIC
AND POLITICAL CONTEXTS
The historical context of a country—the current political, social,
economic, and environmental situation and the cultural and
social norms operating within society—shape the conditions in
which people live.
The effect of political, social, and economic turbulence on
mental and physical health has been powerfully demonstrated
by the decline and subsequent fluctuations in life expectancy
in the Russian Federation after the collapse of the Soviet
Union
51. Analysis of psychological distress in eight countries of the
former Soviet Union found variations between countries,
higher levels of psychological distress among women than
men, and associations with social and economic factors
including poverty, unemployment, low education, disability,
lack of trust in people, and lack of personal support.
52. Depression was largely influenced by current adult
socioeconomic circumstances rather than by education, with
effects stronger in Poland and the Russian Federation than in
the Czech Republic
Countries policies and program to address income inequality,
health, education, employment, housing, participating in society
etc. issues have considerable potential to impact health and its
determinants
53. While mental health was not mentioned in the Millennium
Development Goals (MDGs)
Progress against these goals, including reducing poverty,
hunger, and under-five mortality, increasing access to safe
drinking water, and prevention and treatment services for
HIV/AIDS, malaria and tuberculosis, contributes powerfully to
mental health promotion.
54. The Movement for Global Mental Health aim to improve services for
people with mental disorders, calls for three elements to be included
in the post 2015 agenda. These are:
1. Promote protection of human rights and prevent discrimination
against people with mental illness and psychosocial disability
2. Bridge the massive mental health treatment gap and improve
access to health and social care
3. Explicitly integrate attention to mental health into development
initiatives
55. POLICY ACTION ON THE SOCIAL DETERMINANTS OF MENTAL
HEALTH
Australian government aimed to build upon an existing framework
and not only strive to improve direct mental health services through
the reform, development and implementation of dedicated mental
health policies and action plans, but also considered the wider policy
environment, including housing, education, employment, ageing,
chronic disease, and cultural and ethnic diversity.
57. PRINCIPLES AND ACTIONS
Actions taken to reduce inequalities in mental health
will be of great benefit to countries, societies, and
the global population as a whole, through reducing
the economic, social, and human costs of mental
disorders.
58. PRINCIPLES AND ACTIONS
1. Proportionate universalism
2. Action across sectors
3. Life-course approach
4. Early intervention
5. Healthy mind and healthy body
6. Prioritizing mental health
7. Avoiding short-termism
8. Mental health equity in all policies
9. Knowledge for action at the local level
10. Country-wide strategies
60. 1. PROPORTIONATE UNIVERSALISM
A key principle to be taken.
Most program Focusing on vulnerable and
disadvantaged people
Inequalities in physical and mental health exist along
a social class gradient, targeted services will likely
miss most of these inequalities and creates unfair
‘cutoffs’ which exclude people experiencing
inequities.
The concept of proportionate universalism is a way of
overcoming the limitations of targeted programmes
62. 2. ACTION ACROSS SECTORS
The risk and protective factors associated with mental
health depends on health, education, welfare,
Offices, transport, and housing sectors.
Working in partnership with both health organizations
and agencies
Health equity in all policy - (HiAP) approaches may
be helpful in facilitating collaborative work across
different sectors.
63. CONT….
This will best be achieved by intelligent and appropriate
information sharing, joint planning, strategic design and
support.
It will require the participation and cooperation of
international organizations, governments, nongovernmental
organizations, social institutions and service providers,
community and voluntary groups, as well as the private
sector
65. 3. LIFE-COURSE APPROACH
Taking a life-course perspective implies the recognition that mental health
at each stage of life is influenced by both unique and common factors at
different stages of life.
Appropriate prevention interventions and strategies must be appropriate
to different stages of life.
In many organizations where people are involved in at different stages of
life are the most appropriate to deliver appropriate interventions – early
year settings, schools, employers for instance.
66.
67. 4. EARLY INTERVENTION
As part of the life-course approach, it is particularly important that
every child gets the best possible start in life.
In low- and middle-income countries intervene at the earliest
stages of life can mental disorders and enable infants, children,
and adolescents to maximize their potential, increasing their
chances of a mentally healthy adulthood.
Early intervention disrupting intergenerational transmission of
inequity by trying to break the associations between parental and
child status.
69. 5.HEALTHY MIND AND HEALTHY BODY
Physical and mental health indicates that poor physical health can cause
mental disorders, and vice versa.
Reducing inequalities in mental health cannot be achieved without
reducing inequalities in physical health.
SDoH approach should consider both mental and physical health
implications within all actions to tackle health inequalities
5.HEALTHY MIND AND HEALTHY
BODY
71. 6. PRIORITIZING MENTAL HEALTH
Priority on mental health needs to be raised in low- and middle-
income countries, where the issue is often poorly understood
and/or not recognized as major health concern.
Increased awareness and understanding helps to increased
allocations of financial, medical, and human resources towards
tackling mental disorders and reducing inequalities.
73. 7. AVOIDING SHORT-TERMISM
Progress in policy making is often obstructed by short-term thinking
Require long-term and sustained policies that focus on reducing
inequalities in health through community development, capacity
building, partnerships, and local institution building across the life-
course.
Policy makers give more consideration to the duration of policies and
their long term implications, with a focus on ensuring sustainability of
action.
74. 8. MENTAL HEALTH EQUITY IN ALL POLICIES
Reducing inequalities in mental health is a task that must be taken on
by the whole of government and across all sectors.
All policies across all sectors ensure that their programmes and
strategies will not harm, and potentially reduce mental health
inequities.
76. 9. KNOWLEDGE FOR ACTION AT THE
LOCAL LEVEL
To implement action to prevent and ameliorate mental disorders at the
local level, it is necessary to build systems and processes to provide
information on
Information about social, economic and environmental stressors.
Knowledge on local assets and resources, which factors contribute
psychological distress;
Access to effective therapeutic treatment, and on the unmet need for
therapy.
Assessments of all local development initiatives with respect to their
potential impact on mental health equity .
77. 10. COUNTRY-WIDE STRATEGIES
Country- level strategies on reducing mental health inequalities
Alleviation of poverty and effective social protection across the life-course,
Reduction of inequalities and discrimination,
Prevention of war and violent conflict
Promoting access to employment,
Health care
Housing and education can have positive benefits for mental health
78. Particular emphasis should be given to policies which relate to:
- The treatment of maternal depression
- Early childhood development
- Targeting families who contain people with mental disorders in poverty
alleviation programmes
- Social welfare for the unemployed
- Alcohol policies
79. CONCLUSION
Good mental health is integral to human health and well being. A
person’s mental health and many common mental disorders are
shaped by social, economic, and physical environments.
Risk factors for many common mental disorders are heavily
associated with social inequalities, whereby the greater the
inequality the higher the inequality in risk.
As mental disorders affect physical health these actions would also
reduce inequalities in physical health and improve health overall.
Taking a life-course perspective recognizes that the influences that
operate at each stage of life can affect mental health.
80. Risk and protective factors act at several different levels, including
the individual, the family, the community, the structural, and the
population levels.
A social determinants of health approach requires action across
multiple sectors and levels.
The evidence is convincing that policy making at all levels of
governance and across sectors can make a positive difference to
mental health outcomes
Empowerment of individuals and communities is at the heart of
action on the social determinants.
Intention of this paper will stimulate further research and urgent
action in all countries, worldwide.
81. KEY MESSAGE
Mental health and many common mental disorders are shaped
to a great extent by the social, economic, and physical
environments in which people live.
Social inequalities are associated with increased risk of many
common mental disorders.
Taking action to improve the conditions of daily life from before
birth, during early childhood, at school age, during family
building and working ages, and at older ages provides
opportunities both to improve population mental health and to
reduce the risk of those mental disorders that are associated
with social inequalities.
82. While comprehensive action across the life course is needed,
scientific consensus is considerable that giving every child the
best possible start will generate the greatest societal and
mental health benefits.
Action needs to be universal: across the whole of society, and
proportionate to need in order to level the social gradient in
health outcomes.
This paper highlights effective actions to reduce risk of mental
disorders throughout the life course, at the community level
and at the country level. It includes environmental, structural,
and local interventions. Such actions to prevent mental
disorders are likely to promote mental health in the population.
83. REFERENCE
World Health Organization and Calouste Gulbenkian
Foundation. Social determinants of mental health. Geneva,
World Health Organization, 2014.
Editor's Notes
Specific interventions include water and sanitation improvements, energy infrastructure upgrade, building new transport infrastructure, mitigating environmental hazards, better waste management systems and improved housing.