Mental Health: Basic Concepts

• Chapter 1 introduces the basic concepts of mental health
• The chapter covers the concept of health, mental health, mental illness, and their interrelations
• Explores the history, significance, perspectives, criteria, and models of mental illness

Definition of Health

• Per World Health Organization (WHO), health is a state of complete physical, mental, and social well-being.
• Health is defined as not merely the absence of disease or infirmity.
• Mental health involves realizing one's potential, coping with normal stresses, working productively, and contributing to the community

Mental Illness

• Mental illness can be viewed sociologically as a deviation from socially approved interpersonal standards or an inability to perform sanctioned social roles
• In social science, mental illness refers to dysfunctional interpersonal behavior judged against societal norms per the International Encyclopedia of Psychiatry, Psychology, Psychoanalysis & Neurology in 1992
• Mental illness includes psychological or behavioral manifestations causing impaired functioning due to social, psychological, genetic, physical, or biological disturbances per the American Psychiatric Association
• A mentally ill person requires treatment for a mental disorder other than mental retardation, according to the Indian Mental Health Act of 1987

Mental Health, Mental Ill-Health and Mental Illness

• The relationship between health and illness is often viewed as a continuum
• Mental health and mental illness are seen as opposite ends of the same spectrum

History

• In the mid-19th century, William Sweetzer defined "mental hygiene" as a precursor to promoting positive mental health.
• Dorothea Dix (1802–1887), a schoolteacher, advocated for those with mental illness and against deplorable conditions.
• Dix's work was known as the "mental hygiene movement".
• At the beginning of the 20th century, Clifford Beers founded the National Committee for Mental Hygiene
• Beers opened the first outpatient mental health clinic in the USA.

Significance

• Evidence suggests that nearly half the world's population is affected by mental illness, impacting self-esteem, relationships, and daily functioning
• Emotional abilities are associated with prosocial behaviors, such as stress management and physical health, according to Richards, Campania, & Muse-Burke (2010)
• Maintaining good mental health is crucial for living a long and healthy life

Perspectives

• Sense of Responsibility
• Sense of Self-reliance
• Sense of Direction
• A Set of Personal Values
• Sense of Individuality
• Mental Well-Being
• Lack of a mental disorder
• Cultural and religious considerations

Characteristics of a Healthy Individual (Maria's Jahoda Proposal, 1963)

• Environmental mastery
• Undistorted perception of reality
• Integration
• Autonomy
• Growth, self-development, and self-actualization
• Attitude towards Self

Models of Mental Illness

• Theories include biological, psychological, and social models.
• Examples of models include the biomedical model, cognitive-behavioral theory, and the diathesis-stress model.
• These models explore how genetics, brain chemistry, thought patterns, and environmental factors contribute to mental health conditions.

Specific Models of Mental Illness

• Spiritual Model
• Moral Character Model
• Statistical Model
• Medical Model (Genetics, Neuroimaging, Neurobiology)
• Psychological Models (Psychodynamic, Behavioral, Cognitive-Behavioral, Humanistic/Existential)
• Social Model
• Psychosocial Model (Social Learning Model)
• Family Therapy Model
• Biopsychosocial Model

Spiritual Model

• The first and oldest system, explains mental illness spiritually.
• Consciousness stems from connection to a supernatural force.
• Religious narratives explain good and bad forces, where suffering results from possession by the bad or loss of favor with the good.
• This often involves sin or immoral behavior leading to badness or contamination

Moral Character Model

• The second explanatory system for mental illness is based on moral character.
• Virtues like courage, fortitude, honesty, integrity, compassion, and grace enable an admirable life.

Statistical Model

• Mathematics-based model focuses on defining abnormality.
• Abnormality is defined as any substantial deviation from a statistically calculated average.
• Those who fall within the "Golden Mean" are normal, while those who deviate from the majority are abnormal.

Medical Model

• Attributes mental abnormalities to physiological, biochemical, or genetic causes.
• Treatments include psychopharmacology (drug therapy), electroconvulsive therapy (ECT), or psychosurgery (brain surgery).
• Genetic models suggest psychopathology is inherited.
• Neuroimaging explains mental illness through structural brain changes like ventricular atrophy, volumetric changes, and cortical reduction.

Medical Model (Neurobiology)

• Humans are organisms with natural functions designed by nature.
• Mental illness stems from malfunctioning neurophysiological processes; like a heart attack affecting the circulatory system.

Psychological Models

• The general model suggests individuals develop along a path and adapt to their environment.
• Suffering and dysfunction result from failure to learn crucial elements, learning wrong responses, or adopting short-term solutions with long-term maladaptive consequences.

Psychodynamic Model

• Roots of mental disorders are psychological and in the unconscious mind.
• Mental disorders result from the failure of defense mechanisms to protect the self (or ego) from anxiety.
• Issues are determined by historical emotional experiences, negative childhood experiences, in particular

Behavioral Model

• Only the study of observable behavior and its controlling stimuli/reinforcing conditions can explain human behavior.
• Behavior is understood through learning.
• Mental disorders result from errors or biases in thinking.
• Thoughts/information processing distort, leading to maladaptive emotions and behavior, and affect the view of the world.
• Correcting mental disorders requires changing thinking.

Humanistic/Existential Model

• Mental health problems signal failure to reach potential and stifled psychological growth.
• Human nature is viewed as basically good.
• Emphasizes present conscious processes, de-emphasizing unconscious processes and past causes.
• Focuses on the inherent capacity for responsible self-direction, growth, and self-actualization rather than curing diseases.
• Against labeling people with specific mental disorders.

Social Model

• Societal organization, not just individual characteristics, must be considered causal factors in mental illness.
• Social structure imposes restrictions on behavior.
• Understanding effects of social conditions on mental illness is needed
• Social forces are the most important determinants of mental disorder

Psychosocial Model

• Mental illness is due to the interaction of psychological and social factors
• Psychosocial factors are developmental influences that can handicap a person psychologically which makes them less resourceful to cope with social events
• Four categories of psychosocial causal factors:
  • Early deprivation or trauma
  • Inadequate parenting styles
  • Marital discord and divorce
  • Maladaptive peer relationships

Family Therapy Model

• Suggests individuals with mental illness were victims of a pathological family process (Laing & Esterson, 1964).
• Aims to help all family members work together to resolve conflict.
• Designed to identify/change relationships within the family while paying attention to alignments, discord, engagement, and disengagement.
• Relevant aspects include:
  • Double Bind
  • Schisms and Skewed Families
  • Pseudomutual Families
  • Expressed Emotion

Biopsychosocial Model

• Systematically considers biological, psychological, and social factors and their interactions in understanding health, illness, and healthcare delivery
• Integrates biological, social, and psychological aspects.
• Abnormality caused by the interaction of factors, no single cause.
• Relative importance of each factor depends on the individual and environment.