MEH505 Week One: Module 1: What is Mental Health PDF

**MEH505 Week One:** **Module 1: What is Mental Health?** ** Introduction** The World Health Organization\'s definition of health is "a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity" (WHO, 2002). Mental health is intertwined with and ha...

**MEH505 Week One:** **Module 1: What is Mental Health?** ** Introduction** The World Health Organization\'s definition of health is "a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity" (WHO, 2002). Mental health is intertwined with and has a powerful influence on physical health because the mind and body together make up a single system. Neither mental nor physical health can exist alone. Mental, physical, and social functioning are interdependent. External circumstances change all the time, so mental wellbeing fluctuates -- everyone has good days and bad days.  Jahoda (1958) drew together six criteria for positive mental health which are: 1. balance of psychic forces 2. self-actualization 3. resistance to stress 4. autonomy 5. competence 6. perception of reality. It is the balance which is most important. For example, a person could be too resistant to stress as there are times when anxiety is quite normal. Similarly, one could be too autonomous and form very few if any relationships. Most people have areas of competence and incompetence, and although it is important to be in touch with reality, each person's experience of life is different. Standards of mentally healthy or normal behaviour vary with time, place, culture, and expectations of the social group. One aspect of mental health that Jahoda did not specifically mention is the capacity for mutually satisfying and enduring relationships. People's daily lives are organized around relationships -- as parents, spouses, workers, and friends. They are the source of much satisfaction and also much distress. However, some people become isolated and unhappy because they don't have the skills or in some cases the money to fully participate in society, and this stress affects their mental health (Rogers, 2014). Relationships can help people through difficult times, so for example, all cultures have customs such as funerals when friends and relatives come together to support the bereaved. Myths and legends show us that people have always understood the importance of relationships for mental health. Albert Ellis, the founder or Rational Emotive Therapy, believed humour to be an important aspect of mental health (Ellis, 1977). He noticed that it encourages relaxation and reduces anxiety, brings enjoyment and pleasure, and helps people regard stressful events in a more positive light. At the same time, positive, humorous people are more rewarding to be with, so they tend to have more friends providing social support to help buffer stress. Sigmund Freud paid great attention to humour (1928) and acknowledged it as one of the highest psychic functions because it involves looking at things in a different way. By shifting perspective, one distances oneself from a distressing event, and so it reduces anxiety. This flexibility of mind allows people to be more creative and mentally healthy. Mental Illness has one of the highest disease burdens in Australia (Australian Institute of Health and Wellness, 2018). Nearly half (45%), of Australians from 16-85 will experience a mental disorder at some stage in their life (AIHW, 2018). Nonetheless, there are many ways that counsellors can help people recover and maintain their mental health as discussed in the second part of this module. **References** World Health Organisation (2002). *Strengthening mental health*. Resolution of the Executive Board of the WHO. Geneva. Jahoda, M. (1958). *Current concepts of positive mental health. New York: Joint Commission on Mental Illness and Health, 1*. [https://doi.org/10.1037/11258-000Links to an external site.](https://doi.org/10.1037/11258-000) Rogers, A. (2014). *A sociology of mental health and illness*: Fifth edition. McGraw-Hill Education. Ellis, A. (1977). Fun as psychotherapy. *Rational Living*, *12*(1), 2-6. Freud, S. (1928). Humour. *International Journal of Psychoanalysis*, *9*, 1-6. Australian Institute of Health and Welfare. (2018). *Australia's health 2018.* [https://www.aihw.gov.au/getmedia/7c42913d-295f-4bc9-9c24-4e44eff4a04a/aihw-aus-221.pdfLinks to an external site.](https://www.aihw.gov.au/getmedia/7c42913d-295f-4bc9-9c24-4e44eff4a04a/aihw-aus-221.pdf) ** Subject Learning Outcomes** **This module will help you achieve the following Subject Learning Outcomes:** 1. Critically analyse the social and psychological determinants of prevalent mental health issues and factors that contribute towards their development. 2. Critically reflect on contemporary issues and research to inform professional practice. 3. Critically examine biases and assumptions concerning mental wellbeing. ** Assessment Progression** Assessment 1 is due at the end of Module 6. Please refer to the assessment briefs in the Assessment Area for more detail. In Assessment 1, Critical Analysis Report, you are required to question the information and opinions presented in the debate between different models of mental illness. You should attempt to understand the information and opinions presented from different perspectives (i.e. read related texts), and in relation to the theories, approaches and frameworks related to mental wellbeing. This assessment tests your ability to examine the evidence and present a clear argument. You can prepare for this assessment by utilising the learning resources of this module in order to look at ideas about mental health. **Introduction** Resilience is a core component of mental health. "The essence of resilience is a positive, adaptive response in the face of significant adversity. Stated simply, resilience transforms potentially toxic stress into tolerable stress" (National Scientific Council on the Developing Child, 2015, p. 1). It is the ability to cope which is at the heart of wellbeing. Many people with good mental health have a childhood history of at least one stable and committed relationship with a supportive adult. These relationships build resilience through key capacities---such as the ability to plan, monitor and regulate behaviour, and adapt to changing circumstances (National Scientific Council on the Developing Child, 2015). Since, as previously stated the opposite of mental ill-health is wellbeing; to help clients and communities achieve this and build their resilience to adversity, the research evidence (Aked & Thompson, 2011) shows there are five strategies. They are to connect, be active, take notice, keep learning and give. A counsellor can encourage clients to take up each of these strategies: - Connecting means investing time in building and maintaining relationships with family, friends, neighbours and colleagues. - Being active involves finding an enjoyable physical activity according to one's level of fitness and mobility. - Taking notice is a mindfulness strategy of living in the moment and being aware of the beauty of the environment. - Learning builds confidence and a sense of achievement and increases mental flexibility, and - Giving empowers people. It is rewarding in itself, and it creates connections. People who report higher levels of wellbeing tend to be more involved in the community, have better family and social relationships and are more productive at work (Aked & Thompson, 2011). Longitudinal studies of wellbeing (Koivumaa-Honkanen, 2004) have shown that the prevalence of good moods predicts working days lost through illness five years, likelihood of stroke six years later and of cardiovascular disease ten years later. It is evident that supporting mental health has wide ranging effects of which governments need to be aware (WHO, 2018). **References\ **WHO (2018). *Mental health: strengthening our response.* World Health Organisation. [https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-responseLinks to an external site.](https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response) National Scientific Council on the Developing Child (2015). *Supportive relationships and active skill-building strengthen the foundations of resilience: Working Paper No. 13*. [https://developingchild.harvard.edu/wp-content/uploads/2015/05/The-Science-of-Resilience.pdfLinks to an external site.](https://developingchild.harvard.edu/wp-content/uploads/2015/05/The-Science-of-Resilience.pdf) Aked, J. &Thompson, S. (2011). *Five ways to wellbeing.* New Economics Foundation UK. [https://neweconomics.org/2011/07/five-ways-well-new-applications-new-ways-thinkingLinks to an external site.](https://neweconomics.org/2011/07/five-ways-well-new-applications-new-ways-thinking) Koivumaa-Honkanen, H., Kaprio, J., Honkanen, R., Viinamäki Heimo, & Koskenvuo, M. (2004). Life satisfaction and depression in a 15-year follow-up of healthy adults. *Social Psychiatry and Psychiatric Epidemiology*, *39*(12), 994--999. [https://doi.org/10.1007/s00127-004-0833-6Links to an external site.](https://doi.org/10.1007/s00127-004-0833-6)   **Essential Resources** decorative **Operationalisation of mental health and wellbeing initiatives** Read pages 133-135, which cover the operationalisation of mental health and wellbeing initiatives. Consider the benefits of training to enhance self- esteem, stress management and assertiveness. Decide whether such training could be a worthwhile adjunct to a counselling practice. **Reference:**  Brown, J. S., Mackereth, C. J., & Learmonth, A. M. (2015*). Promoting public mental health and wellbeing: Principles into practice*. Jessica Kingsley Publishers. [http://torrens.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=924076&site=ehost-live&ebv=EB&ppid=pp\_133Links to an external site.](http://torrens.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=924076&site=ehost-live&ebv=EB&ppid=pp_133) (Reading completed: 9/9/24). **Notes: Brown et al., 2015.** To develop mental health and well-being operationally, consider the following detailed strategies: 1. **Health Literacy**: - **Definition**: Health literacy involves the ability to read, obtain, and interpret health information, whether it's on paper, electronic, or in graphical form. - **Approaches**: - **Community Development**: Support individuals and communities to understand health information broadly. - **Educational Settings**: Schools are key for promoting health literacy. Hospital settings can also be effective, as seen in programs like "Skilled for Health" which improved hospital staff's knowledge of nutrition and overall well-being. 2. **Continuing Education**: - **Lifelong Learning**: Beyond formal education, continued learning throughout life, both formally and informally, is linked to greater subjective well-being. - **Higher Qualifications**: Achieving higher levels of education is associated with better mental well-being. 3. **Healthy Lifestyle Choices**: - **Healthy Eating**: Sensible eating improves physical health and can reduce obesity, which is linked to depression. For example, children who eat breakfast regularly show better concentration and attendance at school. - **Physical Activity**: Exercise at all intensity levels can enhance psychological well-being. Group physical activity programs are particularly recommended for mild to moderate depression. Different types of exercise have specific benefits, such as weight resistance training improving body image and self-esteem, and group sports improving mood. These strategies emphasize the importance of community support, continuous education, and healthy lifestyle choices to enhance mental health and well-being.  **Promoting mental health** Read pages 19 to 21 - Positive Mental Health and particularly note the box on page 20 which details different aspects of mental health, e.g. the cultural context. Consider how mental health contributes to all aspects of human life. **Reference:** Herrman, H., Saxena, S. & Moodie. R. Eds. (2004). *Promoting mental health: Concepts, emerging evidence, practice*. [https://www.who.int/mental\_health/evidence/en/promoting\_mhh.pdfLinks to an external site.](https://www.who.int/mental_health/evidence/en/promoting_mhh.pdf) -- Link didn't work... **(Reading Completed 9/9/24)** **Notes: Herrman et al., 2004 (link didn't work... found on WHO website -- Link: [untitled (who.int)](https://iris.who.int/bitstream/handle/10665/42940/9241591595.pdf)** **Notes:** - **Definition & Measurement:** - Mental health has been defined, measured, and recorded over the last 30 years. - Research is mostly in English and from developed countries. - Conceptualized as: - Positive emotion (affect) such as happiness. - Personality traits like self-esteem and mastery. - Resilience, the capacity to cope with adversity. - Various models contribute to understanding positive mental health. - **Intrinsic Value:** - Mental health is essential for individual well-being and functioning. - It is a crucial resource for individuals, families, communities, and nations. - Contributes to societal functions and overall productivity. - Generated in everyday life (homes, schools, workplaces, leisure activities). - Contributes to social, human, and economic capital. - Spirituality can significantly contribute to mental health promotion and is influenced by mental health. - **Individual Resource:** - Mental health contributes to an individual's quality of life. - It can be increased or diminished by societal actions. - Good mental health includes the capacity for mutually satisfying and enduring relationships. - Social cohesion is critical for the economic prosperity of communities, and this relationship is reciprocal. - **Culture & Mental Health:** - Universal qualities of mental health, but expression varies by individual, culture, and context. - Understanding a community's concepts of mental health is crucial for effective promotion. - Cultural sensitivity increases the relevance and success of interventions. - Example: A Xhosa mother in apartheid-era South Africa did not comfort her crying son to ensure he grew strong enough to join the armed struggle. - Young soldiers in Angola experienced disruption in development and education, requiring tailored approaches to help them adjust to peacetime society. - Stigma is a major concern for people affected by HIV/AIDS and understanding their concepts of mental health is vital for developing relevant interventions. - A culture-specific approach may be unhelpful if it assumes homogeneity within cultures and ignores individual differences. - Most cultures today are heterogeneous and overlap; beliefs and actions must be understood in their political, economic, and social contexts. **Summary:** Promoting mental health involves defining and measuring it, with research primarily from developed countries. Mental health is seen as positive emotions, traits, and resilience. It has intrinsic value for individuals and society, contributing to well-being, productivity, and social cohesion. Cultural understanding is crucial for effective mental health promotion, and interventions must consider individual and contextual differences. **Case Study Title: **Heart Health Promotion in Eastern Finland (p. 18-19). **Key Points:** - Project Duration: 25 years in North Karelia, Eastern Finland. - Target: Prevention of cardiovascular disease (CVD). - Achievements: - Men: Reduced smoking, improved diet, 17% reduction in serum cholesterol (1972-1997), controlled blood pressure, increased physical activity. - Women: Similar dietary and health improvements, slight increase in smoking. - **Mortality Rates:** - 73% reduction in coronary heart disease mortality in men under 65 (1967-1995). - 8% annual decline in CVD mortality in recent years. - 65% reduction in CVD mortality in all Finland by 1995. - Significant reduction in lung cancer mortality (70% in North Karelia, 60% in all Finland). **Recommendations for Successful Heart Health Promotion:** 1. Programme Planning: Follow established principles and rules. 2. Frameworks: Use medical/epidemiological and behavioural/social theories. 3. Community Understanding: Engage with community organizations and ensure public participation. 4. Media and Activities: Combine media messages with community activities. 5. Collaboration: Work with formal and informal community leaders. 6. Dedication: Combine theoretical frameworks with hard work. 7. Environment: Change social and physical environments to promote health. 8. National Impact: Use as a demonstration programme with proper evaluation and dissemination. 9. Policy Integration: Collaborate with national health policymakers. **Summary:** The North Karelia project demonstrates the potential of health promotion in preventing CVD through community-based interventions. Significant reductions in smoking, cholesterol levels, and mortality rates were achieved through comprehensive strategies involving community engagement, media, and collaboration with various sectors. The project's success provides valuable insights and recommendations for future health promotion programmes. **Box (Page 20) -- Summary:** **Notes:** 1. **Cultural Context:** - **Jahoda (1958):** Mental health = self-realization, mastery over environment, autonomy. - **Murphy (1978):** Mental health definitions are culturally influenced, varying by setting, culture, socioeconomic, and political factors. 2. **Personality Types:** - **Leighton & Murphy (1987):** Different personality types have varied coping strategies; some may be unhealthy and risk mental illness when challenged. 3. **Affective Dimension:** - **Bradburn (1965):** Positive mental health = subjective well-being. - Subjective well-being impacts the environment more than vice versa. 4. **Salutogenic Approach:** - **Antonovsky:** Focus on coping and salutary factors. - Stressors can have positive, neutral, or negative outcomes. - **Scheier & Carver (1992):** Optimism is key; optimists cope better through acceptance and personal growth. 5. **Resilience:** - **Rutter (1985):** Resilience = interaction of environment and constitution. - Protective factors modify responses to stressors, becoming evident under stress. 6. **Psychoanalytical Approach:** - Positive mental health = use of internal energy for emotional, intellectual, and sexual realization. 7. **Quality of Life Approach:** - **WHO (1995):** Quality of life = individual's perception in cultural context, encompassing social, environmental, psychological, spiritual, and health satisfaction. **Summary:**  Positive mental health is a multifaceted concept influenced by cultural context, personality types, subjective well-being, coping strategies, resilience, psychoanalytical perspectives, and quality of life. Definitions and determinants vary widely, reflecting the complexity and diversity of mental health. decorative **Training to enhance self-esteem and self-confidence** Read pages 133-135, which cover the operationalisation of mental health and wellbeing initiatives. Consider the benefits of training to enhance self- esteem, stress management and assertiveness. Decide whether such training could be a worthwhile adjunct to a counselling practice. **Reference:**  Brown, J. S., Mackereth, C. J., & Learmonth, A. M. (2015*). Promoting public mental health and wellbeing: Principles into practice*. Jessica Kingsley Publishers. [http://torrens.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=924076&site=ehost-live&ebv=EB&ppid=pp\_133Links to an external site.](http://torrens.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=924076&site=ehost-live&ebv=EB&ppid=pp_133) (Reading Complete 9/9/24). -- Notes already applied above as this is second request to read this reference material.  **Wellbeing Concepts** This US Government resource is brief and interesting. You may find it worthwhile to read it all, but attention is particularly drawn to the sections on the definitions and measurement of wellbeing. Consider the relevance of the measurements which are described for individual counselling. **Reference:**  Centres for Disease Control and Prevention. (2018). *Wellbeing concepts*. [https://www.cdc.gov/hrqol/wellbeing.htmLinks to an external site.](https://www.cdc.gov/hrqol/wellbeing.htm) **How to manage your mental health** Prolonged psychological stress is the enemy of our mental health, and physical movement is our best weapon to respond according to a British Olympic champion who is involved in mentoring programs to support vulnerable people. This TEDx talk cites the research to show practical ways of managing and maintaining mental health. As he says, the magical ingredient to ensure mental wellbeing is enjoyment, so many people do not give themselves permission to enjoy themselves. **Reference:**  Taylor, L. (2018, July 19). *How to manage your mental health* \[Video file\]. YouTube. (Watched Video 9/9/24) **Summary:** The speaker shares a personal story about being labelled a "problem child" by a family doctor, who suggested sedation. Instead, the speaker's parents chose to manage his behaviour through physical activity. This approach led to the speaker's involvement in various sports from a young age, eventually leading to a successful diving career, including competing in three Olympic Games and winning a medal in 2004. The speaker emphasizes the importance of physical activity for mental health, noting its benefits in reducing stress, anxiety, and depression. They highlight studies showing that regular exercise can improve mental health conditions like PTSD, ADHD, and anxiety disorders. The speaker advocates for more physical movement to combat the global mental health crisis, suggesting that exercise can significantly improve both mental and physical well-being. **Transcript:**  **Additional Learning Resources** If you would like to learn more about the topics covered in this module here are some additional resources. These resources will contribute to further developing your understand the topics covered. These resources are not essential to complete this module, or the assessments associated with this subject. decorative **Mental Health: Strengthening our Response** This reading develops the following key points: - Mental health is more than the absence of mental disorders. - Mental health is an integral part of health; indeed, there is no health without mental health. - Mental health is determined by a range of socioeconomic, biological and environmental factors. - Cost-effective public health and intersectoral strategies and interventions exist to promote, protect and restore mental health. **Reference:** WHO (2018). *Mental health: strengthening our response*. [https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-responseLinks to an external site.](https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response) **Summary:** **Key Facts** - **Affordable, effective, and feasible strategies** exist to promote, protect, and restore mental health. - **Urgent need for action** on mental health is indisputable. - Mental health has **intrinsic and instrumental value** and is integral to our well-being. - Determined by a **complex interplay** of individual, social, and structural stresses and vulnerabilities. **Concepts in Mental Health** - **Mental health** is a state of well-being enabling people to cope with life's stresses, realize their abilities, learn, work well, and contribute to their community. - It is an **integral component** of health and well-being, crucial for personal, community, and socio-economic development. - Mental health is a **basic human right**. - It exists on a **continuum**, experienced differently by each person, with varying degrees of difficulty and distress. - **Mental health conditions** include disorders, psychosocial disabilities, and other states associated with significant distress, impairment, or risk of self-harm. People with these conditions may experience lower levels of well-being, but this is not always the case. **Determinants of Mental Health** - **Individual Factors**: Psychological and biological factors like emotional skills, substance use, and genetics can increase vulnerability to mental health issues. - **Social and Structural Factors**: Unfavourable circumstances such as poverty, violence, inequality, and environmental deprivation heighten the risk of mental health conditions. - **Developmental Risks**: Risks during sensitive periods, especially early childhood, like harsh parenting and bullying, are particularly harmful. - **Protective Factors**: These include social and emotional skills, positive interactions, quality education, decent work, safe neighbourhoods, and community cohesion, which strengthen resilience. - **Local and Global Threats**: Local threats affect individuals and communities, while global threats like economic downturns, disease outbreaks, humanitarian emergencies, forced displacement, and climate crises impact entire populations. - **Complex Interplay**: Mental health is influenced by a complex interplay of these factors, with no single factor being solely predictive. Many people exposed to risks do not develop mental health conditions, and some without known risks do. **Mental Health Promotion and Prevention** - **Interventions**: Focus on reducing risks, building resilience, and creating supportive environments by addressing individual, social, and structural determinants of mental health. These can target individuals, groups, or entire populations. - **Multisectoral Approach**: Effective programs often require collaboration beyond the health sector, involving education, labour, justice, transport, environment, housing, and welfare sectors. The health sector plays a key role in embedding these efforts within health services and facilitating multisectoral coordination. - **Suicide Prevention**: A global priority included in the Sustainable Development Goals. Key strategies include limiting access to means, responsible media reporting, social and emotional learning for adolescents, early intervention, and banning highly hazardous pesticides. - **Child and Adolescent Mental Health**: Promoted through policies and laws, support for caregivers, school-based programs, and improving community and online environments. School-based social and emotional learning programs are particularly effective. - **Workplace Mental Health**: Growing interest in promoting and protecting mental health at work through legislation, organizational strategies, manager training, and worker interventions. These efforts aim to create environments that support mental well-being and resilience across various settings and stages of life. **Mental Health Care and Treatment** - **Community-Based Care**: Emphasizes accessible, acceptable, and effective care over institutional settings, preventing human rights violations and improving recovery outcomes. - **Integrated Services**: Includes mental health services within general health care (e.g., hospitals, primary care with non-specialist providers), community mental health centres, psychosocial rehabilitation, peer support, and supported living services. - **Non-Health Settings**: Provides mental health care through social services like child protection, school health services, and prisons. - **Innovative Approaches**: Addresses the care gap for common conditions like depression and anxiety by diversifying and scaling up care through non-specialist counselling and digital self-help. This approach aims to create a comprehensive, accessible, and supportive mental health care system. **WHO Response** - **Comprehensive Mental Health Action Plan 2013--2030**: Aims to improve mental health through effective leadership, community-based care, promotion and prevention strategies, and strengthened information systems and research. - **Mental Health Atlas 2020**: Showed insufficient progress against the action plan's targets. - **World Mental Health Report**: Calls for accelerated implementation of the action plan, focusing on three key areas: - **Value Mental Health**: Increase commitment, engagement, and investment from all stakeholders. - **Reshape Environments**: Improve physical, social, and economic environments to protect mental health. - **Strengthen Care**: Ensure accessible, affordable, and quality community-based mental health services. - **Emphasis on Human Rights**: Protecting and promoting human rights, empowering those with lived experience, and ensuring a multisectoral approach. - **Ongoing Efforts**: WHO continues to provide strategic leadership, evidence, tools, and support to strengthen global mental health responses, including in humanitarian settings. This summary highlights WHO's commitment to transforming mental health care and promoting well-being globally. **Conclusion Notes** This reading underscores the multifaceted nature of mental health, emphasizing that it is more than just the absence of mental disorders. Mental health is integral to overall health and well-being, highlighting the adage that there is no health without mental health. It is influenced by a complex interplay of socioeconomic, biological, and environmental factors, which can either protect or undermine mental well-being. Effective and affordable public health strategies exist to promote, protect, and restore mental health. These strategies often require a multisectoral approach, involving sectors such as education, labour, justice, transport, environment, housing, and welfare. The health sector plays a crucial role in embedding these efforts within health services and facilitating coordination across sectors. Promotion and prevention interventions focus on reducing risks, building resilience, and creating supportive environments. These interventions can target individuals, specific groups, or entire populations. Suicide prevention, child and adolescent mental health, and workplace mental health are identified as key areas for action. Community-based mental health care is emphasized as more accessible and acceptable than institutional care, helping to prevent human rights violations and improve recovery outcomes. Integrated services within general health care, community mental health centres, and non-health settings like schools and prisons are crucial for comprehensive care. The WHO's Comprehensive Mental Health Action Plan 2013--2030 aims to improve mental health through effective leadership, community-based care, promotion and prevention strategies, and strengthened information systems and research. Despite some progress, the WHO calls for accelerated implementation of the action plan, emphasizing the need for increased commitment, reshaped environments, and strengthened care systems to achieve better mental health for all. **Learning Activities:** **Learning Activity 1: Introduce Yourself** Write a short paragraph about yourself and the ways you work to enhance your own mental health in the *Introduce Yourself discussion forum*. The *Introduce Yourself discussion forum* is a great way for students to get to know each other and feel part of the college community. This helps you to join with others to make study groups and support each other outside of class time. This has the potential to provide supportive friendships throughout the course. **Learning Activity 2: Reflective Learning Journal** Throughout this Mental Health course, you will be asked to reflect on the different issues raised, using your Learning Journal. A Learning Journal is very important for you to record your growing understanding of the issues which arise in counselling. It is through reflection on practice that professional counsellors strive for continual improvement. This journal can be found via this subject's main navigation menu. At the end of the subject, it can be downloaded so that you can use it when the course is complete. This learning journal will be private between you and the Learning Facilitator. In this Module you are asked to consider how you strengthen your own resilience or ability to bounce back when you get a poor grade or other blow to your wellbeing. Do you practice the five ways to wellbeing, connecting, activity, learning, giving and noticing? If so, which is the most difficult for you and how could you strengthen this strategy? Write your answers in your Learning Journal and make a note to see how these strategies are working for you in Module 6 when you are completing Assessment 1. **Learning Activity 3: The continuum of mental health**  Read: Keyes, C. (2005). *Mental illness and/or mental health? Investigating axioms of the complete state model of health.* *Journal of Consulting and Clinical Psychology*, *73*(3), 539 -548. [http://www.midus.wisc.edu/findings/pdfs/191.pdfLinks to an external site.](http://www.midus.wisc.edu/findings/pdfs/191.pdf) Take note of Table 1 on page 541. Consider the 13 symptoms of mental health and look at how many of them you are experiencing today and how many you experienced five years ago. This shows how mental health is a continuum along which people constantly change position. What factors have affected your position on the continuum either positively or negatively? Write your reflections in your Learning Journal. **Notes from reading:** The abstract discusses a study on mental health using data from the Midlife in the United States study, which included adults aged 25 to 74. The study proposed both continuous and categorical assessments of mental health, distinguishing between flourishing (presence of mental health) and languishing (absence of mental health). **Key findings include:** Mental health (emotional, psychological, and social well-being) and mental illness (depression, anxiety, panic disorder, and alcohol dependence) are separate but correlated dimensions. 18.0% of participants were flourishing, and 16.6% were completely mentally healthy. Completely mentally healthy individuals had fewer health limitations, missed fewer workdays, had fewer work cutbacks, and exhibited better psychosocial functioning (low helplessness, clear life goals, high resilience, and high intimacy). The abstract discusses a study on mental health using data from the Midlife in the United States study, which included adults aged 25 to 74. The study proposed both continuous and categorical assessments of mental health, distinguishing between flourishing (presence of mental health) and languishing (absence of mental health). - Mental health (emotional, psychological, and social well-being) and mental illness (depression, anxiety, panic disorder, and alcohol dependence) are separate but correlated dimensions. - 18.0% of participants were flourishing, and 16.6% were completely mentally healthy. - Completely mentally healthy individuals had fewer health limitations, missed fewer workdays, had fewer work cutbacks, and exhibited better psychosocial functioning (low helplessness, clear life goals, high resilience, and high intimacy). **Table: (p. 541)**  1. Regularly cheerful, in good spirits, happy, calm and peaceful, satisfied, and full of life (positive affect past 30 days) 2. Feels happy or satisfied with life overall or domains of life (avowed happiness or avowed life satisfaction). 3. Holds positive attitudes toward oneself and past life and concedes and accepts varied aspects of self (self-acceptance) 4. Has positive attitude toward others while acknowledging and accepting people's differences and complexity (social acceptance) 5. Shows insight into own potential, sense of development, and open to new and challenging experiences (personal growth) 6. Believes that people, social groups, and society have potential and can evolve or grow positively (social actualization) 7. Holds goals and beliefs that affirm sense of direction in life and feels that life has a purpose and meaning (purpose in life) 8. Feels that one's life is useful to society and the output of his or her own activities are valued by or valuable to others (social contribution) 9. Exhibits capability to manage complex environment, and can choose or manage and mould environments to suit needs (environmental mastery) 10. Interested in society or social life; feels society and culture are intelligible, somewhat logical, predictable, and meaningful (social coherence) 11. Exhibits self-direction that is often guided by his or her own socially accepted and conventional internal standards and resists unsavoury social pressures (autonomy) 12. Has warm, satisfying, trusting personal relationships and is capable of empathy and intimacy (positive relations with others) 13. Has a sense of belonging to a community and derives comfort and support from community (social integration) - [**Positive functioning:** requires high level on six or more symptom scales (Symptoms 3--13) ] **Summary of Table 1: p. 541** The table titled **"Categorical Diagnosis of Mental Health (i.e., Flourishing)"** categorizes mental health based on positive indicators. It has two main criteria: 1. **Hedonia**: Requires a high level on at least one of the following symptom scales: - Regularly cheerful, happy, calm, and satisfied with life. - Feels happy or satisfied with life overall or specific life domains. 2. **Positive Functioning**: Requires a high level on six or more of the following symptom scales: - Positive attitudes toward oneself and past life. - Positive attitude toward others, accepting people's differences. - Insight into own potential and openness to new experiences. - Belief in the potential for growth in people and society. - Goals and beliefs that give a sense of direction and purpose. - Feeling that one's life is useful and valued by others. - Capability to manage complex environments. - Interest in society and social life. - Self-direction guided by internal standards. - Warm, satisfying personal relationships. - Sense of belonging to a community. This table provides a structured way to assess mental health by focusing on positive aspects rather than just the absence of mental illness. **Learning Activity 2: Reflective Learning Journal** **Learning Journal Entry: Enhancing My Resilience** Building resilience and bouncing back from setbacks is crucial for maintaining well-being. The Five Ways to Wellbeing---connecting, being active, learning, giving, and noticing---are excellent strategies to enhance resilience. Here's how each one can help: 1. **Connecting**: Building strong relationships with friends, family, and colleagues can provide emotional support during tough times. 2. **Being Active**: Physical activity can boost your mood and reduce stress. 3. **Learning**: Engaging in new activities or hobbies can provide a sense of achievement and purpose. 4. **Giving**: Helping others can create a sense of belonging and make you feel valued. 5. **Noticing**: Being mindful and appreciating the present moment can help reduce anxiety and improve overall well-being. **My Practices and Strategies to Enhance Resilience** To strengthen my resilience, I engage in various practices and strategies: - **Learning**: I delve into subjects like psychology, sociology, criminology, counselling, meditation, breathwork, and attachment styles in relationships. I also seek professional and community support when needed. - **Being Active**: I enjoy dancing, crochet, and house chores, which keep me physically active and engaged. - **Giving**: Helping others is a significant part of my routine, which brings a sense of fulfillment and connection. - **Noticing**: I recognize when I need to implement social distancing from overstimulation, as I am introverted and have an INFJ personality. I enjoy nature and have set a goal to increase my well-being by going on walks and swimming, although I have a lot on my proverbial plate. I accept my limitations and work within them. For many people, **noticing** or mindfulness can be the most challenging. It requires practice to stay present and not get caught up in worries about the past or future. Here are some ways to strengthen this strategy: - **Mindfulness Meditation**: Start with just a few minutes a day, focusing on your breath and observing your thoughts without judgment. - **Gratitude Journaling**: Write down a few things you're grateful for each day to help shift your focus to the positive aspects of your life. - **Nature Walks**: Spend time in nature and pay attention to the sights, sounds, and smells around you. **Collaborative Learning Activity 4: Resilience** One of the five strategies for resilience discussed in this module is a need to connect. Form **groups of three or four online or in person** and **meet together regularly to discuss what actions you are each taking to maintain your wellbeing in the face of the stresses associated with studying** on top of the demands of everyday life. **Overview for Exam (Weeks 1-9 topics).** **1. Mental Health and Illness Defined** - **Mental Health**: A state of well-being where individuals realize their potential, can cope with the stresses of life, work productively, and contribute to their communities. - **Mental Illness**: Refers to a wide range of mental health conditions that affect mood, thinking, and behaviour, significantly impacting daily functioning. **2. DSM-5 / ICD Classifications** - **DSM-5**: The Diagnostic and Statistical Manual of Mental Disorders (5th Edition) is used primarily in the U.S. It provides standardized criteria for diagnosing mental disorders. - **ICD**: The International Classification of Diseases is maintained by the World Health Organization (WHO) and is used globally for health statistics and to code diseases and health problems. **3. Power, Threat, Meaning Framework** - This framework helps understand how individuals respond to mental health challenges based on their perceived power and the threat they experience from their environment. It emphasizes the importance of context and personal meaning in mental health. **4. Depression: Mental Illness or Distress** - **Distress**: Emotional pain that can affect everyday life, often situational and temporary. - **Mental Illness**: A clinical diagnosis that may require intervention, characterized by persistent symptoms that disrupt functioning. Conversations around this often involve the medical model versus biopsychosocial perspectives. **5. Counselling Depressed Clients** - **Techniques**: Use of Cognitive Behavioural Therapy (CBT), mindfulness, and motivational interviewing to help clients challenge negative thought patterns and behaviours. - **Assessments**: Tools like the PHQ-9 (Patient Health Questionnaire) to assess severity and monitor changes in depression. **6. Biases and Assumptions in Mental Health Disorders** - It\'s important to recognize personal biases that may influence clinical judgment. Common biases include stigma, overgeneralization (e.g., viewing personality disorders as inherently bad), and failure to consider cultural context. **7. Anxiety Disorders** - Types include Generalized Anxiety Disorder (GAD), Social Anxiety Disorder, Panic Disorder, and Phobias. Each has specific symptoms and treatment approaches, usually involving therapy and sometimes medication. **8. Assessments of Depression and Anxiety in Clients** - In addition to PHQ-9, tools for anxiety include the GAD-7 (Generalized Anxiety Disorder scale) and various clinical interviews (e.g., SCID - Structured Clinical Interview for DSM Disorders). **9. BPD (Borderline Personality Disorder) Counselling** - Treatment often includes Dialectical Behaviour Therapy (DBT), focusing on emotional regulation, interpersonal effectiveness, and distress tolerance skills. Understanding the emotional experiences of clients with BPD is crucial. **10. Disordered Eating and Mental Health** - Conditions such as anorexia nervosa, bulimia nervosa, and binge-eating disorder. Treatment often involves a multidisciplinary approach, including psychotherapy, nutritional counselling, and medical monitoring.