Mental Health.pptx

Mental Health Drug Abuse By Dr. Yamamah Al-Hmaid 1  WHO- mental health Health is a state of complete physical, mental and social well-being and not merely the absence of disease. Mental health is a state of mental well-being that enables people to co...

Mental Health Drug Abuse By Dr. Yamamah Al-Hmaid 1  WHO- mental health Health is a state of complete physical, mental and social well-being and not merely the absence of disease. Mental health is a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community. It is more than the absence of mental disorders. It is an integral component of health and well-being that underpins our individual and collective abilities to make decisions, build relationships and shape the world we live in. 2  What is mental health? In our society, a mentally healthy person: Has self-esteem, self-acceptance Is realizing potential Is able to maintain fulfilling relationships Has a sense of psychological well-being Has sense of autonomy (Independent , can take decisions by his own.) Has sense of competence, mastery, purpose However, other cultures may have different ideas about what mental health is. 3  WHO- mental health Concepts of mental health include: 1. subjective well-being, 2. perceived self-efficacy, 3. autonomy, 4. competence, 5. Intergenerational dependence 6. and recognition of the ability to realize one’s intellectual and emotional potential. 4 What is mental disorder? A mental disorder is characterized by a clinically significant disturbance in an individual’s cognition, emotional regulation, or behavior. It is usually associated with distress or impairment in important areas of functioning. 5  The Medical Model and Concepts of Disease To diagnose diseases in physical medicine, doctors perform laboratory tests, do body imaging, take medical history, do physical examinations. Once disease is diagnosed, doctor generally knows: – Its cause – How disease is likely to run its course – What most appropriate treatment 6  Are mental illnesses like other diseases? Mental illnesses cannot be confirmed by objective laboratory tests or body imaging. Diagnosis in mental illness does not lead to an understanding of cause, of the course of the illness, or of the most appropriate treatment. 7  Why Mental Health Mental health problems affect society as a whole, and not just a small, isolated segment They are therefore a major challenge to global development. No group is immune to mental disorders, but the risk is higher among the: 1. poor, homeless, the unemployed, 2. persons with low education, 3. victims of violence, migrants and refugees, 4. indigenous populations, children and adolescents, 5. abused women and the neglected elderly. 8  Determinants of mental health Mental health is determined by a complex interplay of individual, family, community and structural factors that vary over time and space and that are experienced differently from person to person. Mental health conditions result from the interaction between an individual’s vulnerability and the stress caused by life events and chronic stressors 9  When individual vulnerabilities interact with stressors, they can lead to mental health conditions 10  Domain of influence Individual psychological and biological factors – relate to individuals’ intrinsic and learned abilities and habits for dealing with emotions and engaging in relationships, activities, and responsibilities. – Biological vulnerabilities include genetics, but also, for example, high potency cannabis use, substance use by11  Domain of influence Family and community – comprise a person’s immediate surroundings, including their opportunities to engage with partners, family, friends or colleagues, opportunities to earn a living and engage in meaningful activity, and also the social and economic circumstances in which they find themselves. Parenting behaviours and attitudes, physical punishment, bullying, quality schools, jobs 12  Domain of influence Structural factors – relate to people’s broader sociocultural, geopolitical and environmental surroundings, such as infrastructure, inequality, social stability and environmental quality. Access to basic services and commodities, including food, water, shelter, health and the rule of law, is important for mental health. 13  Examples of risks and protective factors that determine mental health 14  Risks undermine mental health Individual, family and community, and structural risks can manifest themselves at all stages of life, but those that occur during developmentally sensitive periods of life are particularly detrimental, often continuing to affect mental health for years or even decades afterwards Children with mental health problems and cognitive impairments are four times more likely to become a victim of violence than others. Adverse childhood experiences, including exposure to violence, increase the risk of developing a wide range of behavioural problems and mental health conditions, from substance use and aggression to depression, anxiety and post-traumatic stress disorder (PTSD). 15  Risks undermine mental health Living in areas where the natural environment has been compromised – for example, through climate change, biodiversity and habitat loss, exploitation or pollution – can also undermine mental health. – growing evidence suggests that exposure to air pollution is likely to adversely affect the brain and increase the risk, severity and duration of mental health conditions at all stages of life 16  Risks undermine mental health Women tend to be more socioeconomically disadvantaged than men and are also more likely to be exposed to intimate partner violence and sexual violence in the community, which are strong risk factors for a range of mental health conditions, especially PTSD. Racism or discrimination against a particular group in society increases the risk of social exclusion and economic adversity, both of which undermine mental health 17  Risks undermine mental health Socially marginalised groups – including the long-term unemployed, sex workers, homeless people and refugees – tend to have higher rates of mental disorder than the general population but can have difficulties in accessing health care. Indigenous peoples, are similarly at greater risk of depression, anxiety, suicide attempts or suicides, and substance-related problems. They too can find it difficult to access the mental health services they need. 18  The vicious cycle of disadvantage Mental ill-health is closely linked to poverty in a vicious cycle of disadvantage People living in poverty can lack the financial resources to maintain basic living standards; they have fewer educational and employment opportunities; they are more exposed to adverse living environments; and they are less able to access quality health care. These daily stresses put people living in poverty at greater risk of experiencing mental health conditions. Similarly, people experiencing severe mental health conditions are more likely to fall into poverty through loss of employment and increased health expenditures. Stigma and discrimination may also undermine their social support structures. They are vulnerable to a downward spiral of lost resources and social exclusion that can worsen existing mental health conditions and increase the risk of substance use, poor parenting or failure at school. 19  The vicious cycle between poverty and mental ill- health exacerbates mental health conditions 20  Global threats to mental health Global threats to mental health are major structural stressors with the potential to slow worldwide progress towards improved well- being. They affect whole populations and so can undermine the mental health of huge numbers of people. Key threats today include economic downturns and social inequalities; public health emergencies; widespread humanitarian emergencies and forced displacement; and the growing climate crisis. 21  Economic and social inequalities Economic downturns are associated with increases in suicide rates. They also increase the risk of depression, anxiety and alcohol use, probably through their damaging effects on employment, income, security and social networks. Countries with greater income inequalities and social polarization have been found to have a higher prevalence of schizophrenia, depression, anxiety and substance use. 22  Public health emergencies Public health emergencies can have profound and long-lasting impacts on people’s mental health, both exacerbating pre-existing conditions and inducing new ones. They can also impact key infrastructure, disrupting basic services and supplies and making it difficult to provide affected people with formal mental health care. The COVID-19 pandemic is the most prominent global example and has severely impacted people’s mental health all over the world 23  Public health emergencies Research on the 2013–2016 Ebola epidemic in West Africa shows that many people have experienced acute and long-term mental health and psychosocial effects. – Fear of the virus can cause acute anxiety and distress. – The grief of losing loved ones to the virus can last a long time. – Physical isolation of exposed individuals and communities heightens the risk of psychosocial impacts. – Outbreaks, and the response to them, can break local support systems, depleting people’s coping resources, fracturing communities and undermining trust in health services. – Many survivors develop mental health conditions, such as anxiety and mood disorders. 24  Public health emergencies The COVID-19 pandemic has created several short- or long-term stressors for mental health: – Stress from the potential health impacts of the virus. – Stress from public health and social measures. – Stress from unemployment and financial insecurity. – Stress from false information and uncertainty. 25  Humanitarian emergencies and forced displacement Inevitable disruptions to all health services during an emergency means people with severe mental health conditions struggle to access the services and support they need. Risks to mental health, such as violence and loss, as well as poverty, discrimination, overcrowding, food insecurity and the breakdown of social networks are also widespread in humanitarian emergencies. Almost all people affected by emergencies will experience psychological distress. For most people, this improves over time. But for others, the impacts on mental health can endure. 26  Humanitarian emergencies and forced displacement 1 in 5 people living in settings affected by conflict in the preceding ten years is estimated to have a mental disorder. Mental disorders are also estimated to be very common among survivors of natural disasters. Frontline responders, such as emergency care providers and relief workers, are at particular risk of mental health problems, both in the short and long term. Mental health conditions such as depression, anxiety, PTSD and psychosis are much more prevalent among refugees than among host populations. May face poor living conditions, adverse socioeconomic conditions, discrimination, isolation, strained family and support networks, uncertainty around work permits and legal status (asylum application), and in some cases immigration detention. 27  Climate crisis Evidence is now accumulating to show the climate crisis can impact mental health, through stresses and risks imposed by extreme weather events as well as through longer-term environmental change such as rising temperatures, rising sea levels, air pollution, prolonged droughts and gradual spread of climate-sensitive diseases. Extreme weather events – including tropical storms, floods, mudslides, heatwaves, and wildfires – have increased by at least 46% since 2000. They can result in depression, anxiety, PTSD and other stress-related conditions for many of those affected. Incremental environmental change can also be devastating. It can upset food and water supplies, alter growing conditions, reshape natural habitats and landscapes and weaken infrastructure. It can cause people to lose their homes and force communities to disperse. It can result in financial and social stress, and increase the risks of poverty, food insecurity, violence, aggression and forced displacement 28 The global prevalence of mental disorders in 2019 29  Global prevalence In both males and females, anxiety disorders and depressive disorders are the two most common mental disorders. Anxiety disorders become prevalent at an earlier age than depressive disorders, which are rare before ten years of age. They continue to become more common in later life, with highest estimates in people between 50 and 69. Among adults, depressive disorders are the most prevalent of all mental disorders. Schizophrenia, which occurs in 24 million people and in approximately 1 in 200 adults (aged 20 years and above), is a primary concern of mental health services in all countries. In its acute states, it is the most impairing of all health conditions (an individual experiencing acute schizophrenia is expected to have only one fifth of the health and functioning of a fully healthy person.) Bipolar disorder, another key concern of mental health services around the world, occurs in 40 million people and approximately 1 in 150 adults globally in 2019.Both disorders primarily affect working-age populations. 30  Prevalence in males and females Depressive and anxiety disorders are about 50% more common among women than men throughout the life- course, while men are more likely to have a substance use disorder. More than 10% of pregnant women and women who have just given birth experience depression. In women a significant associations found between victimization (intimate partner violence or sexual violence) and depression, anxiety, stress conditions including PTSD, and suicidal ideation. Women living with a severe mental disorder are much more likely to have experienced domestic and sexual violence during their life than other women 31  Prevalence in children and adolescents Around 8% of the world’s young children (aged 5–9 years) and 14% of the world’s adolescents (aged 10–19 years) live with a mental disorder. half of the mental disorders present in adulthood had developed by the age of 14 years. Idiopathic developmental disorders, which cause developmental disability, are the most common type of mental disorder in young children. The second most prevalent mental disorder in young children is autism spectrum disorder. Attention-deficit/hyperactivity disorder is particularly common in adolescent boys. Anxiety and depressive disorders at this age may be associated with bullying victimization Eating disorders are more common among females. 32 33  Geographical disparities Mental disorders are somewhat more common in high- income countries (15.1%) but they are also common in low-income countries (11.6%). The variations in prevalence rates across regions and income groups may be explained by at least three factors.  First, demographic factors lessen prevalence rates in low-income countries: populations here tend to have a higher proportion of children under ten years of age, for whom mental disorders are much less common.  Second, war and conflict contribute to the relatively higher rates of mental disorder in WHO’s Eastern Mediterranean Region.  Third, sociocultural factors have a role. For example, differing cultural understandings and conceptualizations of mental health and mental health conditions may influence people’s readiness to disclose mental health symptoms in surveys. 34  Mortality Both mental health conditions and suicide are rarely recorded as the cause of death on death certificates or in country mortality statistics. It is an important underlying or causative factor. people with mental health conditions are known to experience higher mortality rates compared with the general population (schizophrenia and bipolar disorder – die on average 10 to 20 years earlier) Suggested causes:  Side effects of medications (obesity, glucose intolerance and dyslipidemia(  exposed to the well-known risk factors for noncommunicable diseases (NCDs), including smoking, alcohol use, unhealthy diet and physical inactivity  once a person is channeled into a mental health service, their physical health too often gets neglected  the signs and symptoms of physical illness are often misattributed to a concurrent mental health condition in what is known as “diagnostic overshadowing”. 35 36 Gaps in public mental health 37 Gaps in public mental health 38  Mental health conditions are widespread, undertreated and under-resourced 39  Barriers to demand for care 1. Poor supply: high cost, poor quality and limited accessibility, Discrimination in insurance coverage for mental disorders. 2. Low levels of health literacy about mental health (patients, caregivers, general practitioner) 3. Stigma: All over the world, people living with mental health conditions are the subject of deep-rooted stigma and discrimination. People with mental health conditions are commonly assumed to be lazy, weak, unintelligent or difficult. They are also often believed to be violent and dangerous, when in fact they are more at risk of being attacked or harming themselves than harming other people 40  Etiology Inheritance-Genetics/ Intra-uterine Drug Abuse environment Schizophrenia, Alcohol, Heroin etc Huntington’s Upbringing Neurological Mothering, diseases education, parenting MS,Brain tumour Trauma/head injury Biochemistry/ metabolic Porphyria, Diabetes Infections- Vascular-CVA HIV,Syphilis,CJD Nutrition/ 41 PCM 42 43  Burn-out an "occupational phenomenon": International Classification of Diseases 28 MAY 2019 - Burn-out is included in the 11th Revision of the International Classification of Diseases (ICD-11) as an occupational phenomenon. It is not classified as a medical condition. 44 45  WHO Global Action Programme (mhGAP) The program is based on four strategies that should help enhance the mental health of populations. Advocacy, information, policy and research are the key words underlying WHO’s new global mental health programme, which aims at closing the gap between those who receive care and those who do not. 46