Mental Health

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Mental health is a level of psychological well-being, or an absence of mental illness.[1] It is the "psychological state of someone who is functioning at a satisfactory level of emotional and behavioral adjustment".[2] From the perspective of positive psychology or holism, mental health may include an individual's ability to enjoy life, and create a balance between life activities and efforts to achieve psychological resilience.

According to the World Health Organization (WHO), mental health includes "subjective well-being, perceived self-efficacy, autonomy, competence, inter-generational dependence, and self-actualization of one's intellectual and emotional potential, among others."[3] The WHO further states that the well-being of an individual is encompassed in the realization of their abilities, coping with normal stresses of life, productive work and contribution to their community.[4] Cultural differences, subjective assessments, and competing professional theories all affect how "mental health" is defined.[3] A widely accepted definition of health by mental health specialists is psychoanalyst Sigmund Freud's definition: the capacity "to work and to love" - considered to be a simple and more accurate definition of mental health.

Mental Health and Mental Illness

According to the U.S. surgeon general (1999), mental health is the successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and providing the ability to adapt to change and cope with adversity. The term mental illness refers collectively to all diagnosable mental disorders—health conditions characterized by alterations in thinking, mood, or behavior associated with distress or impaired functioning.[5]

A person struggling with his or her mental health may experience stress, depression, anxiety, relationship problems, grief, addiction, ADHD or learning disabilities, mood disorders, or other mental illnesses of varying degrees.[6][7] Therapists, psychiatrists, psychologists, social workers, nurse practitioners or physicians can help manage mental illness with treatments such as therapy, counseling, or medication.

Mental illnesses are categorized as follows:

Text Box: Neurosis: Also known as psychoneuroses, neuroses are minor mental illnesses like phobias, obsessive-compulsive disorders, and anxiety disorders, among others.
Psychosis: Psychoses are major mental illnesses in which the mental state impairs thoughts, perception and judgement. Delusions and hallucinations are marked symptoms. This may require the use of psychotic drugs[8] as well as counselling techniques in order to treat them.

Views[edit]

Mental health is also used as a consumerist euphemism for mental illness, especially when used in conjunction with "concerns", "problems", or "clinic".[citation needed] Consequently, "mental health" is now being equated with mental illness without reference to the positive strengths associated with mental health.[citation needed] Similarly, the term "behavioral health" is being used, incorrectly, to refer to mental illness, as a consumerist approach to avoiding the stigma associated with the words "mental" and "illness". Consequently, some mental illness clinics are now identified by the inaccurate phrase behavioral wellness.[citation needed]

The new field of global mental health is "the area of study, research and practice that places a priority on improving mental health and achieving equity in mental health for all people worldwide."[9]

History[edit]

Text Box: See also: History of mental disorders

In the mid-19th century, William Sweetser[10] was the first to coin the term "mental hygiene" which can be seen as the precursor to contemporary approaches to work on promoting positive mental health.[11] Isaac Ray, one of the thirteen founders of the American Psychiatric Association, further defined mental hygiene as an art to preserve the mind against incidents and influences which would inhibit or destroy its energy, quality or development.

Dorothea Dix (1802–1887) was an important figure in the development of "mental hygiene" movement. Dix was a school teacher who endeavored throughout her life to help people with mental disorders, and to bring to light the deplorable conditions into which they were put.[12] This was known as the "mental hygiene movement".[12] Before this movement, it was not uncommon that people affected by mental illness in the 19th century would be considerably neglected, often left alone in deplorable conditions, barely even having sufficient clothing.[12] Dix's efforts were so great that there was a rise in the number of patients in mental health facilities, which sadly resulted in these patients receiving less attention and care, as these institutions were largely understaffed.[12]

Emil Kraepelin in 1896 developed the taxonomy mental disorders which has dominated the field for nearly 80 years. Later the proposed disease model of abnormality was subjected to analysis and considered normality to be relative to the physical, geographical and cultural aspects of the defining group.

At the beginning of the 20th century, Clifford Beers founded the Mental Health America - National Committee for Mental Hygiene after publication of his accounts from lived experience in lunatic asylums "A mind that found itself" in 1908[13] and opened the first outpatient mental health clinic in the United States.[14]

The mental hygiene movement, related to the social hygiene movement, had at times been associated with advocating eugenics and sterilisation of those considered too mentally deficient to be assisted into productive work and contented family life.[15][16] In the post-WWII years, references to mental hygiene were gradually replaced by the term 'mental health' due to its positive aspect that evolves from the treatment of illness to preventive and promotive areas of healthcare.[17]

Significance

Mental illnesses are more common than cancer, diabetes, or heart disease. Over 26 percent of all Americans over the age of 18 meet the criteria for having a mental illness. Serious mental disorders affect an estimated 6 percent of the adult population, or approximately 1 in 17 people. A little more than half receive treatment.[18] A WHO report estimates the global cost of mental illness at nearly $2.5 trillion (two-thirds in indirect costs) in 2010, with a projected increase to over $6 trillion by 2030.

Evidence from the World Health Organization suggests that nearly half of the world's population are affected by mental illness with an impact on their self-esteem, relationships and ability to function in everyday life.[19] An individual's emotional health can also impact physical health and poor mental health can lead to problems such as substance abuse.[20]

Maintaining good mental health is crucial to living a long and healthy life. Good mental health can enhance one's life, while poor mental health can prevent someone from living an enriching life. According to Richards, Campania, & Muse-Burke, "There is growing evidence that is showing emotional abilities are associated with prosocial behaviors such as stress management and physical health."[20] Their research also concluded that people who lack emotional expression are inclined to anti-social behaviors (e.g., drug and alcohol abuse, physical fights, vandalism), which are a direct reflection of their mental health and suppress emotions.[20]

Perspectives[edit]

Mental well-being[edit]

Mental health can be seen as an unstable continuum, where an individual's mental health may have many different possible values.[21] Mental wellness is generally viewed as a positive attribute, even if the person does not have any diagnosed mental health condition. This definition of mental health highlights emotional well-being, the capacity to live a full and creative life, and the flexibility to deal with life's inevitable challenges. Some discussions are formulated in terms of contentment or happiness.[22] Many therapeutic systems and self-help books offer methods and philosophies espousing strategies and techniques vaunted as effective for further improving the mental wellness. Positive psychology is increasingly prominent in mental health.

A holistic model of mental health generally includes concepts based upon anthropological, educational, psychological, religious and sociological perspectives, as well as theoretical perspectives from personality, social, clinical, health and developmental psychology.[23][24]

An example of a wellness model includes one developed by Myers, Sweeney and Witmer. It includes five life tasks—essence or spirituality, work and leisure, friendship, love and self-direction—and twelve sub tasks—sense of worth, sense of control, realistic beliefs, emotional awareness and coping, problem solving and creativity, sense of humor, nutrition, exercise, self care, stress management, gender identity, and cultural identity—which are identified as characteristics of healthy functioning and a major component of wellness. The components provide a means of responding to the circumstances of life in a manner that promotes healthy functioning.

The tripartite model of mental well-being[25][26] views mental well-being as encompassing three components of emotional well-being, social well-being, and psychological well-being. Emotional well-being is defined as having high levels of positive emotions, whereas social and psychological well-being are defined as the presence of psychological and social skills and abilities that contribute to optimal functioning in daily life. The model has received empirical support across cultures.[26][27][28] The Mental Health Continuum-Short Form (MHC-SF) is the most widely used scale to measure the tripartite model of mental well-being.[29][30][31]

Children and young adults[edit]

Mental health and stability is a very important factor in a person’s everyday life. Social skills, behavioural skills, and someone’s way of thinking are just some of the things that the human brain develops at an early age. Learning how to interact with others and how to focus on certain subjects are essential lessons to learn from the time we can talk all the way to when we are so old that we can barely walk. However, there are some people out there who have difficulty with these kind of skills and behaving like an average person. This is a most likely the cause of having a mental illness. A mental illness is a wide range of conditions that affect a person’s mood, thinking, and behavior. About 26% of people in the United States, ages 18 and older, have been diagnosed with some kind of mental disorder. However, not much is said about children with mental illnesses even though there are many that will develop one, even as early as age three.

The most common mental illnesses in children include, but are not limited to, ADHD, Autism and anxiety disorder, as well as depression in older children and teens. Having a mental illness at a younger age is much different from having one in your thirties. Children’s brains are still developing and will continue to develop until around the age of twenty-five.[32] When a mental illness is thrown into the mix, it becomes significantly harder for a child to acquire the necessary skills and habits that people use throughout the day. For example, behavioral skills don’t develop as fast as motor or sensory skills do.[32] So when a child has an anxiety disorder, they begin to lack proper social interaction and associate many ordinary things with intense fear.[33] This can be scary for the child because they don’t necessarily understand why they act and think the way that they do. Many researchers say that parents should keep an eye on their child if they have any reason to believe that something is slightly off.[32] If the children are evaluated earlier, they become more acquainted to their disorder and treating it becomes part of their daily routine.[32] This is opposed to adults who might not recover as quickly because it is more difficult for them to adapt.

Mental illness affects not only the person themselves, but the people around them. Friends and family also play an important role in the child’s mental health stability and treatment. If the child is young, parents are the ones who evaluate their child and decide whether or not they need some form of help.[34] Friends are a support system for the child and family as a whole. Living with a mental disorder is never easy, so it’s always important to have people around to make the days a little easier. However, there are negative factors that come with the social aspect of mental illness as well. Parents are sometimes held responsible for their child’s own illness.[34] People also say that the parents raised their children in a certain way or they acquired their behavior from them. Family and friends are sometimes so ashamed of the idea of being close to someone with a disorder that the child feels isolated and thinks that they have to hide their illness from others.[34] When in reality, hiding it from people prevents the child from getting the right amount of social interaction and treatment in order to thrive in today’s society.

Stigma is also a well-known factor in mental illness. Stigma is defined as “a mark of disgrace associated with a particular circumstance, quality, or person.” Stigma is used especially when it comes to the mentally disabled. People have this assumption that everyone with a mental problem, no matter how mild or severe, is automatically considered destructive or a criminal person. Thanks to the media, this idea has been planted in our brains from a young age.[35] Watching movies about teens with depression or children with Autism makes us think that all of the people that have a mental illness are like the ones on TV. In reality, the media displays an exaggerated version of most illnesses. Unfortunately, not many people know that, so they continue to belittle those with disorders. In a recent study, a majority of young people associate mental illness with extreme sadness or violence.[36] Now that children are becoming more and more open to technology and the media itself, future generations will then continue to pair mental illness with negative thoughts. The media should be explaining that many people with disorders like ADHD and anxiety, with the right treatment, can live ordinary lives and should not be punished for something they cannot help.

Prevention[edit]

Text Box: See also: Mental disorder § Prevention

Mental health can also be defined as an absence of a mental disorder. Focus is increasing on preventing mental disorders. Prevention is beginning to appear in mental health strategies, including the 2004 WHO report "Prevention of Mental Disorders", the 2008 EU "Pact for Mental Health" and the 2011 US National Prevention Strategy.[37][page needed] Prevention of a disorder at a young age may significantly decrease the chances that a child will suffer from a disorder later in life. Prevention may need to regularly consult physician for at least twice a year to detect any signs that reveal any mental health concerns.[38][unreliable medical source?]

Cultural and religious considerations[edit]

Mental health is a socially constructed and socially defined concept; that is, different societies, groups, cultures, institutions and professions have very different ways of conceptualizing its nature and causes, determining what is mentally healthy, and deciding what interventions, if any, are appropriate.[39] Thus, different professionals will have different cultural, class, political and religious backgrounds, which will impact the methodology applied during treatment.

Research has shown that there is stigma attached to mental illness.[40] In the United Kingdom, the Royal College of Psychiatrists organized the campaign Changing Minds (1998–2003) to help reduce stigma.[41] Due to this stigma, responses to a positive diagnosis may be a display of denialism.[42]

Many mental health professionals are beginning to, or already understand, the importance of competency in religious diversity and spirituality. The American Psychological Association explicitly states that religion must be respected. Education in spiritual and religious matters is also required by the American Psychiatric Association.[43]

Emotional improvement[edit]

Unemployment has been shown to have a negative impact on an individual's emotional well-being, self-esteem and more broadly their mental health. Increasing unemployment has been show to have a significant impact on mental health, predominantly depressive disorders. This is an important consideration when reviewing the triggers for mental health disorders in any population survey.[44] In order to improve your emotional mental health, the root of the issue has to be resolved. "Prevention emphasizes the avoidance of risk factors; promotion aims to enhance an individual's ability to achieve a positive sense of self-esteem, mastery, well-being, and social inclusion."[45] It is very important to improve your emotional mental health by surrounding yourself with positive relationships. We as humans, feed off companionships and interaction with other people. Another way to improve your emotional mental health is participating in activities that can allow you to relax and take time for yourself. Yoga is a great example of an activity that calms your entire body and nerves. According to a study on well-being by Richards, Campania and Muse-Burke, "mindfulness is considered to be a purposeful state, it may be that those who practice it believe in its importance and value being mindful, so that valuing of self-care activities may influence the intentional component of mindfulness."[20]

Care Navigation[edit]

Text Box: Main article: Mental Health Care Navigator

Mental health care navigation helps to guide patients and families through the fragmented, often confusing mental health industries. Care navigators work closely with patients and families through discussion and collaboration to provide information on best therapies as well as referrals to practitioners and facilities specializing in particular forms of emotional improvement. The difference between therapy and care navigation is that the care navigation process provides information and directs patients to therapy rather than providing therapy. Still, care navigators may offer diagnosis and treatment planning. Though many care navigators are also trained therapists and doctors. Care navigation is the link between the patient and the below therapies. A clear recognition that mental health requires medical intervention was demonstrated in a study by Kessler et al. of the prevalence and treatment of mental disorders from 1990 to 2003 in the U. S. A. Despite the prevalence of mental health disorders remaining unchanged during this period, the number of patients seeking treatment for mental disorders increased threefold.[46]

Emotional issues[edit]

Emotional mental disorders are a leading cause of disabilities worldwide. Investigating the degree and severity of untreated emotional mental disorders throughout the world is a top priority of the World Mental Health (WMH) survey initiative,[47] which was created in 1998 by the World Health Organization (WHO).[48] "Neuropsychiatric disorders are the leading causes of disability worldwide, accounting for 37% of all healthy life years lost through disease.These disorders are most destructive to low and middle-income countries due to their inability to provide their citizens with proper aid. Despite modern treatment and rehabilitation for emotional mental health disorders, "even economically advantaged societies have competing priorities and budgetary constraints".

The World Mental Health survey initiative has suggested a plan for countries to redesign their mental health care systems to best allocate resources. "A first step is documentation of services being used and the extent and nature of unmet needs for treatment. A second step could be to do a cross-national comparison of service use and unmet needs in countries with different mental health care systems. Such comparisons can help to uncover optimum financing, national policies, and delivery systems for mental health care."

Knowledge of how to provide effective emotional mental health care has become imperative worldwide. Unfortunately, most countries have insufficient data to guide decisions, absent or competing visions for resources, and near constant pressures to cut insurance and entitlements. WMH surveys were done in Africa (Nigeria, South Africa), the Americas (Colombia, Mexico, United States), Asia and the Pacific (Japan, New Zealand, Beijing and Shanghai in the People's Republic of China), Europe (Belgium, France, Germany, Italy, Netherlands, Spain, Ukraine), and the middle east (Israel, Lebanon). Countries were classified with World Bank criteria as low-income (Nigeria), lower middle-income (China, Colombia, South Africa, Ukraine), higher middle-income (Lebanon, Mexico), and high-income.

The coordinated surveys on emotional mental health disorders, their severity, and treatments were implemented in the aforementioned countries. These surveys assessed the frequency, types, and adequacy of mental health service use in 17 countries in which WMH surveys are complete. The WMH also examined unmet needs for treatment in strata defined by the seriousness of mental disorders. Their research showed that "the number of respondents using any 12-month mental health service was generally lower in developing than in developed countries, and the proportion receiving services tended to correspond to countries' percentages of gross domestic product spent on health care". "High levels of unmet need worldwide are not surprising, since WHO Project ATLAS' findings of much lower mental health expenditures than was suggested by the magnitude of burdens from mental illnesses. Generally, unmet needs in low-income and middle-income countries might be attributable to these nations spending reduced amounts (usually <1%) of already diminished health budgets on mental health care, and they rely heavily on out-of-pocket spending by citizens who are ill equipped for it".