Transcript Mental Health - Dr. Carol O`Donnell

Mental Health
Aim: To discuss differences between
a medical and holistic approach to
mental health
What is Mental Health?
• Western perspective: The right to happiness,
which is progressively gained through the
application of science to life
• Eastern approach: Equanimity, which is
gained through the discipline of learning to
face pain and impermanence
dispassionately
Medical model diagnosis
• Pharmaceutical Benefits Scheme subsidises
pharmaceutical prescription
• Do drugs primarily dull the individual’s
perception and expression of unhappiness in
order to make them less disturbing to
others?
• Are symptoms part of a threatened identity?
Communicate or Label?
• The question ‘how do you feel and what
might we do about it’ is very different to the
query ‘What diagnosis do I give to these
symptoms of disturbance, and is there a
drug that can reduce them?’
• What does the patient prefer?
Mental illness in Australia
• 18% of population report symptoms of
mental disorder.
• 18% report a disability of which 12% are
intellectual, mental or psychiatric
• 3% of Australians live in households where
someone has a long-term mental disorder
not related to developmental delay
Most common mental disorders
• Anxiety disorders, affective disorders and
substance use disorders.
• About a quarter of people who report a
disorder say they have more than one
• 6% of population over 65 suffer from
dementia
• Men report feeling better than women
Mental disorders of children
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Attention deficit disorder
Oppositional disorder
Separation disorder
Conduct disorder (aggressive)
Overanxious disorder
Simple phobia, social phobia
Depression
Mental disorders of young people
• Car accidents, suicides, poisonings,
violence and cancer are the major causes of
death
• Six times as many male deaths as female
deaths (although more young women
admitted to hospital for suicide attempts)
Common problems of youth
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Sexual identity and expression
Interpersonal conflict or loss
Academic performance and expectations
Employment, accommodation & family
Family, peer or legal discipline or abuse
A recent move, or exposure to suicide
Alcohol and other drug abuse
Rational and experiential
knowledge
Knowing but not experiencing and
Experiencing but not knowing need to be
balanced
The desire to avoid risk may also promote
uncertainty and reduce the kind of
experiential learning which is the key to
personal resilience
NSW govt. priority populations
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Schizophrenic and related disorder
Bipolar disorder (manic depression)
Major depression
Panic disorder, social phobia and obsessive
compulsive disorder
• Postnatal depression
Anxiety and Depression
• We need to be accepted by significant
others
• We desperately seek to feel superior to the
majority, or we desperately seek to feel
normal
• Depression as learned helplessness
• Learning to be different
Mental illness, drugs and the law
• Using drugs can be seen as a social
problem, a sign of mental illness, or a cure
for mental illness
• In NSW 80% of prisoners jailed for
offences related to alcohol or other drug use
• 60% had a history of illicit drug use
• One third of males and half of females had
been assessed or treated for mental illness
NSW Prisoners
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60% not functionally literate or numerate
40% long term unemployed
60% did not complete year ten
16% sexually abused as children
64% have no stable family and many are
state wards
De-institutionalisation
• In 1996 around 16% of diagnosed mental illness
treated in hospitals
• UN Principles for the protection of persons with
mental illness says people have a right to live,
work, and receive treatment in the community
(1991)
• Need for effective implementation of standards
and comparative outcome monitoring
Hospitals
• Clinical indicators for psychiatric patients
defines an indicator as a measure of the
clinical management and outcome of care
• How do the outcomes of this diagnosis and
treatment process compare with nonmedical or psychiatric treatments and
outcomes?
Need for community based care
and mentoring
• National mental health plan and report
(2000) and NSW Government Disability
policy implementation should promote a
coordinated range of approaches to
improving mental health in regional
communities
• These should be managed in partnerships
which promote client autonomy
Mentoring
• Effectively organised systems for
community based mentoring should be
developed by tertiary education institutions
and the communities they serve
• This could assist the practical and
theoretical education of students, as well as
serve the community