Transcript الشريحة 1

Islamic University of Gaza
CMHN
social factors and mental illness
Prepared by :
Ahmed Fiad
Ahmed El khaldi
Supervised by: Dr.Ashraf El Jedi
Outline of presentation :
- Introduction . 
- Social characteristics that are fairly easily 
measured :
social class –gender – urban centers – 
unemployment – migration – season of
birth effect – other factors.
Conti.. (outline..)
- Characteristics that are harder to 
measure : stigma ,libeling and alienation
, social disintegration .
- Social network . 
- Effect of stress. 
- Life crises scale. 
Introduction :
- Do social factors actually cause mental 
illness, or do they exacerbate something
that is innate within the individual
concerned?
- There is a tenuous link between social 
factors and mental illness as many
variables intervene .
- It can be said, in positive and negative 
way ,can have an effect upon both the
prognosis and causation in psychiatric
conditions
Social characteristics that are 
fairly easily measured :
Social class :
- Studies have demonstrated the link 
between social class and schizophrenia in
lowest and the highest social groups
- Work cited in freeman (1984): 
“Would suggest that it is not simply being in 
the lowest social class by itself that causes
the condition of schizophrenia , but rather
that additional factors (as financial position
and stress) increase the exiting potential
vulnerability of the individual sufferer”.
Conti.. (social class):
- Freeman it was discovered that the 
incidence of schizophrenia was the
same in all social classes, it was the
prevalence that was making the
difference.
Gender :
- A finding that attention is the 
preponderance of females over males in
psychiatric hospital admissions,
sometimes 40% more than males
(depression).
- If depression is omitted then admission 
rates between sexes are not much
different .
Urban centers :
- A large number of studies have shown 
proportionately more chronically mentally
ill persons in the centers of cities as
opposed to outlying suburbs.
- Rural –urban differences in psychiatric 
disorders :
- The differences in mental health 
between rural and urban areas are
slight.
Conti.. (urban centers)
- A recent study in new Zealand comparing 
controlled groups of women in urban and
rural found no difference in psychiatric
morbidity .
- A study by Warner (1985:40) suggests: 
“that the social networks in rural areas may
be more supportive than those in urban
centers”
In rural areas there is greater dependence 
upon the weather, and geographical
isolation may incline towards loneliness and
depression .
Unemployment:
- Unemployment is now commonly cited as 
a reason for the apparent increase in
mental illness.
- An increase of 4.1 per cent in suicides and 
3.3 per cent in first admission to psychiatric
hospitals, as well as other adverse social
effects.
Conti.. (unemployment)
- During the first tow years of the effects 
there is an increase in suicide rates and
other violent deaths as a result of 'criminal
aggression'.
- As a result unemployment is therefore 
seen as a number one mental health
menace.
Migration:
- A number of studies reveal that some 
migrant groups have a higher rate of
schizophrenic breakdown than the host
population .
- There is differences in females have a 
higher rates of admission after arrival than
males and the reason are the time of
breakdown between sexes was males have
to accommodate with culture ,stress, etc
Season of birth effect
:
- A surprising finding emerging in recent 
years has been the season-of-birth effect in
schizophrenia .
- The birth of persons with schizophrenia in 
the winter and spring months of the year to
be more than the expected rate by 5-10 per
cent.
Other factors :
Overcrowding, 
high-rise building, 

and noise levels…. 
Characteristics that are
harder to measure:
Stigma ,labelling and alienation:
- Stigma and labelling have been popular 
concepts with sociologists.
- Stigma may cause isolation to the mentally 
ill and their families it is difficult to see how it
could be by itself a cause of the condition .
- Sociologists have argued between 
schizophrenia and term craziness.
Conti.. (stigma..)
Alienation from the dominant social group 
may be the cause of a number of
deviations, for example crime, suicide or
mental illness.
In western countries the mentally ill are 
even more alienated by denied useful social
roles.
Social disintegration :
- Disintegration was marked by poverty, 
cultural confusion, poor leadership, high
crime rates and fragmented communication
net works (Freeman 1984:51).
- Much higher than expected rates of 
psychiatric morbidity occurred in the areas
of social disintegration .
Social Network
- Social network are believed to promote
better health education , improve access
to health services and enforce or change
societal.
- Studies have shown that there is a
correlation between mental health and
lower levels of social network ,as
evidenced by levels of interpersonal trust
and norms at reciprocity.
Conti…
- Studies found demonstration relationships between mental illness and
social isolation ,poverty , life events and
psychological stress.
-
- There is some support for this as mental
disorder such as schizophrenia with to cope
with the usual demands of interpersonal
interaction decoding of social
communication
Conti..
- Speck and Rueveni report a “ network 
therapy “ intervention into the life of a
young female chronic schizophrenia who
lived unhappily at home and who also made
repeated suicidal threats.
- Speck and Rueveni developed form of 
intervention by having meetings in the
family home inviting all those who knew the
family to attend for a relatively formal
meeting followed by coffee and general
socializing.
Conti..
- Those who had lowest level of interpersonal stress and highest degrees of
social support fared better regardless of
patient quality of living arrangement .
- The use of community network has clearly
been much neglected.
Effect of Stress
- Stressful circumstances , making people 
feel worried ,anxious and unable to cope
,are damaging mental health
Conti..
- Social and psychological circumstances
cane cause long term stress , continuing
anxiety ,insecurity, low self-esteem ,social
isolation and lack of control overwork and
home life.
Have powerful effects on health .
- Long periods of anxiety and insecurity and
the lack of supportive friendships are
increase severity of stressful.
* Emotional atmosphere in the family
environment:
- A somewhat different approach has
developed from the observation the
some
- schizophrenics relapse more quickly than
others when discharged home .
- Some family environments may therefore be
more deleterious than others .
- Despite the buffering effects of neuroleptic
drug .
Conti..
- Family atmospheres in which responses to
sufferers are ones rejection or hostility ,
Or where there is emotional over involvement
are likely to be those that will impair the
sufferer mental health .
* Life Crises Scale:
- Researchers holmes and masuda have
concluded that clusters of certain life
events helps to make a person vulnerable to
illness. They found that the
events of ordinary life – such as marriage ,
vacation , a new job can help to trigger
because they require energy to cope with
them and therefore reduce a person
resistance to illness.
Conti..
Directions :
- Using yourself or a client as the subject ,
place a check mark on the line to the left to
each event that has occurred in the
subject life during the past year. If the event
has occurred more than , place a check
mark for each occurrence.
Conti..
1. Death of spouse.
2. Divorce.
3. Marital separation.
4.Jail
term
5. Death of close family
member
6. Personal injuries or
illness
CONTI..
7. Marriage.
.
8. Firing from work.
9 . Marital reconciliation .
10.
Retirement
11. Change in health of family
member
12. Pregnancy
Conti..
13. sexual difficulties .
14 . gain if new family member.
16. change in financial
state
17. death of close
friend
18. change in number of aguments with
spouse .
Conti..
19. mortgage over $ 10 000.
20 foreclosure of mortgage or
loan.
21. change in responsibilities at
work
22. son or daughter leaving
home
23. trouble with inlaws
24. outstanding personal achievement
Conti..
26. Beginning or ending
school
27. Change in living
conditions.
.28. Revision of personal
habits
30. Troubles with
boss
31. Change in work hours or
conditions
Conti..
32. change in
residence
33. change in
school
34 change in
recreation
35. change in church
activities
36. change in social
Conti..
39. Change in number of family gettogethers
40. Change in eating
habits
41.
Vacation
42.
Christmas
43. Minor violations of the law