What is mental health?
Health is important for development of the country. World health Organization (WHO ) defines health as “ a state of physical, mental, social and spiritual well-being and not merely the absence of disease or infirmity”. WHO defines mental health as mental well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community. In this positive sense, mental health is the foundation for individual well-being and the effective functioning of a community.
Mental health has impact on
- Educational out come
- Productivity at work
- Development of Positive personal relationships
- Crime rate
- Alcohol & drug abuse
Why is mental health important?
More than 450 million people suffer from mental disorders. According to WHO, by the year 2020, depression will constitute the second largest disease burden worldwide (Murray & Lopez, 1996). Global burden of mental health will be well beyond the treatment capacities of developed and developing countries. The social and economic costs associated with growing burden of mental ill health focused the possibilities for promoting mental health as well as preventing and treating mental illness. Thus the Mental Health is linked to behaviour and seen as fundamental to physical health and quality of life.
- Physical health and mental health are closely associated and it is proved beyond doubt that depression leads to heart and vascular diseases
- Mental disorders also affect persons health behaviour like eating sensibly, regular exercise, adequate sleep, engaging in safe sexual practices, alcohol and tobacco use, adhering to medical therapies thus increasing the risk of physical illness.
- Mental ill health also leads to social problems like unemployment, broken families, poverty, drug abuse and related crime.
- Poor mental health plays a significant role in diminished immune functioning.
- Medically ill patients with depression have worse outcome than those without.
- Chronic illnesses like diabetes, cancer, heart disease increases the risk of depression
What are the difficulties in implementation of mental health programmes?
- Stigma is associated with mental illness and patients are discriminated in the society in all aspects like education, employment, marriage etc, which leads to delay in seeking medical advice.
- Vagueness in concepts of mental health and illness, with lack of definitive signs and symptoms which result in diagnostic confusion.
- People feel that mental illnesses occur in those who are mentally weak or due to spirits
- Many people are in the opinion that mental illness is irreversible that lead to therapeutic nihilism.
- Many people believe that preventive measures are unlikely to succeed.
- Many people believe that drugs used to treat mental illness may cause many side effects and leads to addiction. They feel that these drugs merely induce sleeping.
- Data collected by WHO demonstrated that there is large gap between burden caused by mental health problems and the resources available in countries to prevent and treat them.
- In most parts of the world, the treatment of mental illness was alienated from rest of medicine and health care until recently.
- Psychiatric patients and their families fail to act like pressure groups as they are reluctant to come together because of severe social stigma and lack of knowledge about their rights.
- Even Non Governmental Organizations (NGOs) consider this as a difficult field as it needs long term commitment and they are scared to deal with mentally handicapped.
What causes mental illness?
- Neuro transmitters: Mental illnesses have been linked to an abnormal balance of special chemicals in the brain called neurotransmitters. Neurotransmitters help nerve cells in the brain communicate with each other. If these chemicals are out of balance or are not working properly, messages may not make it through the brain correctly, leading to symptoms of mental illness.
- Genetics (heredity): Many mental illnesses run in families, suggesting that people who have a family member with a mental illness are more likely to develop a mental illness. Susceptibility is passed on in families through genes. Experts believe many mental illnesses are linked to abnormalities in many genes - not just one. That is why a person inherits a susceptibility to a mental illness and doesn't necessarily develop the illness. Mental illness itself occurs from the interaction of multiple genes and other factors - such as stress, abuse, or a traumatic event -- which can influence, or trigger, an illness in a person who has an inherited susceptibility to it.
- Infections: Certain infections have been linked to brain damage and the development of mental illness or the worsening of its symptoms. For example, a condition known as paediatric autoimmune neuropsychiatric disorder (PANDA) associated with the Streptococcus bacteria has been linked to the development of obsessive-compulsive disorder and other mental illnesses in children
- Brain defects or injury: Defects in or injury to certain areas of the brain has also been linked to some mental illnesses
National mental health policies should not be solely concerned with mental disorders, but should also recognize and address the broader issues which promote mental health. This includes mainstreaming mental health promotion into policies and programmers in government and business sectors including education, labour, justice, transport, environment, housing, and welfare, as well as the health sector.
WHO response to Mental Health
WHO supports governments in the goal of strengthening and promoting mental health. WHO has evaluated evidence for promoting mental health and is working with governments to disseminate this information and to integrate the effective strategies into policies and plans. Early childhood interventions (e.g. home visits for pregnant women, pre-school psycho-social activities, combined nutritional and psycho-social help for disadvantaged populations)
- support to children (e.g. skills building programmes, child and youth development programmes)
- socio-economic empowerment of women (e.g. improving access to education and micro credit schemes)
- social support for elderly populations (e.g. befriending initiatives, community and day centres for the aged)
- programmes targeted at vulnerable groups, including minorities, indigenous people, migrants and people affected by conflicts and disasters (e.g. psycho-social interventions after disasters)
- mental health promotional activities in schools (e.g. programmes supporting ecological changes in schools and child-friendly schools)
- mental health interventions at work (e.g. stress prevention programmes)
- housing policies (e.g. housing improvement)
- Violence prevention programmes (e.g. community policing initiatives); and community development programmes (e.g. 'Communities That Care' initiatives, integrated rural development)
Source: Dr Sudha Rani, Assistant Professor of Psychiatry, Institute of Mental Health, Hyderabad
- National Institute for the Mentally Handicapped (NIMH)